Cardiology News / Recent Literature Review / Second Quarter 2014

Abstract

ESC Congress: Barcelona, 30/8-3/9/14

TCT: Washington, 12-17/9/14

HCS Annual Meeting: Athens, 23-25/10/2014

AHA: Chicago, 15-19/11/14

20^th Annual Boston AF Symposium: Orlando, 8-10/1/15

HCS Working Groups Seminar: Ioannina, 2/2015

ACC: San Diego, 14-16/3/15

HRS: Boston, 13-16/5/15

EuroPCR: Paris, 19-22/5/15

Europace: Milan, 21-24/6/15

ESC: London, 29/8-2/9/15

Short QT Syndrome is Highly Lethal

     A total of 62 out of 73 short QT syndrome (SQTS) patients (84% male; mean age, 26 ± 15 years; corrected QT interval, 329 ± 22 ms) were followed for 60 ± 41 months. Cardiac arrest (CA) was the most frequent presenting symptom (40% of probands). There was an age dependency in the susceptibility to arrhythmias, with a peak in the occurrence of CA in the first year of life (4%) and a second peak (1.3%) between 20 and 40 years of age; the probability of a first occurrence of CA by 40 years of age was 41%. Despite the male predominance, female patients had a similar risk profile. Familial disease was present in 44% of kindreds, but the yield of genetic screening was low (14%). A history of CA was the only predictor of recurrences at follow-up (p< 0.0000001). Arrhythmias occurred mainly at rest. The authors concluded that SQTS is highly lethal with CA often as the first manifestation of the disease with a peak incidence in the first year of life; survivors of CA have a high CA recurrence rate; implantation of a defibrillator is strongly recommended (Mazzanti A et al, J Am Coll Cardiol 2014;63:1300-1308).

Inferior Vena Cava (IVC) Filters in Patients With Acute Symptomatic Venous Thromboembolism (VTE) and a Significant Bleeding Risk Lower Pulmonary Embolism Mortality but Increase Risk of Recurrence

    In a prospective cohort study of patients with acute VTE identified from the RIETE (Computerized Registry of Patients With Venous Thromboembolism), the investigators assessed the association between IVC filter insertion due to significant bleeding risk and the 30-day outcomes [all-cause mortality, pulmonary embolism (PE)-related mortality, and VTE rates]. Of 40,142 patients who had acute symptomatic VTE, 371 received an IVC filter. A total of 344 patients treated with a filter were matched with 344 patients treated without a filter. There was a non-significant trend toward lower risk of all-cause death for filter insertion (6.6% vs 10.2%; p = 0.12). The risk adjusted PE-related mortality rate was lower for filter insertion than no insertion (1.7% vs 4.9%; p = 0.03). Risk-adjusted recurrent VTE rates were higher for filter insertion than for no insertion (6.1% vs 0.6%; p < 0.001). The authors concluded that in patients presenting with VTE and a significant bleeding risk, IVC filter insertion compared with anticoagulant therapy was associated with a lower risk of PE-related death and a higher risk of recurrent VTE (Muriel et al, J Am Coll Cardiol 2014;63:1675–1683). ... (excerpt)