Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Jan 2018
Trends in Survival After In-Hospital Cardiac Arrest During Nights and Weekends.
Survival after in-hospital cardiac arrest (IHCA) is lower during nights and weekends (off-hours) compared with daytime during weekdays (on-hours). As overall IHCA survival has improved over time, it remains unknown whether survival differences between on-hours and off-hours have changed. ⋯ Despite an overall improvement in survival, lower survival in IHCA during off-hours compared with on-hours persists.
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J. Am. Coll. Cardiol. · Jan 2018
Potential U.S. Population Impact of the 2017 ACC/AHA High Blood Pressure Guideline.
The 2017 American College of Cardiology/American Heart Association (ACC/AHA) Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults provides recommendations for the definition of hypertension, systolic and diastolic blood pressure (BP) thresholds for initiation of antihypertensive medication, and BP target goals. ⋯ Compared with the JNC7 guideline, the 2017 ACC/AHA guideline results in a substantial increase in the prevalence of hypertension, a small increase in the percentage of U.S. adults recommended for antihypertensive medication, and more intensive BP lowering for many adults taking antihypertensive medication.
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J. Am. Coll. Cardiol. · Jan 2018
Implantable Cardioverter-Defibrillators in Children and Adolescents With Brugada Syndrome.
Young patients presenting with symptomatic Brugada syndrome have very high risks for ventricular arrhythmias and should be carefully considered for implantable cardioverter-defibrillator (ICD) placement. However, this therapy is associated with high rates of inappropriate shocks and device-related complications. ⋯ ICD therapy is an effective strategy in young patients with symptomatic Brugada syndrome, treating potentially lethal arrhythmias in >25% of patients during follow-up. Appropriate shocks were significantly associated with previously aborted sudden cardiac death and spontaneous type I electrocardiograms. However, ICDs are frequently associated with complications and inappropriate shocks, both of which remain high regardless of careful device implantation and programming.