Abstracts Archive 2002

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Ventricular pacing or dual-chamber pacing for sinus-node dysfunction

Pacemaker syndrome occurred in 16% of patients in the ventricular pacing group, and 38% of patients in the ventricular pacing group crossed over to dual-chamber pacing. Compared to ventricular pacing, dual-chamber pacing does not improve the risk of death or nonfatal stroke, but does reduce the need for hospitalization for heart failure and the risk of atrial fibrillation. Quality of life improves to a greater degree with dual-chamber than with ventricular pacing.

Perspective: Based on the results of this study, the most compelling reasons for implanting a dual-chamber instead of a ventricular pacemaker in patients with sinus-node dysfunction are a >50% reduction in risk of chronic atrial fibrillation and a high prevalence of pacemaker syndrome with ventricular pacing.

Beta-blocker therapy and symptoms of depression, fatigue, and sexual dysfunction

The data from clinical trials do not support the popular belief that beta-blocker therapy is associated with substantial risks of depressive symptoms, fatigue and sexual dysfunction. As such, these agents should be utilized appropriately in context of there documented benefits.

Perspective: The current study should help clear the common myth among physicians that the use of beta-blockers is associated with a substantial increase in the risk of depressive symptoms, fatigue and sexual dysfunction. Thus, these findings should stimulate them to refrain from withholding these agents among appropriate patients with acute coronary syndromes, heart failure and hypertension.   

Risks and benefits of estrogen plus progestin in healthy postmenopausal women. principal results from the women’s health initiative randomized controlled trial

Overall health risks exceeded benefits from use of combined estrogen + progestin for an average 5.2-year follow-up among healthy postmenopausal women. The results indicate this regimen should not be initiated or continued for primary prevention of CHD.

Perspective: The WHI is a landmark mega-trial that will solve many unanswered issues. The WHI data and safety monitoring board terminated this part of the study because of the increased risk of invasive breast cancer from active treatment that was evident at about 4 years. In an accompanying editorial, Fletcher and Colditiz note that about 38% of PMP women in the U.S. use HRT, and while the relative risk from HRT is “unexpected and disquieting,” when applying the results to practice they must be translated to absolute risk. The latter is that about 1 in 100 women will experience a CV event or breast cancer in 5 years as a result of treatment. Nevertheless, when the indication for HRT is prevention of cardiovascular disease and fractures, even this small risk is too great (primum non-nocere). There are new and effective osteoporosis prevention treatments (e.g., raloxifene) that may also have cardioprotective effects. The WHI arm evaluating estrogen alone in PMP women who had undergone a previous hysterectomy will continue. But in an accompanying article in the same issue, Lacey et al. reported an increase in risk of ovarian cancer in women treated with estrogens for over 10 years. What about short-term use of estrogens with or without progestins for menopausal symptoms? Symptomatic postmenopausal women will not be happy. While this study was not designed to answer this question, the evidence from HERS and the WHI suggest CVEs and VTE rates increase within a short period of time.   

Amiodarone and mortality among elderly patients with acute myocardial infarction with atrial fibrillation

Amiodarone was not independently associated with short-term or long-term mortality in elderly patients discharged after a hospitalization for AMI complicated by atrial fibrillation. Although our data suggest that amiodarone may be safe to use in this population, randomized controlled trial data are needed to confirm this finding.

Effect of atenolol on symptomatic ventricular arrhythmia without structural heart disease: A randomized placebo-controlled study

Atenolol improves symptoms and decreases PVC count from ambulatory monitoring. Placebo improved symptoms to the same extent as atenolol but had no effect on severity of VA. This might be the so-called placebo effect, which is a concern when treating patients or doing research on the effects of a drug.

Major outcomes in high-risk hypertensive patients randomized to angiotensin-converting enzyme inhibitor or calcium channel blocker vs diuretic: The Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT).

Thiazide-type diuretics are superior in preventing 1 or more major forms of CVD and are less expensive. They should be preferred for first-step antihypertensive therapy.

Accessory Pathway Localization by QRS Polarity in Children with Wolff-Parkinson-White Syndrome

AP characterization by QRS polarity in children with WPW syndrome is more diverse than in adults.

Inducible Ventricular Flutter and Fibrillation Predict for Arrhythmia Occurrence in Coronary Artery Disease Patients Presenting with Syncope of Unknown Origin

Ventricular fibrillation and ventricular flutter induced at electrophysiologic studies have prognostic significance for arrhythmia occurrence in patients presenting with syncope. These induced arrhythmias may not be as nonspecific as previously thought and treatment should be considered for these patients. 

