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  • Limited data exist concerning the long term incidence

    2019-06-20

    Limited data exist concerning the long-term incidence and prognosis of Solithromycin manufacturer failure after myocardial infarction, particularly in the era of coronary revascularization. New-onset heart failure significantly increases the mortality risk among these patients [23]. Current ICD trials have shown that the time from shock to a heart failure event ranges from 160 to 204 days, depending on the number of appropriate or inappropriate shocks and the etiology of heart failure [24]. Patients with chronic CAD who are treated with ICDs have improved survival rates but an increased risk of heart failure [25]. Thus, heart failure patients with an ICD shock are at increased Solithromycin manufacturer risk of heart failure-related hospitalization and heart failure events [26,27]. In addition to triggering heart failure, ICD shocks are painful, and furthermore do not provide complete protection against sudden cardiac death [28]. Prophylactic and therapeutic VT ablation appear to prolong the time to recurrence of VT or a rapid rate of non-sustained VT in patients with stable VT, previous myocardial infarction, and reduced left ventricular ejection fraction (LVEF) [19,29]. In the Surgical Treatment for Ischemic Heart Failure (STICH) trial, patients with CAD and an EF≥35% were randomized to receive either a coronary artery bypass graft (CABG) or medical therapy. There was no interaction between ischemia and treatment for any clinical endpoint [30]. In CAD with severe LV dysfunction, inducible myocardial ischemia does not identify patients with worse prognosis, or those that could benefit from CABG over optimal medical therapy [30]. Thus, it is largely unknown whether revascularization therapy attenuates infrequent VT, or influences appropriate ICD shock in Japanese patients. The previous multinational study [31] showed variation across countries in readmission rates, mortality, and outcome after myocardial infarction. This may have resulted from differences in health-care policy, quality of health systems and clinical practice. These factors could account for differences in appropriate device therapy, and hospitalization and mortality rates in Japan, which have not yet been determined. Therefore, in this study, we will elucidate the current status of appropriate device therapy in CAD patients implanted with a cardiac device, and evaluate how appropriate therapy is influenced by catheter ablation and revascularization.
    Conflict of interest
    Introduction Pulmonary vein isolation (PVI) via catheter ablation has been shown to be a highly effective treatment option for patients with symptomatic paroxysmal atrial fibrillation (AF). The recurrence of AF within 3 months after PVI is common and is not considered to be the result of catheter ablation procedure failure, because the early recurrence of AF in this period is not always associated with late recurrence of AF. Therefore, this period is referred to as the “blanking period” [1,2]. However, the clinical significance of early recurrence is controversial because most studies determine AF recurrence on the basis of symptoms [3]. The incidence of symptomatic and asymptomatic AF recurrence within 3 months after PVI has not been well investigated.
    Material and methods
    Results
    Discussion
    Conclusion
    Conflict of interest
    Introduction The implantable cardioverter-defibrillator (ICD) can prevent sudden cardiac death; however, recent studies have reported that ICD shock therapy, whether appropriate or inappropriate, may reduce the life expectancy of ICD recipients [1–3]. Inappropriate and unnecessary shock delivery is attributable to each ICD device׳s algorithm for detecting ventricular tachyarrhythmia (VTA). One algorithm detects VTA when a certain number of beats in the detection zone reaches the pre-programmed number of intervals to detect (NID). Many studies have explored ways to avoid inappropriate and unnecessary ICD shocks for fast ventricular tachycardia (FVT). Some have reported that increasing NID and using antitachycardia pacing (ATP) effectively avoids inappropriate and unnecessary ICD shocks for FVT [4–10]. In the case of ventricular fibrillation (VF), increased NID may prolong the time to shock therapy and pose higher risks of hemodynamic deterioration and unstable VF waves, resulting in a higher number of undersensed VFs and higher defibrillation thresholds [11,12]. However, very few studies have evaluated the influence of prolonged time to shock therapy on the safety of ICD shock therapy. This SANKS study evaluated the effects of increased NID in the VF detection zone (VF NID) on the safety of ICD shock therapy and the number of inappropriate ICD shocks.