Dr. Daniel Friedman talks with Dr. Marc Gillinov of the Cleveland Clinic about a study that randomized patients undergoing mitral valve surgery to atrial fibrillation ablation and left atrial appendage ligation or no ablation. The study concluded that atrial fibrillation ablation improves rhythm control in patients undergoing cardiac surgery, though more patients undergoing ablation required permanent pacemaker placement. The study did not look at clinical outcomes beyond rhythm control.
Dr. Emily Zeitler talks to Dr. Bernard Gersh of the Mayo Clinic about the LEGACY trial, a trial that compared physician-directed weight loss to usual care for the prevention of recurrent atrial fibrillation after ablation.
Dr. Sean Pokorney, a fellow at the DCRI, discusses his poster presented at ACC, The Myth of the Stable INR patient, in which he uses data from the ORBIT-AF registry to show that many patients on warfarin have INR values outside of the therapeutic range.
Drs. Matthew Sherwood and Ben Steinberg have used data from major clinical trials and registries to answer important clinical questions regarding novel oral anticoagulant therapy. They present their findings here.
Dr. Tristram Hove provides an overview and discusses future directions for the care of patients with atrial fibrillation.
Duke Cardiology fellow Matt Sherwood interviews Dr. David Holmes on the PREVAIL trial results, embargo breaks, and how the WATCHMAN device will fare in the future. Get insights on this controversial issue at ACC.13.
Dr. Sana Al-Khatib presented on, “The Implantable Cardioverter-Defibrillator: Where Have We Been? Where Are We Going?”
We were delighted to have Duke alum Dr. Gust Bardy visit with us last week. He has previously helped conduct the landmark Sudden Cardiac Death in Heart Failure Trial (SCD-HeFT). His work with implantable defibrillators has continued wtih the development of an entirely subcutaneous ICD. He presented the fascinating story of its development last week at Duke Cardiology Grand Rounds.
US-based clinical registries, such as the National Cardiovascular Data Registry and Get With The Guidelines, have been instrumental in identifying and addressing gaps in quality of care for patients across the country. It is fascinating to see approaches in other countries who have developed nationwide clinical registries, inclusive of all citizens. In Sweden, clinical registries like SCAAR and SWEDEHEART, have not only been used to describe trends in nationwide clinical outcomes but are now being used as a platform for the conduct of randomized trials. With rich characterization of patients and longitudinal followup, clinical registries can be used to identify, enroll, and follow patients randomized to treatments or strategies of care that need more investigation. These innovative “randomized clinical registry studies” are being conducted in the US as well. We need more of them.
Dr. Jon Piccini discusses electrophysiology at ACC 2012 with cardiology fellow Ben Steinberg.