Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Nov 2010
Randomized Controlled Trial Comparative StudyRandomized, controlled trial of individualized heparin and protamine management in infants undergoing cardiac surgery with cardiopulmonary bypass.
We sought to determine whether infants (younger than 1 year old) had similar clinical benefits with individualized anticoagulation management as older children and adult undergoing cardiopulmonary bypass (CPB). ⋯ This study supports the use of the HMS device, with a modified protocol for infants younger than 1 year of age, for anticoagulation management during CPB. Clinical guidelines for the use of the HMS device should be modified for infants younger than 1 year of age.
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J. Am. Coll. Cardiol. · Nov 2010
Comparative StudyRoles of the left atrial roof and pulmonary veins in the anatomic substrate for persistent atrial fibrillation and ablation in a canine model.
the aim of this study was to establish the electrophysiological consequences of pulmonary vein encircling ablation (PVEA) and linear left atrial roof ablation (LARA) for the atrial fibrillation (AF) substrate in an experimental model. ⋯ both PVEA and LARA had beneficial but limited actions in this canine model. LARA suppressed AF perpetuation by interrupting LA roof reactivation, without affecting AF vulnerability. PVEA suppressed AF initiation by prolonging regional effective refractory period but failed to affect the AF-perpetuating substrate. These findings indicate the need to systematically study individual stepwise components to refine AF ablation procedures.
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J. Am. Coll. Cardiol. · Nov 2010
Comparative StudyAssessment of conventional cardiovascular risk factors and multiple biomarkers for the prediction of incident heart failure and atrial fibrillation.
the purpose of this study was to assess the predictive accuracy of conventional cardiovascular risk factors for incident heart failure and atrial fibrillation, and the added benefit of multiple biomarkers reflecting diverse pathophysiological pathways. ⋯ conventional cardiovascular risk factors predict incident heart failure and atrial fibrillation with reasonable accuracy in middle-age individuals free from disease. Natriuretic peptides, but not other biomarkers, improve discrimination modestly for both diseases above and beyond conventional risk factors and substantially improve risk classification for heart failure.