Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
Pearl Toh, 5 days ago
Obeticholic acid significantly improves fibrosis and disease activity in patients with nonalcoholic steatohepatitis (NASH), a chronic liver disease currently with no approved therapy, according to an interim analysis of the landmark REGENERATE* study.
6 days ago
Testosterone treatment may slightly improve sexual functioning and quality of life in men without underlying organic causes of hypogonadism, but it offers little to no benefit for other common symptoms of ageing, according to a study. In addition, long-term efficacy and safety of this therapy remain unknown.

Direct current cardioversion feasible for high-risk AF patients with LAAO devices

07 Nov 2019

High-risk atrial fibrillation (AF) patients with an endocardial left atrial appendage occlusion (LAAO) device may undergo direct current cardioversion (DCCV) without the need for oral anticoagulation (OAC) if preprocedural trans-oesophageal echocardiography shows good device position, suggests a study.

“DCCV is a common rhythm control strategy in patients with symptomatic AF or [atrial] flutter,” the authors said.

A total of 148 patients (mean age, 72±7 years; 59 percent men) with an LAAO device who underwent DCCV for symptomatic AF or atrial flutter were included in this multicentre retrospective study. All patients (100 percent) had a trans-oesophageal echocardiogram prior to DCCV.

Of the patients, 2.7 percent had device-related thrombus. All of them were successfully treated with OAC and were able to undergo DCCV after 6–8 weeks. Sinus rhythm was restored in all patients, and none suffered from DCCV-related thromboembolic complications.

About one in five patients (22 percent) were newly started on OAC after DCCV. No difference in DCCV-related complications was found between patients treated with or without OAC after DCCV. Patients on OAC post-DCCV underwent cardioversion at an earlier time following implantation (3.6 vs 8.6 months; p=0.003).

During follow-up, three transient ischaemic attacks occurred but were unrelated to DCCV. There were no device or left atrial thrombosis, device dislodgement, or new device leak seen during a median follow-up of 12.8 months (interquartile range, 11.8–14.2 months). Unfortunately, one patient died due to a noncardiac cause during follow-up.

“The preliminary results are encouraging, but further large studies are warranted to establish safety,” the authors said.

Digital Edition
Asia's trusted medical magazine for healthcare professionals. Get your MIMS Doctor - Malaysia digital copy today!
Sign In To Download
Editor's Recommendations
Most Read Articles
Pearl Toh, 31 Dec 2019
Adding the neuraminidase inhibitor oseltamivir to usual care speeds up recovery from influenza-like illness by a day compared with usual care alone, with even greater benefits seen in older, sicker patients with comorbidities, according to the ALIC4E study.
23 Dec 2019
At a Menarini-sponsored symposium held during the Asian Pacific Society Congress, renowned cardiologist Prof John Camm provided the latest evidence for chronic stable angina with or without concomitant diseases, with a special focus on the antianginal agent ranolazine and combination therapies. The event was chaired and moderated by Dr Dante Morales from the University of the Philippines College of Medicine.
Pearl Toh, 5 days ago
Obeticholic acid significantly improves fibrosis and disease activity in patients with nonalcoholic steatohepatitis (NASH), a chronic liver disease currently with no approved therapy, according to an interim analysis of the landmark REGENERATE* study.
6 days ago
Testosterone treatment may slightly improve sexual functioning and quality of life in men without underlying organic causes of hypogonadism, but it offers little to no benefit for other common symptoms of ageing, according to a study. In addition, long-term efficacy and safety of this therapy remain unknown.