Abstract:
PURPOSE OF REVIEW:Many patients requiring cardiac arrhythmia device surgery are on chronic oral anticoagulation therapy. The periprocedural management of their anticoagulation presents a dilemma to physicians, particularly in the subset of patients with moderate-to-high risk of arterial thromboembolic events. Physicians have responded by treating patients with bridging anticoagulation while oral anticoagulation is temporarily discontinued. However, there are a number of downsides to bridging anticoagulation around device surgery; there is a substantial risk of significant device pocket hematoma with important clinical sequelae; bridging anticoagulation may lead to more arterial thromboembolic events and bridging anticoagulation is expensive. RECENT FINDINGS:In response to these issues, a number of centers have explored the option of performing device surgery without cessation of oral anticoagulation. The observational data suggest a greatly reduced hematoma rate with this strategy. Despite these encouraging results, most physicians are reluctant to move to operating on continued Coumadin in the absence of confirmatory data from a randomized trial. SUMMARY:We have designed a prospective, single-blind, randomized, controlled trial to address this clinical question. In the conventional arm, patients will be bridged. In the experimental arm, patients will continue on oral anticoagulation and the primary outcome is clinically significant hematoma. Our study has clinical relevance to at least 70 000 patients per year in North America.
journal_name
Curr Opin Cardioljournal_title
Current opinion in cardiologyauthors
Birnie D,Healey JS,Krahn A,Essebag V,Sivakumaran S,Tang A,Simpson Cdoi
10.1097/hco.0b013e32831bef53subject
Has Abstractpub_date
2009-01-01 00:00:00pages
82-7issue
1eissn
0268-4705issn
1531-7080journal_volume
24pub_type
杂志文章,评审abstract:PURPOSE OF REVIEW:Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in patients with mild-to-severe heart failure. However, up to 40% of CRT recipients are nonresponders. This review addresses important aspects with regard to the identification and management of CRT nonresponders. RECENT FINDINGS...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,meta分析,评审
doi:10.1097/HCO.0000000000000140
更新日期:2015-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Rheumatic heart disease (RHD) affects over 30 million people worldwide. Substantial variation exists in the surgical treatment of patients with RHD. Here, we aim to review the surgical techniques to treat RHD with a focus on rheumatic mitral valve (MV) repair. We introduce novel educational paradigms ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章
doi:10.1097/HCO.0000000000000826
更新日期:2020-12-24 00:00:00
abstract::The explosion of high-resolution imaging technology in recent years has led to the increasing problem of choosing imaging modalities appropriate to specific clinical questions. In terms of structural information, for example, the relative benefits of ultrasound versus magnetic resonance imaging versus computed tomogr...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199212000-00015
更新日期:1992-12-01 00:00:00
abstract::Despite recent advances in operative and percutaneous surgical techniques for valvular heart disease, medical management of complications of valvular disease, such as atrial fibrillation and infection, and prevention of thromboembolism remain important clinical problems. This review discusses recent data that address...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199104000-00005
更新日期:1991-04-01 00:00:00
abstract:PURPOSE OF REVIEW:Myocardial fibrosis is a common feature of many cardiomyopathies, including hypertrophic cardiomyopathy. Myocardial fibrosis has been shown to be reversible and treatable with timely intervention. Although early detection and assessment of fibrosis is crucial, adequate diagnostics are still in develop...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e32835f5a2b
更新日期:2013-05-01 00:00:00
abstract:PURPOSE OF REVIEW:The presence of tricuspid regurgitation in the setting of right ventricular dysfunction is associated with poor prognosis. The purpose of this review is to describe the pathophysiology of functional tricuspid regurgitation, summarize the current reports favoring a more aggressive approach toward tricu...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e3283512051
更新日期:2012-05-01 00:00:00
abstract::Although it has been the topic of intense medical and surgical attention for over 20 years, the coexistence of severe carotid artery disease in patients undergoing coronary artery bypass graft continues to be a major cause of perioperative morbidity and mortality. Refinements in diagnostic modalities, mainly by duplex...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199609000-00012
更新日期:1996-09-01 00:00:00
