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The Role of Atrial Arrhythmia Ablation in Adolescent and Adult Congenital Heart Disease
AbstractPurpose of ReviewAtrial arrhythmias cause significant morbidity in patients with congenital heart disease (CHD). Catheter ablation remains one of the most effective treatment modalities for atrial arrhythmias. However, patients with congenital heart disease present unique challenges for catheter ablation.Recent FindingsRecent expert consensus guidelines inform physicians about treating arrhythmias in patients with CHD. These guidelines outline appropriate selection criteria for ablation and highlight treatment alternatives. The authors also suggest electrophysiology laboratory and physician standards for performing...
Source: Current Cardiovascular Risk Reports - February 18, 2019 Category: Cardiology Source Type: research

How to Choose Between His Bundle Pacing and Biventricular Pacing for Cardiac Resynchronization Therapy
AbstractPurpose of ReviewThe goal of this critical appraisal is to evaluate the role for His bundle pacing (HBP) in cardiac resynchronization, examine early clinical and physiologic data, as well as offer recommendations for selecting patients for HBP versus biventricular pacing for CRT.Recent FindingsBiventricular pacing with a left ventricular (LV) coronary sinus lead has been the primary mode of delivering cardiac resynchronization therapy (CRT) for over two decades. By fusing multiple wavefronts of activation, biventricular pacing shortens and homogenizes ventricular activation, increases left ventricular ejection frac...
Source: Current Cardiovascular Risk Reports - February 11, 2019 Category: Cardiology Source Type: research

Optimizing Anticoagulation in Older Patients with Nonvalvular Atrial Fibrillation
AbstractPurpose of ReviewWe sought to review the current issues on optimization of anticoagulation in elderly patients with nonvalvular atrial fibrillation (NVAF).Recent FindingsAdvanced age is a risk factor for stroke and as one advances in age, the risk of stroke also increases. One of the many challenges of oral anticoagulation for stroke prevention in the elderly patients with NVAF is the underutilization of anticoagulants. Commonly cited reasons for hesitation by physician in prescribing oral anticoagulants are advanced age, increase risk of bleeding, and the difficulty in maintaining an adequate time in therapeutic r...
Source: Current Cardiovascular Risk Reports - January 25, 2019 Category: Cardiology Source Type: research

Worldwide Dyslipidemia Guidelines
AbstractPurpose of ReviewThis review aims to identify common features of guidelines by comparing and summarizing similarities between five guidelines distributed by high-profile cardiovascular societies across the globe. We include guidelines from North America: ACC/AHA (2013 American College of Cardiology/American Heart Association Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults) and CCS (2016 Canadian Cardiovascular Society Guidelines for the Management of Dyslipidemia for the Prevention of Cardiovascular Disease in the Adult) and from Europe: PoLA (2016 Polish Lipi...
Source: Current Cardiovascular Risk Reports - January 25, 2019 Category: Cardiology Source Type: research

Noninvasive Cardiac Radioablation for Ventricular Arrhythmias
AbstractPurpose of ReviewIn this review, we describe the general principles and clinical use of stereotactic radioablation (SR) and its specific application to the treatment of malignant cardiac ventricular arrhythmias, or stereotactic arrhythmia radioablation (STAR). The principles of STAR, and the unmet needs in cardiac arrhythmia ablation are described. The basic pathophysiology of radioablative effect on cardiac tissues, the clinical experience to date, and future directions are discussed.Recent FindingsBasic preclinical research has demonstrated in large animal models (porcine, canine) that delivery of SR energy to ca...
Source: Current Cardiovascular Risk Reports - January 21, 2019 Category: Cardiology Source Type: research

Management of Brugada Syndrome in the Developing Countries
AbstractPurpose of ReviewThe goal of this article is to review the current paradigm for the diagnosis and management of Brugada Syndrome.Recent FindingsOne area of particular interest is the recent reports on the use of ablation for treatment and the relevance to our understanding of this genetic disorder.SummaryThis review discusses issues with management and treatment of Brugada Syndrome that have applications that should apply to patients in the developed and developing world. (Source: Current Cardiovascular Risk Reports)
Source: Current Cardiovascular Risk Reports - November 20, 2018 Category: Cardiology Source Type: research