Efficacy of Metoprolol and Sotalol in the Prevention of Recurrences of Sustained Ventricular Tachyarrhythmias in Patients with an Implantable Cardioverter Defibrillator

Metoprolol is as efficacious as sotalol in preventing VT/VF recurrences in patients with an ICD. 

Frequent and Prolonged Asymptomatic Episodes of Paroxysmal Atrial Fibrillation Revealed by Automatic Long-Term Event Recorders in Patients with a Negative 24-Hour Holter

In patients still complaining of palpitations after one negative 24-hour Holter, numerous, prolonged, and often asymptomatic episodes of PAF can be revealed by long-term automatic event recorders.

What Is the Minimal Pacing Rate that Prevents Torsades de Pointes? Insights from Patients with Permanent Pacemakers

Programmed lower rates ≤ 70 beats/min are not protective. At programmed lower rates > 70 beats/min, TP may occur only when facilitated by programmable pause-promoting features or oversensing.

Percutaneous Transcatheter Implantation of an Aortic Valve Prosthesis for Calcific Aortic Stenosis: First Human Case Description

Nonsurgical implantation of a prosthetic heart valve can be successfully achieved with immediate and midterm hemodynamic and clinical improvement.

Acute Results of Transvenous Cryoablation of Supraventricular Tachycardia (Atrial Fibrillation, Atrial Flutter, Wolff-Parkinson-White Syndrome, Atrioventricular Nodal Reentry Tachycardia)

This novel cryoablation system appears to be safe and can successfully treat different types of SVTs, including AF. Isolation of PVs is possible without producing stenosis.

A COMPARISON OF RATE CONTROL AND RHYTHM CONTROL IN PATIENTS
WITH ATRIAL FIBRILLATION

Management of atrial fibrillation with the rhythm-control strategy offers no survival advantage over the rate-control strategy, and there are potential advantages, such as a lower risk of adverse drug  effects, with the rate-control strategy.

A COMPARISON OF RATE CONTROL AND RHYTHM CONTROL IN PATIENTS WITH RECURRENT PERSISTENT ATRIAL FIBRILLATION

Rate control is not inferior to rhythm control for the prevention of death and morbidity from cardiovascular causes and may be appropriate therapy in patients with a recurrence of persistent atrial fibrillation after electrical cardioversion.

Risk associated with pregnancy in hypertrophic cardiomyopathy

Maternal mortality is increased in patients with HCM compared with the general population. However, absolute maternal mortality is low.

Demonstration of a Left Atrial Input to the Atrioventricular Node in Humans

The A-H interval prolonged as the site of pacing was progressively moved from the distal to the proximal coronary sinus. The mitral annulus provides a left atrial input to the human AV node.

Mercury, Fish Oils, and the Risk of Myocardial Infarction

The toenail mercury level was directly associated with the risk of myocardial infarction, and the adipose-tissue DHA level was inversely associated with the risk. High mercury content may diminish the cardioprotective effect of fish intake.

Association of cholesterol levels, hydroxymethylglutaryl coenzyme-a reductase inhibitor treatment, and progression of aortic stenosis in the community

In the community, progression of AS shows no trend of association with cholesterol levels. Statin treatment, however, is associated with slower progression, suggesting that the effects of statin treatment on progression of AS should be pursued with appropriate clinical trials.

Circadian and Seasonal Variation of Malignant Arrhythmias in a Pediatric and Congenital Heart Disease Population

In contrast to previously studied adult patients, fewer events occurred in the early morning (7.5%), with the most therapies occurring between 6 P.M. and midnight (35%). An increased frequency of therapies was observed in the fall and winter (September-January), representing 60% of all appropriate shocks. Unlike adult populations, Mondays did not have an increased frequency of malignant arrhythmias.

Response to Adenosine Differentiates Focal From Macroreentrant Atrial Tachycardia Validation Using Three-Dimensional Electroanatomic Mapping

Adenosine administered during AT (at doses sufficient to result in AV block) terminated or transiently suppressed focal AT in 33 of 35 cases, whereas 8 of 8 macroreentrant ATs were adenosine insensitive (P<0.001).

Coronary Bypass Graft Patency in Patients With Diabetes in the Bypass Angioplasty Revascularization Investigation (BARI)

Despite diabetic patients’ having smaller distal vessels and vessels judged to be of poorer quality, diabetes does not appear to adversely affect patency of IMA or vein grafts over an average of 4-year follow-up. Previously observed differences in survival between CABG-treated patients with and without diabetes may be largely a result of differential risk of mortality from noncardiac causes.

Characteristics and outcome among patients having out of hospital cardiac arrest at home compared with elsewhere

Of patients in whom the arrest took place at home, 11.3% were admitted to hospital alive, v 19.4% in the elsewhere group; corresponding figures for survival after one month were 1.7% v 6.2%. Sixty five per cent of out of hospital cardiac arrests in Sweden occur at home. Fewer than 2% were alive after one month.

