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Should radiofrequency ablation be first-line therapy after a first episode of symptomatic atrial flutter?Radiofrequency catheter ablation (RFA) is a cost-effective approach that has modified the treatment of patients with supraventricular tachycardia. In the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) study, we compared RFA treatment with amiodarone therapy after the first episode of symptomatic atrial flutter. Results showed that RFA should be considered a first-line treatment, especially in elderly patients, because it has a better long-term success rate, the same risk of subsequent atrial fibrillation as amiodarone, and fewer secondary effects compared with amiodarone. Radiofrequency catheter ablation first-line therapy should be recommended in routine clinical practice, even when the atrial flutter is isolated without a previously documented atrial fibrillation episode.
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Large-scale clinical epidemiology of stable angina in women and menWe performed a whole-country study using linked health care records in Finland and showed that stable angina as the initial symptomatic manifestation of coronary disease occurs as frequently in women as it does in men. Among easily recognized subgroups, the absolute rates of prognostic outcomes were similarly high in women and men.
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Risk Factors, Comorbidities, and Costs of Heart FailureOf the predominating risk factors or comorbidities that occur with HF, hypertension appears to be the most prevalent.
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Proposed Physician Fee Schedule Update Implements Reform ProvisionsCMS published its annual regulatory update to the Medicare Physician Fee Schedule, including rules implementing key provisions of the Affordable Care Act.
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The Ongoing Debate Over the Use of Opioids in Treating Chronic Noncancer PainSteve Gelfand, MD, secretary of Physicians for Responsible Opioid Prescribing (PROP) responds to recent comments by Drs. Cole and Webster in Pain Management.
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Beach Body: Consider These Non-Surgical Body Contouring Options for the SummerAs the weather warms and spring turns to summer, the layers of clothing come off. It’s the time of year when people ramp up their diet and exercise regimens to tighten up that beach body.
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The aging of strokeStroke is an especially important disease to study in terms of secular trends because it is so common, deadly, and disabling.
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Integrating the existing emergency medical system with automated external defibrillators for out-of-hospital cardiac arrestWe investigated whether a program based on diffuse deployment of automated external defibrillators operated by trained volunteers and laypersons across the largest county in Italy would safely and effectively improve the current survival rate among patients with out-of-hospital cardiac arrest. Compared with historical control subjects, the new strategy resulted in a 3-fold increase in 1-year survival free of neurologic impairment.
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Analysis of regional left ventricular functionWe performed cineventriculography, unenhanced echocardiography, contrast-enhanced echocardiography, and magnetic resonance imaging to define the presence of regional left ventricular wall motion abnormalities. Interobserver agreement in the analysis of regional wall motion abnormality was highest for contrast-enhanced echocardiography, followed by cineventriculography and cardiac magnetic resonance imaging; it was lowest for unenhanced echocardiography. Contrast-enhanced echocardiography also showed the highest accuracy in the detection of panel-defined regional wall motion abnormalities.
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Multiple Sclerosis Prevalence Nears 1 Million US PatientsA new report shows that multiple sclerosis diagnoses have steadily risen in older patients in the past 5 years, bucking previous patient rate estimates.
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Can reduction in electrocardiographic left ventricular hypertrophy be helpful in preventing clinical heart failure?As clinical cardiologists, we face an ever-changing landscape with regard to the management and care of hypertensive patients.
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A Closer Look- Athletic screening: A delicate balancing actWhen Hank Gathers collapsedon court during a college basketball game against Portland State on March 4, 1990, and later died, the event both jolted the national consciousness and set into motion changes in the athletic preparticipation screening process. Although another collapse had occurred just 4 months before, and an irregular heartbeat was detected at that time, Gathers was not compliant with the prescribed beta blocker and continued to play. An autopsy revealed that the 23-year-old Gathers suffered from cardiomyopathy.
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Cardiovascular events in hypertension trials: A focus on perindoprilPharmacologic inhibition of the renin-angiotensin aldosterone system (RAAS) has become a widely accepted approach to lowering blood pressure (BP).
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Survival after heart failureWe conducted a multi-hospital population-based study of 2445 residents of a large New England metropolitan area hospitalized with acute heart failure and found that the long-term prognosis for these patients remains poor. More than one third of patients died in the first year after hospital discharge,and nearly 4 of 5 patients died over the 5-year follow-up period. Several demographic and clinical factors were associated with an adverse prognosis. It is important to know the factors that negatively affect long-term survival after hospital discharge for decompensated heart failure so that treatment can be directed toward specific high-risk groups.
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Living with Rosacea: Signs and SymptomsEarly treatment of rosacea is crucial for the prevention of irreversible damage.
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Introducing a New Tablet Computer for DocsThe PhreesiaPad is a tablet that lets practice increase collections, capture clear and legible patient documentation, and enhance clinical care & productivity.