Social Networks and Health Outcomes: Importance for Racial and Socioeconomic Disparities in Cardiovascular Outcomes
AbstractPurpose of ReviewA large body of research has indicated social network characteristics are associated with health and mortality. Additional literature suggests the structure and function of social networks differ by race and socioeconomic status. The current paper seeks to synthesize and further contextualize these two separate bodies of work, as well as illustrate potential mechanisms by which social networks may contribute to current disparities in cardiovascular disease outcomes.Recent FindingsAn increasing number of studies have examined the link between social networks and cardiovascular outcomes. Social isola...
Source: Current Cardiovascular Risk Reports - October 25, 2018 Category: Cardiology Source Type: research

Personalized Approach to Statin Selection in Primary Prevention: Genetic Risk Scores Vs Imaging Risk Scores
AbstractPurpose of ReviewThis review addresses how assessment of coronary artery calcium (CAC) and information on genetic profile can guide statin therapy in primary prevention of atherosclerotic cardiovascular disease (ASCVD).Recent FindingsCAC provides information beyond that given by standard risk factors, improving discrimination and risk reclassification, especially in the intermediate-risk stratum. A substantial proportion of individuals in primary prevention have CAC  = 0 and very good prognosis over 10 years (ASCVD risk<5%). Conversely, CAC>100 is usually associated with 10-year ASCVD risk>7.5%, even ...
Source: Current Cardiovascular Risk Reports - October 17, 2018 Category: Cardiology Source Type: research

Sugar-Sweetened Beverage Taxes: the Potential for Cardiovascular Health
AbstractPurpose of ReviewGlobal sugar-sweetened beverage (SSB) consumption is high, with important implications for cardiovascular health. International momentum with the adoption and implementation of SSB taxes has been mounting in recent years, as has the evidence supporting such a policy for population health. In this review, we summarise the influence of regular SSB consumption on cardiovascular health and provide a global perspective on SSB consumption and SSB tax action and evidence. We further discuss the might and organised opposition of the beverage industry and the policy enablers for affirmative action.Recent Fi...
Source: Current Cardiovascular Risk Reports - October 10, 2018 Category: Cardiology Source Type: research

Lipoprotein(a) —It Is Risky, but What Do We Do About It?
AbstractPurpose of ReviewLipoprotein(a) [Lp(a)] is a pro-inflammatory, pro-thrombotic, and pro-atherogenic lipoprotein particle. Lp(a) binds and transports oxidized phospholipids in the bloodstream. It is one of the strongest genetic risk factors for coronary artery disease, stroke, and calcific aortic valve stenosis.Recent FindingsElevated Lp(a) levels, or hyperlipoproteinemia(a), is associated with cardiovascular outcomes even in high-risk individuals who achieve their low-density lipoprotein cholesterol target with statins. Lifestyle modification therapy and dietary supplements have little impact on plasma Lp(a) levels....
Source: Current Cardiovascular Risk Reports - September 29, 2018 Category: Cardiology Source Type: research

Time to Make a Change: Assessing LDL-C Accurately in the Era of Modern Pharmacotherapeutics and Precision Medicine
AbstractPurpose of ReviewThe Friedewald equation for estimation of low-density lipoprotein cholesterol (LDL-C) was published in 1972 as an alternative to direct assessment by preparative ultracentrifugation. In this equation, very low-density lipoprotein is estimated by dividing triglycerides by a fixed factor (5 in mg/dL or 2.2 in mmol/L) and subtracting this term from non-high-density lipoprotein cholesterol (non-HDL-C). This method was derived in fasting samples from a small cohort of patients with primarily genetic dyslipidemias followed at the NIH. The method served well as the global standard for LDL-C estimation for...
Source: Current Cardiovascular Risk Reports - September 13, 2018 Category: Cardiology Source Type: research

Delivery of Automated External Defibrillators (AED) by Drones: Implications for Emergency Cardiac Care
AbstractPurpose of ReviewOut-of-hospital cardiac arrest (OHCA) remains a significant health problem in the USA and only 8.6% of victims survive with good neurological function, despite advances in emergency cardiac care. The likelihood of OHCA survival decreases by 10% for every minute without resuscitation.Recent FindingsAutomatic external defibrillators (AEDs) have the potential to save lives yet public access defibrillators are underutilized (<  2% of the time) because they are difficult to locate and rarely available in homes or residential areas, where the majority (70%) of OHCA occur. Even when AEDs are within c...
Source: Current Cardiovascular Risk Reports - September 3, 2018 Category: Cardiology Source Type: research