abstract::The publications of 2000 and 2001 stress how interventional pediatric cardiology has moved from angioplasty to device placement. This review summarizes the important articles during the past year that evaluated the safety and efficacy of atrial septal defect devices, patent ductus occluders, and stents to treat coarct...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200205000-00013
更新日期:2002-05-01 00:00:00
abstract:PURPOSE OF REVIEW:While the prognostic power of adenosine single photon emission computed tomography myocardial perfusion imaging has been validated in multiple patient populations including those with known or suspected coronary artery disease, the utility of this modality in assessing risk after an acute myocardial i...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e32820652c9
更新日期:2007-09-01 00:00:00
abstract:PURPOSE OF REVIEW:To date 16 genes have been associated with arrhythmogenic cardiomyopathy (ACM). Mutations in these genes can lead to a broad spectrum of phenotypic expression ranging from disease affecting predominantly the right or left ventricle, to biventricular subtypes. Understanding the genetic causes of ACM is...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000509
更新日期:2018-05-01 00:00:00
abstract:PURPOSE OF REVIEW:The health benefits of physical activity and exercise are clear; virtually everyone can benefit from becoming more physically active. Most international guidelines recommend a goal of 150 min/week of moderate-to-vigorous intensity physical activity. Many agencies have translated these recommendations ...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000437
更新日期:2017-09-01 00:00:00
abstract:PURPOSE OF REVIEW:In this study, we review the evidence for both long-standing and newer oral antiplatelet agents as secondary prevention in coronary artery disease, and give our opinion on where each agent's treatment role lies. RECENT FINDINGS:Platelets play a pathological role in acute coronary syndromes and are th...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e328338f7b5
更新日期:2010-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Hypertension and dyslipidemia frequently coexist, and endothelial dysfunction is associated with the pathophysiology of both atherosclerosis and hypertension. Evidence is convincing for an overlapping role of oxidative stress, renin-angiotensin system activation, and dyslipidemia in the genesis of end...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/01.hco.0000231401.87232.71
更新日期:2006-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Despite its continued increase in prevalence in minorities, data regarding hypertension (HTN) control among such ethnic groups remains limited. This review highlights the most recent literature on the epidemiology, prevalence, and treatment strategies of HTN among four racial groups (non-Hispanic Whit...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000293
更新日期:2016-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Cardiovascular implantable electronic devices are widely used to treat symptomatic arrhythmias, prevent sudden cardiac death, and improve symptoms and cardiac function. Continued population growth and expanding indications have resulted in a progressive increase in the number of cardiovascular implant...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000247
更新日期:2016-01-01 00:00:00
abstract:PURPOSE OF REVIEW:The number of clinically available genetic tests for heritable cardiovascular diseases has recently increased because of novel gene discoveries and advancements in DNA sequencing technologies. The purpose of this review is to provide up-to-date genetic testing information and guidance on how to incorp...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e32835fb728
更新日期:2013-05-01 00:00:00
abstract::Though tachyarrhythmias occur commonly in patients with the Wolff-Parkinson-White syndrome, many patients remain asymptomatic. Recent studies suggest that routine electrophysiologic testing in these individuals is of limited value. However, electrophysiologic testing remains very helpful in the symptomatic patient fo...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:
更新日期:1991-02-01 00:00:00
abstract::Hypertrophic cardiomyopathy has been shown to be a genetically heterogeneous disorder, linked to at least four different loci on chromosomes 14, 1, 15, and 11. Thus far, three genes have been identified that harbor mutations leading to hypertrophic cardiomyopathy. These genes--cardiac beta myosin heavy chain, alpha tr...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199505000-00010
更新日期:1995-05-01 00:00:00
abstract::The authors analyzed the early outcomes in two groups of patients undergoing coronary artery bypass grafting (CABG) with single versus bilateral internal thoracic arteries (ITA) in their institution. One thousand sixty-nine patients underwent CABG with single or bilateral ITAs from 1990 to 2000. Of these patients, 911...
