Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Oct 1995
Comparative StudyDigoxin or flecainide for prophylaxis of supraventricular tachycardia in infants?
This study compared the safety and efficacy of digoxin and flecainide in the prophylaxis of supraventricular tachycardia in infants. ⋯ Comparison with previous natural history studies suggests that digoxin is ineffective in the prophylaxis of supraventricular tachycardia. Oral flecainide was effective in a small number of infants, with no adverse effects (95% CI 0% to 12%), and may now be preferred as the primary prophylactic agent.
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J. Am. Coll. Cardiol. · Oct 1995
Comparative StudyIdentification of patent foramen ovale permitting paradoxic embolism.
We sought to analyze the morphologic and functional characteristics of the patent foramen ovale in patients with different clinical likelihoods for paradoxic embolism. ⋯ Right to left contrast shunting is more severe and opening of the patent foramen ovale is larger in patients with ischemic arterial events considered to be due to paradoxic embolism. In patients with a patent foramen ovale as the only potential cause for ischemic events and no signs of venous thrombosis, morphologic and functional variables assessed by transesophageal echocardiography may be helpful in estimating the likelihood of paradoxic embolism.
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J. Am. Coll. Cardiol. · Sep 1995
Randomized Controlled Trial Multicenter Study Clinical TrialContemporary reperfusion therapy for cardiogenic shock: the GUSTO-I trial experience. The GUSTO-I Investigators. Global Utilization of Streptokinase and Tissue Plasminogen Activator for Occluded Coronary Arteries.
This study sought to examine the incidence, temporal profile and clinical implications of shock in a large trial of thrombolytic therapy for acute myocardial infarction. ⋯ Because cardiogenic shock occurred most often after admission and with recurrent ischemia and reinfarction, recognizing signs of incipient shock may improve outcome. Fewer patients treated with rt-PA developed shock, yet those developing shock had the same high mortality rate as those presenting with shock, regardless of treatment. Only angioplasty was associated with a significantly lower mortality rate.
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J. Am. Coll. Cardiol. · Sep 1995
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialAsymptomatic Cardiac Ischemia Pilot (ACIP) study: outcome at 1 year for patients with asymptomatic cardiac ischemia randomized to medical therapy or revascularization. The ACIP Investigators.
This report discusses the outcome at 1 year in patients in the Asymptomatic Cardiac Ischemia Pilot (ACIP) study. ⋯ After 1 year, revascularization was superior to both angina-guided and ischemia-guided medical strategies in suppressing asymptomatic ischemia and was associated with better outcome. These findings require confirmation by a larger scale trial.