The New England journal of medicine
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Randomized Controlled Trial Multicenter Study
Cryoballoon Ablation as Initial Therapy for Atrial Fibrillation.
In patients with symptomatic paroxysmal atrial fibrillation that has not responded to medication, catheter ablation is more effective than antiarrhythmic drug therapy for maintaining sinus rhythm. However, the safety and efficacy of cryoballoon ablation as initial first-line therapy have not been established. ⋯ Cryoballoon ablation as initial therapy was superior to drug therapy for the prevention of atrial arrhythmia recurrence in patients with paroxysmal atrial fibrillation. Serious procedure-related adverse events were uncommon. (Supported by Medtronic; STOP AF First ClinicalTrials.gov number, NCT03118518.).
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Multicenter Study Observational Study
Resumption of Cardiac Activity after Withdrawal of Life-Sustaining Measures.
The minimum duration of pulselessness required before organ donation after circulatory determination of death has not been well studied. ⋯ After withdrawal of life-sustaining measures, transient resumption of at least one cycle of cardiac activity after pulselessness occurred in 14% of patients according to retrospective analysis of waveforms; only 1% of such resumptions were identified at the bedside. These events occurred within 4 minutes 20 seconds after a period of pulselessness. (Funded by the Canadian Institutes for Health Research and others.).
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Randomized Controlled Trial Multicenter Study
REGN-COV2, a Neutralizing Antibody Cocktail, in Outpatients with Covid-19.
Recent data suggest that complications and death from coronavirus disease 2019 (Covid-19) may be related to high viral loads. ⋯ In this interim analysis, the REGN-COV2 antibody cocktail reduced viral load, with a greater effect in patients whose immune response had not yet been initiated or who had a high viral load at baseline. Safety outcomes were similar in the combined REGN-COV2 dose groups and the placebo group. (Funded by Regeneron Pharmaceuticals and the Biomedical and Advanced Research and Development Authority of the Department of Health and Human Services; ClinicalTrials.gov number, NCT04425629.).
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Randomized Controlled Trial Multicenter Study
Polypill with or without Aspirin in Persons without Cardiovascular Disease.
A polypill comprising statins, multiple blood-pressure-lowering drugs, and aspirin has been proposed to reduce the risk of cardiovascular disease. ⋯ Combined treatment with a polypill plus aspirin led to a lower incidence of cardiovascular events than did placebo among participants without cardiovascular disease who were at intermediate cardiovascular risk. (Funded by the Wellcome Trust and others; TIPS-3 ClinicalTrials.gov number, NCT01646437.).
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Randomized Controlled Trial Multicenter Study
Bupropion and Naltrexone in Methamphetamine Use Disorder.
The use of naltrexone plus bupropion to treat methamphetamine use disorder has not been well studied. ⋯ Among adults with methamphetamine use disorder, the response over a period of 12 weeks among participants who received extended-release injectable naltrexone plus oral extended-release bupropion was low but was higher than that among participants who received placebo. (Funded by the National Institute on Drug Abuse and others; ADAPT-2 ClinicalTrials.gov number, NCT03078075.).