Heart rhythm : the official journal of the Heart Rhythm Society
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Sudden death of a sibling is thought to be associated with greater risk of death in long QT syndrome (LQTS). However, there is no evidence of such an association. ⋯ Sudden death of a sibling prompted more aggressive treatment but did not predict risk of death or ACA, whereas QTc >/= 0.53 s, gender, and syncope predicted this risk. All subjects should receive appropriate beta-blocker therapy. The decision to implant an ICD should be based on an individual's own risk characteristics (QTc, gender, and history of syncope).
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Comparative Study
Efficacy of pulmonary vein isolation by cryoballoon ablation in patients with paroxysmal atrial fibrillation.
Radiofrequency ablation of pulmonary veins (PVs) has emerged as an effective treatment for patients with paroxysmal atrial fibrillation (AF). However, serious complications raise concern about an even wider application. In terms of safety, cryoenergy has advantages compared with radiofrequency. A new cryoenergy balloon catheter has been recently developed to make AF ablation shorter and safer. ⋯ This is the first study that reports the results of the new cryoballoon AF ablation approach showing 86% freedom from AF recurrence after 6 months. Cryoballoon PV ablation promises to be effective for patients with paroxysmal AF and normally sized left atria.
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Clinical Trial
Outcomes and costs of implantable cardioverter-defibrillators for primary prevention of sudden cardiac death among the elderly.
The clinical outcomes and costs of implantable cardioverter-defibrillators (ICDs) used for primary prevention of sudden cardiac death in nonexperimental settings are uncertain. ⋯ ICD implantation was associated with reduced mortality in a nonexperimental, elderly, primary-prevention patient population hospitalized for CHF. The additional health-care costs of ICD implantation were substantial but comparable to published cost-effectiveness models that have projected ICDs to be cost-effective.