Cardiology News / Recent Literature Review / First Quarter 2015
HRS Meeting: Boston, 13-16/5/2015
EuroPCR: Paris, 19-22/5/2015
Europace: Milan, 21-24/6/2015
ESC: London, 29/8-2/9/2015
TCT 2015: San Francisco, 11-15/10/2015
HCS: Thessaloniki, 29-31/10/2015
AHA: Orlando, 7-11/11/2015
Low-Level Transcutaneous Electrical Vagus Nerve Stimulation (LLTS) Suppresses Atrial Fibrillation
Patients with paroxysmal AF were randomized to 1 h of 20 Hz LLTS (n= 20) or sham control (n= 20) by attaching a flat metal clip onto the tragus in the right ear. AF was induced by burst atrial pacing at baseline and after 1 h of LLTS or sham treatment. Blood samples from the coronary sinus and the femoral vein were collected at those time points and analyzed for inflammatory cytokines, including tumor necrosis factor alpha and C-reactive protein. Pacing-induced AF duration decreased significantly by 6.3 ± 1.9 min compared with baseline in the LLTS but not in the control group (p=0.002). AF cycle length increased significantly from baseline by 28.8 ± 6.5 ms in the LLTS but not in control group (p= 0.0002). Femoral vein but not coronary sinus tumor necrosis factor (TNF)-alpha and C-reactive protein levels decreased significantly only in the LLTS group. The authors concluded that LLTS suppresses AF and decreases inflammatory cytokines in patients with paroxysmal AF, supporting a role of neuromodulation to treat AF (Stavrakis S et al, J Am Coll Cardiol 2015;65:867-875).
Among Patients with Early Repolarization Syndrome, Programmed Stimulation Does not Predict Future Arrhythmic Events
In a multicenter study, 81 patients, aged 36+13 years, with early repolarization (ER) syndrome and aborted sudden death due to ventricular fibrillation (VF) underwent an electrophysiology study (EPS). VF was inducible in only 18 of 81 (22%) patients. During follow-up of 7.0 ± 4.9 years, 6 of 18 (33%) patients with inducible VF, and 21 of 63 (33%) noninducible patients experienced VF recurrences (p= NS). VF storm occurred in 3 inducible and 4 noninducible patients. VF inducibility was not associated with maximum J-wave amplitude or J-wave distribution (inferior, odds ratio -OR: 0.96; lateral, OR: 1.57; inferior and lateral, OR: 0.83; all p = NS), which have previously been shown to predict outcome in patients with an ER pattern. The authors concluded that EPS did not enhance risk stratification in ER syndrome (Mahida S et al, J Am Coll Cardiol 2015;65:151-159)... (excerpt)
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