journal_title:Current opinion in cardiology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1097/00001573-200211000-00003
更新日期:2002-11-01 00:00:00
abstract:PURPOSE OF REVIEW:Implantation of circulatory assist devices as a permanent alternative to heart transplantation, so-called Destination Therapy, has become a promising new option for treatment of patients with advanced heart failure who are not candidates for heart transplantation. RECENT FINDINGS:The landmark REMATCH...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/01.hco.0000153949.42189.03
更新日期:2005-03-01 00:00:00
abstract:PURPOSE OF REVIEW:In this review, we firstly highlight the role of dyslipidemia as a trigger in the initiation and progression of endothelial dysfunction, considered the earliest atherosclerotic lesion and patent in children with risk factors.In this context, we also revise methods that reflect the impact of endothelia...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000249
更新日期:2016-01-01 00:00:00
abstract:PURPOSE OF REVIEW:Dyslipidaemias are noted in all stages of chronic kidney disease (CKD). Currently most evidence for their treatment comes from secondary retrospective analyses of patient subgroups with CKD recruited into clinical trials powered of hypertensive and dyslipideamic cohorts powered for cardiovascular endp...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0b013e328353b988
更新日期:2012-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Advanced heart failure is a chronic, systemic disease, which affects other organs in ways that are incompletely understood. Patients with advanced heart failure commonly develop congestive hepatopathy, which may lead to progressive hepatic injury and fibrosis. Because the independent adverse effects o...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/HCO.0000000000000288
更新日期:2016-05-01 00:00:00
abstract::The ECG is the most widely used noninvasive diagnostic and prognostic test administered to patients with suspected or proven coronary artery disease. When considering appropriate use of the electrocardiogram, physicians need to examine the clinical question being asked, the additional information that can be derived,...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199208000-00008
更新日期:1992-08-01 00:00:00
abstract::Indications for cardiac catheterization--including coronary angiography--have substantially broadened with the advent of nonsurgical therapeutic interventions performed in the catheterization laboratory. Consequently, the increasing number of facilities performing these procedures require clear and unmistakable guidel...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-199307000-00004
更新日期:1993-07-01 00:00:00
abstract:PURPOSE OF REVIEW:Cardiac magnetic resonance imaging has an expanding role as a preferred modality for the detection and characterization of myocardial viability. RECENT FINDINGS:Improving the accuracy of cardiac magnetic resonance for detecting viable myocardium has been one focus of investigators. In segments with i...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/01.hco.0000240584.68720.ae
更新日期:2006-09-01 00:00:00
abstract:PURPOSE OF REVIEW:This article is an update on DiGeorge syndrome research focusing on the synergy of human and model systems genetics toward the understanding of conotruncal and aortic arch defects. RECENT FINDINGS:The identification of mutations of the human T-Box1 (TBX1) gene and progress on research of Tbx1 functio...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200405000-00002
更新日期:2004-05-01 00:00:00
abstract:PURPOSE OF REVIEW:To provide an update on the management of patients with diabetes mellitus and requiring coronary revascularization. RECENT FINDINGS:Evidence continues to show that patients with diabetes mellitus and ischemic heart disease represent a very high-risk group of patients. Choice of stent appears importan...
journal_title:Current opinion in cardiology
pub_type: 杂志文章
doi:10.1097/HCO.0000000000000421
更新日期:2017-09-01 00:00:00
abstract::Optimized medical treatment for the non-ST segment elevation acute coronary syndromes (NSTE ACS) should consist of a combined antithrombotic/anti-anginal regimen. Standard antithrombotic treatment is currently unfractionated heparin and aspirin, and in high-risk patients glycoprotein IIb/IIIa inhibitors. However, low-...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:10.1097/00001573-200111000-00012
更新日期:2001-11-01 00:00:00
abstract::Interest in transmyocardial laser revascularization for the treatment of otherwise inoperable coronary artery disease has increased rather dramatically in recent years. The results of several industrially sponsored clinical series have been reported recently, all with significant improvement in angina pectoris that ap...
journal_title:Current opinion in cardiology
pub_type: 杂志文章,评审
doi:
更新日期:1997-09-01 00:00:00