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The safest and most effective treatment for symptomatic vertebral artery stenosis has not yet been proven. Here, we discuss the merits and pitfalls of endovascular treatment for this under-recognized disease entity.
The development of left ventricular assist devices could be considered an 'imaginative leap'. In the current phase of critical evaluation of these devices, a study of patients who received first-generation left ventricular assist devices has indicated that they might affect late post-transplant survival. The validity and significance of these findings need to be examined further.
Detection of fetal conduction system abnormalities relies upon magnetocardiographic or electrocardiographic recording techniques. Appropriate fetal treatment requires awareness of arrhythmia characteristics, mechanisms, and their potential associations. This Review discusses current and future diagnostic techniques and pharmacologic treatments for fetal arrhythmia.
Atrial fibrillation (AF) is the most common cardiac arrhythmia. Early management of this disorder using imaging, antiarrhythmia drugs and catheter ablation is necessary to prevent the progression of AF. In this Review, the authors discuss the current status of important facets of the early management of AF and emphasize the need for a greater understanding of the underlying etiology, which will lead to novel treatment approaches and amelioration of AF.
Sudden cardiac death (SCD) is a serious health concern worldwide. Despite the need for risk factors that can identify high-risk individuals, there are few available owing to the complex and often asymptomatic nature of SCD. In this Review, Sumeet Chugh outlines novel risk markers and predictors of SCD that will allow more effective prevention, and suggests a framework for studies in the future for the discovery and validation of these risk markers.
The number of patients undergoing implantation of a cardioverter-defibrillator (ICD) is increasing, as the indications for device therapy have broadened. Despite the mortality benefits associated with ICDs, they can also cause substantial complications. Drs. Wazni and Wilkoff explore the issues involved in managing patients with an ICD and discuss approaches for reducing these adverse effects, from prevention of infection, and the choice of lead and implantation technique, to strategies for programming and monitoring the device.
This Review discusses the effects of intensive glycemic control on cardiovascular disease in patients with diabetes, and examines key factors in recent intervention trials that might have contributed to their disparate findings. The authors suggest that care of these patients should focus on achieving current treatment goals, rather than on changes to glycemic targets.