Atrial Fibrillation

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DURHAM, N.C. -- Women at risk of sudden cardiac death are two to three times less likely to receive an implantable cardioverter-defibrillator than men who are at risk, investigators here have found.

BURLINGTON, Mass. -- Pooled data from seven randomized trials of thiazolidinediones for type 2 diabetes confirmed a significant risk of congestive heart failure with either pioglitazone (Actos) or rosiglitazone (Avandia), but neither increased the risk of cardiovascular death.

WALTHAM, Mass. -- Only about 19% of patients had at least one rehab session in the year after a heart attack or coronary artery bypass graft, despite recommendations by professional groups for rehab in that population.

NEW YORK -- Inpatients cared for by full-time hospitalists were likely to be discharged almost a day sooner than those in the care of nonhospitalists, but there was no significant difference in readmission rates or mortality, researchers found.

Congestive heart failure and cirrhosis are the most common causes of transudative pleural effusions, while pneumonia and malignancy are responsible for the majority of exudative effusions. Plain chest films are valuable in confirming the presence of an effusion, providing clues to the cause, and directing the method of pleural fluid sampling. Thoracentesis is safe and simple, and it is diagnostic in about 75% of cases. Pleural biopsy is indicated for unexplained exudative effusions, most of which are found to result from malignancy or tuberculosis. Medical thoracoscopy, if available, is the procedure of choice for patients with these effusions. Thoracoscopy permits visually directed pleural biopsies and allows for therapeutic intervention at the time of diagnosis, obviating the need for subsequent invasive procedures.

PHILADELPHIA -- The beta-blocker carvedilol (Coreg) does not appear to benefit children or adolescents with symptomatic systolic heart failure, suggest preliminary trial results.

LOS ANGELES -- Dronedarone, an investigational drug, proved significantly more effective than placebo in maintaining sinus rhythm and in reducing the ventricular rate during recurrent atrial fibrillation.

Heparin-induced thrombocytopenia (HIT) is a common and serious complication of heparin therapy, occurring in about 1% to 5% of patients.1 It occurs more often with unfractionated heparin than with low molecular weight heparin. Complications of HIT include venous thromboembolism, arterial thrombosis, skin necrosis, and limb gangrene.2,3 Before the introduction of the direct thrombin inhibitors, the mortality rate associated with HIT was 20% to 25%.4-6