This thought provoking article by Drew et al., utilized state-of-the art monitoring technology to document the problem of "alarm fatigue" by recording an astounding number of alarm events; 2,558,760 unique alarms were triggered for 461 patients over a 31-day period.
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Insights into the problem of alarm fatigue with physiologic monitor devices: a comprehensive observational study of consecutive intensive care unit patients
April 8, 2015
March 17, 2015
The study investigated management of atrial fibrillation existing at the time of mitral valve surgery, randomizing 260 pts to ablation or observation. The end point was freedom from afib at both 6 and 12 mos. Ablation yielded success in 63% compared to 29% of controls, but was associated with a higher risk of pacemaker implant (21% vs 8%).
February 24, 2015
This is an excellent summary of the pros and cons of LAA occlusion for stroke prevention in non valvular AF.
January 10, 2015
The FDA recently approved the fourth new oral anticoagulant, Savaysa for use in non-valvular afib, DVT, and PE. It is another factor Xa inhibitor. Use in non-valvular afib requires renal function assessment prior to prescribing, as the drug is renally excreted. Paradoxically, efficacy may be reduced in patients with better-than-normal renal functi
November 10, 2014
The authors explored a sample of Medicare patients who survived sepsis during hospitalization to assess the impact of afib developing during sepsis on long-term outcomes. Of nearly 139,000 sepsis survivors, 7% had new onset afib during sepsis. Of those pts, 55% were found to have afib after hospitlization. New onset afib during sepsis was associat
November 6, 2014
This is a new “real-world” study comparing bleeding risk in Medicare patients treated with dabigatran (n=1302) and warfarin (n=8102) for newly diagnosed atrial fibrillation. The use of dabigatran was associated with a significantly higher risk of any, major, and gastrointestinal bleeding when compared with warfarin.
New-onset Atrial Fibrillation Post-surgery for Esophageal and Junctional Cancer: Incidence, Management, and Impact on Short- and Long-term Outcomes
October 8, 2014
The authors investigated the impact of new onset a-fib after esophagectomy in 437 pts. Risk factors included age, diabetes, induction therapy, and cardiac history. A-fib was associated with postoperative pneumonia, symptomatic pleural effusions, and an increase in C-reactive protein. It was not associated with anastomotic leak or mortality. 92% o
Postoperative Atrial Fibrillation Significantly Increases Mortality, Hospital Readmission, and Hospital Costs
August 30, 2014
The study provides a risk-adjusted impact of postoperative atrial fibrillation on hospital mortality, resouces utlization, and costs. 49,264 patients from the STS database who underwent cardiac surgery were extracted from 2001-2012.
June 26, 2014
The cause of ischemic stroke remains elusive in up to 20-40% of cases. In patients with cryptogenic stroke, 8.9% of patients with long term monitoring using an insertable cardiac monitor were found to an episode of atrial fibrillation, which may have implications in therapy.
Effectiveness of Biatrial Epicardial Application of Amiodarone Releasing Adhesive Hydrogel to Prevent Postoperative AF
June 1, 2014
This study assessed whether the application of a poly based hydrogel containing amioderone applied to the epicardium at the time of surgery reduced the incidence of post-operative atrial fibrillation. The study randomised 100 patients undergoing cardiac surgery to either receive the amioderone spray at the time of surgery or no intervention.