Impact of age and sex on sudden cardiovascular death following myocardial infarction

Compared with non-SCD the risk of SCD is relatively highest in the younger age groups, but the absolute risk of SCD is much higher among the upper age groups than the younger. The risk of SCD was slightly lower in women but not enough to warrant a different treatment strategy.

Effect of ß-Blocking Therapy on Outcome in the Multicenter UnSustained Tachycardia Trial (MUSTT)

ß-Blockers were associated with decreased total mortality for the entire study population (5-year mortality 50% with ß-blockers versus 66% without ß-blockers. The mortality benefit associated with ß-blockers was present in patients with and without inducible tachycardia, except those treated with implantable defibrillators. There was no significant effect of ß-blocker therapy on the rate of arrhythmic death or cardiac arrest. ß-Blocking agents have beneficial effects on survival of patients having characteristics of those enrolled in the MUSTT trial. These effects do not appear to be due to a specific antiarrhythmic effect of ß-blockers. The beneficial effects of ß-blockers were demonstrable in all patients except those treated with implantable defibrillators.

Non–High-Density Lipoprotein Cholesterol Levels Predict Five-Year Outcome in the Bypass Angioplasty Revascularization Investigation (BARI)

HDL-C and LDL-C did not predict events during follow-up. Among patients with lipid values in BARI, non-HDL-C is a strong and independent predictor of nonfatal myocardial infarction and angina pectoris at 5 years, even after consideration of powerful clinical variables.

One-year mortality among unselected outpatients with heart failure

Among patients with reduced left ventricular ejection fraction, 1-year mortality was 14·3%, and predictors were similar except that female gender was no longer associated with reduced mortality. Unselected outpatients with heart failure have a poor prognosis, particularly those with advanced heart failure and a recent hospital stay for heart disease.

Comparative effects of permanent biventricular and right-univentricular pacing in heart failure patients with chronic atrial fibrillation

As compared with conventional VVIR pacing, effective biventricular pacing seems to improve exercise tolerance in NYHA class III heart failure patients with chronic atrial fibrillation and wide paced-QRS complexes.

Relation of Ejection Fraction and Inducible Ventricular Tachycardia to Mode of Death in Patients With Coronary Artery Disease: An Analysis of Patients Enrolled in the Multicenter Unsustained Tachycardia Trial

Both low ejection fraction and inducible tachyarrhythmias identify patients with coronary disease at increased mortality risk. Ejection fraction does not discriminate between modes of death, whereas inducible tachyarrhythmia identifies patients for whom death, if it occurs, is significantly more likely to be arrhythmic, especially if ejection fraction is 30%.

Sex-Based Differences in the Effect of Digoxin for the Treatment of Heart Failure

The effect of digoxin therapy differs between men and women. Digoxin therapy is associated with an increased risk of death from any cause among women (adjusted hazard ratio for the comparison with placebo, 1.23), but not men, with heart failure and depressed left ventricular systolic function.

Cardiac arrest and ventricular arrhythmia in patients taking antipsychotic drugs: cohort study using administrative data

The increased risk of cardiac arrest and ventricular arrhythmia in patients with treated schizophrenia could be due to the disease or its treatment. Overall, the risk with thioridazine was no worse than that with haloperidol. Thioridazine may, however, have a higher risk at high doses, although this finding could be due to chance. To reduce cardiac risk, thioridazine should be prescribed at the lowest dose needed to obtain an optimal therapeutic effect.

Effects of the Amount and Intensity of Exercise on Plasma Lipoproteins

The highest amount of weekly exercise, with minimal weight change, had widespread beneficial effects on the lipoprotein profile. The improvements were related to the amount of activity and not to the intensity of exercise or improvement in fitness.

Nonsurgical Reduction of the Interventricular Septum in Patients with Hypertrophic Cardiomyopathy

Nonsurgical septal reduction leads to sustained improvements in both subjective and objective measures of exercise capacity in association with a persistent reduction in resting and stress-induced left ventricular outflow tract gradients (resting gradient, from 64±36 to 16±15 mm Hg; P<0.001; stress-induced gradient, from 132±34 to 45±19 mm Hg; P<0.001). It is also associated with a high incidence of procedure-related complete heart block(27 percent), however, often requiring permanent pacing.

Aspirin and Mortality from Coronary Bypass Surgery

Early use of aspirin after coronary bypass surgery is safe and is associated with a reduced risk of death and ischemic complications involving the heart, brain, kidneys, and gastrointestinal tract.

Programmed Electrical Stimulation in Brugada Syndrome: How Reproducible Are the Results?

