Keeping you up to date on recent headlines in cardiovascular healthcare:

AF 'Think Tank' to meet .... The Heart Rhythm Society (Washington) has partnered with the Cardiac Safety Research Consortium (Durham, North Carolina), the Duke Clinical Research Institute, (also Durham) the FDA, the American College of Cardiology (Washington), the National Institutes of Health and the Advanced Medical Technology Association (Washington) to organize an Atrial Fibrillation Think Tank on April 27-28. The 1-1/2 day program will discuss specific areas related to AF ablation, cardiac safety and a national registry of procedures and outcomes from the academic/clinical, regulatory, industry and reimbursement perspectives. The program will be held at the FDA's White Oak Facility (Silver Spring, Maryland.) (www.hrsonline.org/Policy/DevicesDrugsFDA/af_think_tank.cfm)

'Red flag for cardiovascular disease: daytime sleepiness' .... Clinicians should be alert to patients reporting "excessive" day time sleepiness (EDS), says the European Society of Cardiology, after a French study found healthy elderly people who regularly report feeling sleepy during the day have a significantly higher risk of dying from cardiovascular disease. The Three City study, published in Stroke, by the American Heart Association (Dallas) found that elderly people who reported excessive day time sleepiness have a 49% relative risk increase of cardiovascular death (from cerebrovascular disease, myocardial infarction and heart failure), compared to those who do not report sleepiness. (www.escardio.org/about/press/Pages/welcome.aspx)

Noninvasive optical device for acute stroke monitoring developed .... Researchers at the University of Pennsylvania (Philadelphia) say they have completed the first successful demonstration of a noninvasive optical device to monitor cerebral blood flow in patients with acute stroke. The ultimate goal of this research is to improve the management of patients with stroke and other brain disorders by providing continuous bedside monitoring of brain blood flow and metabolism. (www.upenn.edu/pennnews/)

Framingham project to develop heart disease blood tests .... The landmark Framingham Heart Study is launching a major initiative to discover risk factors and markers that could lead to new blood tests to identify individuals at high risk of heart disease and stroke. Called the Systems Approach to Biomarker Research in Cardiovascular Disease (SABRe CVD), the initiative will identify and validate new biomarkers such as proteins or molecules in the blood for heart disease. Researchers will study about 1,000 blood biomarkers. (www.nih.gov/news/health/mar2009/nhlbi-12.htm)

Study links AF, increased risk of death in diabetic patients .... Results from a large, international, randomized, controlled trial show a strong link between diabetics who have atrial fibrillation (AF) and an increased risk of other heart-related problems and death. The findings are published in the European Heart Journal, published yesterday. The ADVANCE study of 11,140 patients with Type 2 diabetes found that patients who had AF at the start of the trial had a 61% increased risk of dying from any cause, a 77% increased risk of dying from cardiovascular causes such as a heart attack or stroke, and a 68% increased risk of developing heart failure or other cerebrovascular problems such as stroke, compared to diabetic patients without AF.

(Paper available: www.oxfordjournals.org/our_journals/eurheartj/press_releases/freepdf/ehp055.pdf)

'Seeing' stem cells helps in fight vs. PAD .... A study presented at the 34th annual meeting of the Society of Interventional Radiology describes the use of simple imaging to view transplanted stem cells and to confirm that they remain alive in the body once injected. Frank Wacker, MD, an interventional radiologist at Johns Hopkins School of Medicine (Baltimore, Maryland), said, "One day, stem cells may enable the targeted delivery of cellular treatments to PAD patients who may be facing amputation and death. The use of C-arm CT for image-guided delivery in the angio lab enabled us to precisely target cell delivery in relationship to blood vessels without transferring to a separate CT scanner to obtain the similar information. (Abstract at: www.SIRmeeting.org.)

Nation's first Convergent Ex-Maze procedure performed .... FirstHealth Moore Regional Hospital (Pinehurst, North Carolina) reported that one of its heart surgeons and a cardiologist specializing in electrophysiology have performed the nation's first-ever Convergent Ex-Maze procedure to correct atrial fibrillation (AF). Surgeon Andy Kiser, MD, who led the development of the Ex-Maze procedure for AF, and electrophysiologist Mark Landers, MD, partnered to perform the groundbreaking procedure in late January. Kiser said the case was significant because showing that AF can be treated "without chest incisions and by working with the electrophysiologist during the procedure, we can do a complete atrial fibrillation treatment." (www.firsthealth.org/)

Dangerous cardiomyopathy identified with new test .... A study led by investigators at Beth Israel Deaconess Medical Center (Boston) published in the March 12 issue of The New England Journal of Medicine has demonstrated that a new immunohistochemical test is reliable in diagnosing a dangerous arrhythmogenic right ventricular cardiomyopathy (ARVC). The researchers determined that a reduced plakoglobin signal could serve as a biomarker for ARVC early in the course of the disease, and using this, they made the correct diagnosis in 10 of 11 subjects with definite ARVC and correctly ruled out ARVC in 10 of 11 subjects who did not have the condition. (www.bidmc.org.)

Heart ultrasound allows treating complex conditions without open surgery .... Physicians will be able to utilize less invasive techniques to treat structural heart disease with the help of cardiovascular ultrasound technology, according to a new guideline in a March issue of the Journal of the American Society of Echocardiography. The document, "Echocardiography-Guided Interventions," outlines each type of echocardiography study as it relates to specific procedures, and makes recommendations to help guide the selection of the "right" type of echocardiogram. It discusses all modalities of echocardiography, but emphasizes intracardiac echocardiography (ICE), a newer type of echo that places the imaging probe within the heart during these procedures.

(www.asecho.org/i4a/pages/index.cfm?pageid=1)

Heart attack trends concerning prevention, mortality rates, hospitalization .... A report in Circulation from the Framingham Heart Study, which compared acute myocardial infarction (AMI) incidence in 9,824 men and women over four decades, has proposed an explanation for the apparent paradox of improved prevention, falling mortality rates but stable rates of hospitalization. The study finds that over the past 40 years rates of AMI diagnosed by ECG decreased by 50%, whereas rates of AMI diagnosed exclusively by infarction biomarkers doubled. This "evolving" diagnosis of AMI, say the investigators, "offers an explanation for the apparently steady national AMI rates in the face of improvements in primary prevention" That hospitalized AMI has not similarly declined is explained by the greater sensitivity of diagnostic AMI biomarkers. (http://circ.ahajournals.org/)

Technique uses IRE for eliminating reblockage of arteries .... A new technique for avoiding the reblockage of arteries that have been cleared through angioplasty and stent insertion, described as "easily implementable," has been developed by researchers led by Professor Boris Rubinsky of Hebrew University of Jerusalem. The technique employs the phenomenon of irreversible electroporation (IRE), which destroys cells within seconds using very short electric field pulses. It causes no damage to structures other than the cells themselves. Compared with other technologies for local destruction of cells and tissue, IRE is simple and does not require special training, the researchers said. (www.hunews.huji.ac.il/)

Compiled by Don Long, MDD National Editor

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