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(Circulation. 2007;115:1.)
© 2007 American Heart Association, Inc.
Issue Highlights
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IS DUAL-CHAMBER PROGRAMMING INFERIOR TO SINGLE-CHAMBER PROGRAMMING IN AN IMPLANTABLE CARDIOVERTER- DEFIBRILLATOR? RESULTS OF THE INTRINSIC RV (INHIBITION OF UNNECESSARY RV PACING WITH AVSH IN ICDs) STUDY, by Olshansky et al. |
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 Top IS DUAL-CHAMBER PROGRAMMING... SILDENAFIL IMPROVES EXERCISE...LOCALIZATION AND QUANTIFICATION...Images in Cardiovascular...Correspondence |
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Although implantable cardioverter defibrillators reduce sudden death in high risk patients with depressed ventricular function, the impact on mortality is blunted by progressive heart failure. Implantable cardioverter defibrillators also provide bradycardia pacing that can vary from continuous to rare back-up pacing. A previous study found that dual-chamber (DDD) pacing increased mortality, likely due to adverse effects of unnecessary right ventricular pacing. Yet DDD pacing systems offer desirable atrial pacing and arrhythmia classification. In this issue of Circulation, Olshansky and coworkers conducted a noninferiority trial comparing single-chamber VVI pacing to a DDD pacing algorithm in patients for whom the algorithm minimized right ventricular pacing. DDD pacing did not increase the combined end point of mortality and hospitalizations for heart failure and showed a favorable trend toward benefit. Thus, with attention to pacing programming, DDD pacing can be safely employed in selected implantable cardioverter defibrillator recipients for whom atrial sensing and pacing is desirable. See p 9.
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SILDENAFIL IMPROVES EXERCISE HEMODYNAMICS AND OXYGEN UPTAKE IN PATIENTS WITH SYSTOLIC HEART FAILURE, by Lewis et al. |
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TopIS DUAL-CHAMBER PROGRAMMING...SILDENAFIL IMPROVES EXERCISE...LOCALIZATION AND QUANTIFICATION...Images in Cardiovascular...Correspondence |
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The type 5 phosphodiesterase inhibitor sildenafil has been shown to lower pulmonary vascular resistance and pressures in patients with heart failure by augmenting an important determinant of exercise function in heart failure. Lewis and colleagues administered a single oral dose of sildenafil (50 mg) to 13 patients with New York Heart Association class III heart failure. They found that sildenafil lowered pulmonary resistance and pressures and improved exercise capacity in those patients with a pulmonary arterial pressure greater than 25 mm Hg. The Lewis et al study thus provides support for the utility of type 5 phosphodiesterase inhibition in this subset of patients with heart failure. See p 59.
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LOCALIZATION AND QUANTIFICATION OF PLATELET-RICH THROMBI IN LARGE BLOOD VESSELS USING NEAR-INFRARED FLUORESCENCE IMAGING, by Flaumenhaft et al. |
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TopIS DUAL-CHAMBER PROGRAMMING...SILDENAFIL IMPROVES EXERCISE...LOCALIZATION AND QUANTIFICATION...Images in Cardiovascular...Correspondence |
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Visualization of clot formation in vivo, particularly real-time visualization, has been limited by the size of blood vessels and the limitations of the currently available technologies. The ability to detect thrombus formation would be important for research as well as clinical events caused by thrombotic occlusion or disruption. In the current issue of Circulation, Flaumenhaft and colleagues utilize platelets labeled with a near-infrared fluorophore in animal models and demonstrate the visualization of thrombus in the coronary, carotid, and femoral vessels. The translation of this technology to human patients would have diagnostic implications in a wide variety of clinical scenarios secondary to thrombosis. See p 84.
Visit http://circ.ahajournals.org:
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Images in Cardiovascular Medicine |
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TopIS DUAL-CHAMBER PROGRAMMING...SILDENAFIL IMPROVES EXERCISE...LOCALIZATION AND QUANTIFICATION...Images in Cardiovascular...Correspondence |
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Serial Assessment of Liquefaction Necrosis of Mitral Annular Calcification by Echocardiography and Multislice Computed Tomography. See p e1.
Papillary Fibroelastoma of the Aortic Valve: Appearance in 64-Slice Spiral Computed Tomography, Magnetic Resonance Imaging, and Echocardiography. See p e3.
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Left Main Coronary Artery Compression Syndrome: Evaluation With 64-Slice Cardiac Multidetector Computed Tomography. See p e7.
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Correspondence |
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TopIS DUAL-CHAMBER PROGRAMMING...SILDENAFIL IMPROVES EXERCISE...LOCALIZATION AND QUANTIFICATION...Images in Cardiovascular...Correspondence |
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See p e9.
Related Articles:
Circulation 2007 115: e1-e2.
Circulation 2007 115: e3-e6.
Circulation 2007 115: e7-e8.
Circulation 2007 115: e9.
Circulation 2007 115: 59-66.
Circulation 2007 115: 9-16.
Circulation 2007 115: 84-93.
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