CardioExchange Archive

March 24th, 2010

Freezing in AF Ablation—Not So Fast, You All

John Mandrola, MD, FACC

CardioExchange welcomes this guest post reprinted with permission from Dr. John M, a blog by private-practice electrophysiologist and CardioExchange member, Dr. John Mandrola. Freezing the heart is in the news. The STOP-AF trial was presented at ACC, and it sure has generated much excitement about atrial fibrillation ablation. This is a good thing.  However, as is […]

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February 17th, 2010

Which Strategy for Severe Calcific Aortic Stenosis?

Anju Nohria, MD and James Fang, MD

The patient is a 72-year-old man with a history of ischemic cardiomyopathy (LV ejection fraction, 30%–35%) and NYHA class II/III heart-failure symptoms at baseline. Over the previous month, he had experienced recurrent episodes of volume overload and sustained ventricular tachycardia (VT) requiring intravenous diuretics and up-titration of his amiodarone therapy. He then presented in VT […]

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December 7th, 2009

Dabigatran vs Warfarin: War or Peace?

Samuel Goldhaber, MD

CardioExchange Editors: Given the results of both your RE-COVER study and the recently published RE-LY study, should anybody still be using warfarin? Goldhaber: Warfarin is not going to fade away into oblivion.  Anyone currently stable on warfarin has little reason to abandon this time-tested drug.  If once monthly INRs are usually in the therapeutic range, and if […]

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November 13th, 2009

Genetic Testing in Unexplained Thrombosis – Part II

thomasmorgan and Richard A. Lange, MD, MBA

An expert weighs in on a case of unexplained VTE in a patient under 50. (see Part I)   The rationale for genetic testing in unexplained thrombosis is to gain a better understanding of why VTE occurred and to document risk factors for recurrent events. However, genetic testing in this setting is somewhat controversial. Knowing […]

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November 6th, 2009

Darbepoetin–Trick or Treat? Part II

philipmarsden and Andrew M. Kates, MD

(SEE PART 1 OF SERIES) I was amazed by three things when the results from Trial to Reduce Cardiovascular Events with Aranesp Therapy (TREAT) were presented Friday October 30th, 2009 at the American Society of Nephrology Annual Meeting in San Diego: Thousands of atttendees came to hear TREAT presented by Dr M. Pfeffer–The room was tense […]

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November 4th, 2009

Darbepoetin—Trick or Treat? Part I

martingallagher and Brahmajee Kartik Nallamothu, MD, MPH

(SEE PART II OF SERIES) When the FDA approved the use of recombinant erythropoietin for patients with renal disease in 1989 it was based upon the ability of this agent to reduce the need for blood transfusion, increase patient’s exercise tolerance and improve quality of life. At the time, the perceived risk of blood transfusion […]

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November 3rd, 2009

Does coronary revascularization make noncardiac surgery safer?

Richard A. Lange, MD, MBA

Does coronary revascularization make noncardiac surgery safer?  If so, when?   On the cardiology consult service today, we evaluated a man who needs a “low risk” gastrointestinal surgical procedure urgently.  He presented to hospital admission with a prolonged hypotensive episode associated with anterior ST depression and mildly elevated troponin levels and without chest pain. He had […]

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November 2nd, 2009

Genetic Testing in Unexplained Thrombosis – Part I

Harlan M. Krumholz, MD, SM

The case. (For an expert’s response, see Part II) A very healthy 44-year-old man who engaged in daily vigorous physical activity suddenly developed shortness of breath and pleuritic chest pain. He was quickly diagnosed with multiple pulmonary emboli. He was not overweight and had no recent history of long trips, injuries, periods of bed rest, […]

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