As dabigatran becomes more widely used in AF patients, electrophysiologists are trying to figure out how to handle anticoagulation in patients taking the drug and for whom AF ablation is planned. In a new study published in the Journal of the American College of Cardiology, Dhanunjaya Lakkireddy and colleagues report on a multicenter, observational study of 290 patients…

This content is exclusive to CardioExchange. To continue reading, please log in or request an invitation.

A 22-year-old white man presented to the ER with acute non-ST-segment-elevation MI, after playing basketball. He had experienced chest pain on and off for more than 10 hours before presentation. His initial EKG showed T-wave inversions in leads III and avF (see image), and his troponin T level was 1.2 ng/mL. The patient’s initial pain…

This content is exclusive to CardioExchange. To continue reading, please log in or request an invitation.

A NEJM editorial fellow interviews a NEJM editorialist about subclinical AF and the risk of stroke.

Long distance runners may be lonely but they are not at high risk for sudden cardiac arrest, according to a study published in the New England Journal of Medicine. The RACER (Race Associated Cardiac Arrest Event Registry) investigators analyzed data from 10.9 million registered participants in marathons and half-marathons that took place in the U.S. during the first decade of this…

This content is exclusive to CardioExchange. To continue reading, please log in or request an invitation.

A new study published in the New England Journal of Medicine sheds some much-needed light on the precise role of subclinical atrial fibrillation (AF) in the prognosis and development of ischemic stroke. ASSERT (Asymptomatic Atrial Fibrillation and Stroke Evaluation in Pacemaker Patients and the Atrial Fibrillation Reduction Atrial Pacing Trial) followed 2580 patients with a newly implanted pacemaker or ICD…

This content is exclusive to CardioExchange. To continue reading, please log in or request an invitation.

Current guidelines for the treatment of acute MI recommend that serum potassium be maintained between 4.0 and 5.0 mEq/L, and some believe that the upper limit could be raised to 5.5, but evidence is based on small, outdated studies. Now a study published in JAMA suggests that the ideal potassium range should be adjusted downward. Abhinav Goyal…

This content is exclusive to CardioExchange. To continue reading, please log in or request an invitation.

A new meta-analysis finds that dabigatran is associated with a higher risk of myocardial infarction and acute coronary syndromes. An editorial raises questions about the enthusiasm to embrace new drugs.

A 21-year-old Division I college football player presented with palpitations that had started during athletic practice. He was referred to a cardiologist for further evaluation. Vital signs and physical exam were normal. An EKG showed prominent R waves, inverted T waves in leads V1–V2, along with a biphasic T wave in lead V3. QRS axis and…

This content is exclusive to CardioExchange. To continue reading, please log in or request an invitation.

In an updated safety communication, the FDA announced on Monday that it is adding new warnings  to the dronedarone (Multaq, Sanofi) label. On the basis of results from the PALLAS trial, which was discontinued early due to safety concerns, the drug label will now warn: Healthcare professionals should not prescribe Multaq to patients with AF who…

This content is exclusive to CardioExchange. To continue reading, please log in or request an invitation.

The FDA announced today that it is initiating a safety review of dabigatran (Pradaxa, Boehringer Ingelheim). The review was prompted by reports of serious bleeding events in people taking the drug. Bleeding complications, the FDA acknowledges, are a “a well-recognized complication of all anticoagulant therapies.” The agency says it is “working to determine whether the reports of…

This content is exclusive to CardioExchange. To continue reading, please log in or request an invitation.