Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.

CRT with defibrillation trumps pacing in NICM patients with +MWF

07 Sep 2017
While pacemakers are already life-saving devices, a new breed of biodegradable batteries would offer even greater possibilities

Cardiac resynchronization therapy with defibrillation (CRT-D) is superior to CRT(-P) with pacing in nonischaemic cardiomyopathy (NICM) patients with left ventricular midwall fibrosis (+MWF) but not in those without (-MWF), according to a recent study.

Researchers calculated clinical events in patients with NICM who were +MWF (n=68) or ‒MWF (n=184) and who underwent cardiac magnetic resonance prior to CRT device implantation to determine whether CRT-D was better than CRT-P.

Among the included patients, +MWF appeared to independently predict total mortality (adjusted hazard ratio [aHR], 2.31; 95 percent CI, 1.45 to 3.68), total mortality or heart failure hospitalization (aHR, 2.02; 1.32 to 3.09), total mortality or hospitalization for major adverse cardiac events (aHR, 2.02; 1.32 to 3.07), death from pump failure (aHR, 1.95; 1.11 to 3.41), and sudden cardiac death (aHR, 3.75; 1.26 to 11.2) over a maximum follow-up period of 14 years (median 3.8 years; IQR, 2.0 to 6.1 years for +MWF and 4.6 years; IQR, 2.4 to 8.3 years for ‒MWF).

Separate analyses of +MWF and ‒MWF revealed that total mortality (aHR, 0.23; 0.07 to 0.75), total mortality or heart failure hospitalization (aHR, 0.32; 0.12 to 0.82), and total mortality or hospitalization for major adverse cardiac events (aHR, 0.30; 0.12 to 0.78) were lower after CRT-D than after CRT-P in NICM patients who were +MWF, but not in those who were −MWF.

These findings have significant implications for the choice of device therapy in NICM patients, according to researchers.

“Recent studies have cast doubt on the benefit of CRT-D versus CRT-P for patients with NICM. Left ventricular myocardial scar portends poor clinical outcomes,” they noted.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
DOWNLOAD
Editor's Recommendations
Most Read Articles
Elvira Manzano, 6 days ago
Bisphosphonates have proven antifracture efficacy and remain to be the cornerstone of osteoporosis treatment. However, a drug holiday is of particular importance with bisphosphonates due to some signals with long-term use of the drug, including rare incidence of atypical femoral fracture (AFF) and osteonecrosis of the jaw (ONJ), says a leading endocrinologist at AFOS 2017.
Yesterday
Drinking coffee, whether caffeinated or decaffeinated, is associated with a reduced risk of cardiovascular disease (CVD) and ischaemic heart disease (IHD) mortality in patients with a prior myocardial infarction (MI), according to a recent study.
3 days ago
Breast cancer patients have notably different microbiomes in the local breast tissue and urinary tract, a recent study reveals. Particularly, species in the Methylobacterium genus are reduced in the local breast tissue while the urinary tract is enriched in gram-positive bacteria.
Pearl Toh, 13 Oct 2017
Women with higher plasma tryptophan concentrations were less likely to have poor sleep quality during pregnancy, especially among those with anxiety symptoms, according to the GUSTO* study.