The American journal of cardiology
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Randomized Controlled Trial Clinical Trial
Clinical predictors of implantable cardioverter-defibrillator shocks (results of the CASCADE trial). Cardiac Arrest in Seattle, Conventional versus Amiodarone Drug Evaluation.
The Cardiac Arrest in Seattle, Conventional Versus Amiodarone Drug Evaluation (CASCADE) study evaluated antiarrhythmic drug therapy in high-risk survivors of out-of-hospital ventricular fibrillation. Antiarrhythmic drug therapy for 228 patients was randomized to amiodarone or conventional antiarrhythmic drugs. Additional therapy with an implantable cardioverter-defibrillator was provided to 105 of these patients. ⋯ The independent clinical predictors of shocks were low ejection fraction (p = 0.002), female gender (p = 0.007) and conventional antiarrhythmic drug therapy (p = 0.015). The only independent predictor of a shock associated with syncope was conventional antiarrhythmic drug therapy (p = 0.035). Patients treated with amiodarone receive fewer shocks than patients treated with conventional drug therapy.
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Multicenter Study Clinical Trial
Atrial septal defect occlusion with the buttoned device (a multi-institutional U.S. trial).
A clinical trial was conducted of the buttoned device for transcatheter closure of ostium secundum atrial septal defect. Occlusion was attempted in 57 patients aged 1 to 62 years (median 5). The procedure was abandoned in 7 patients after 1 or more unsuccessful attempts, and devices were released in 50 patients. ⋯ An episode of asymptomatic atrial flutter was noted in a 46-year-old patient which may have been related to device implantation, but which has not recurred. There have been no cases of endocarditis or thromboembolism in 350 patient-months of follow-up. The buttoned device provided effective closure of the atrial septal defect in 45 of 57 patients (79%) in whom implantation was attempted and in 45 of 46 patients (98%) in whom device implantation was successfully accomplished.(ABSTRACT TRUNCATED AT 250 WORDS)