Ventricular arrhythmia inducibility in patients with Brugada syndrome, at variance with healthy controls, is high and does not correlate with clinical presentation. PES inducibility is deeply influenced by the protocol used.

Implantation Strategy of the Atrial Dipole Impacts Atrial Sensing Performance of Single Lead VDD Pacemakers

In a multivariate regression analysis, patient age >66 years, Pmin <0.6 mV, >1.3 mV and atrial dipole placement in the low right atrium were independently predictive for undersensing.

ST-Segment Deviation Following Implantable Cardioverter Defibrillator Shocks: Incidence, Timing, and Clinical Significance

ST-segment deviation following endocardial ICD shocks is a frequent phenomenon, occurring acutely and resolving during the first few minutes postshock. It may have no prognostic implications. 

Dual Chamber Pacing in Hypertrophic Cardiomyopathy: Long-Term Effects on Diastolic Function

Chronic DDD pacing reduces obstruction but impairs diastolic function in HCM. In patients with normal diastolic function, the untoward effects of pacing on diastolic function are more evident than in patients with abnormal diastolic function at baseline. This suggests that DDD pacing might be beneficial in a subgroup of patients with obstructive HCM and abnormal diastolic function. 

Long-Term Follow-Up Results of Tilt Training Therapy in Patients with Recurrent Neurocardiogenic Syncope

In only one patient syncope recurrence was observed during rather irregular tilt training therapy. Moreover, in 19 patients who abandoned tilt training after about 1 year, no syncope recurrence was reported during daily life, which suggests that the disturbed autonomic reflex activity in these patients may have been restored. 

Usefulness of Orthostatic Self-Training for the Prevention of Neurocardiogenic Syncope

Once a day training for up to 30 minutes was effective and easily accepted by the patients for the prevention of neurocardiogenic syncope. 

Oral vitamin K lowers the international normalized ratio more rapidly than subcutaneous vitamin K in the treatment of warfarin-associated coagulopathy. A randomized, controlled trial.

 BACKGROUND: Excessive anticoagulation due to warfarin use is associated with hemorrhage. Subcutaneously administered vitamin K has not been evaluated for the treatment of warfarin-associated coagulopathy, yet it is widely used. OBJECTIVE: To show that oral vitamin K is more effective than subcutaneous vitamin K in the treatment of warfarin-associated coagulopathy. DESIGN: Randomized, controlled trial. SETTING: Two teaching hospitals. PATIENTS: Patients with an international normalized ratio (INR) between 4.5 and 10.0. INTERVENTION: Warfarin therapy was withheld, and 1 mg of vitamin K was given orally or subcutaneously. MEASUREMENTS: The primary outcome measure was the INR on the day after administration of vitamin K. Secondary outcome measures were hemorrhage and thrombosis during a 1-month follow-up period. RESULTS: 15 of 26 patients receiving oral vitamin K and 6 of 25 patients receiving subcutaneous vitamin K had therapeutic INRs on the day after study drug administration (P = 0.015; odds ratio, 4.32 [95% CI, 1.13 to 17.44]). CONCLUSION: Oral vitamin K lowers INR more rapidly than subcutaneous vitamin K in asymptomatic patients who have supratherapeutic INR values while receiving warfarin.

Cumulative effect of complete left bundle-branch block and chronic atrial fibrillation on 1-year mortality and hospitalization in patients with congestive heart failure. A report from the Italian network on congestive heart failure (in-CHF database)

In patients with congestive heart failure, the contemporary presence of left bundle-branch block and atrial fibrillation was associated with a significant increase in mortality.

Functional abnormalities in patients with permanent right ventricular pacing: The effect of sites of electrical stimulation

This study demonstrates that preserved synchronous ventricular activation with RVOT pacing prevents the long-term deleterious effects of RVA pacing on myocardial perfusion and function in patients implanted with a permanent pacemaker.

Reproducibility of sequential head-up tilt testing in patients with recent syncope, normal ECG and no structural heart disease

The rate of positive responses decreases with sequential head-up tilt tests. The reproducibility of the cardioinhibitory responses is very poor. In contrast, the reproducibility of the negative responses is high.

Work stress and risk of cardiovascular mortality: prospective cohort study of industrial employees

High job strain and effort-reward imbalance seem to increase the risk of cardiovascular mortality. The evidence from industrial employees suggests that attention should be paid to the prevention of work stress.

Public Use of Automated External Defibrillators

Automated external defibrillators deployed in readily accessible, well-marked public areas in Chicago airports were used effectively to assist patients with cardiac arrest. In the cases of survivors, most of the users had no duty to act and no prior training in the use of these devices.

Emotional and Physical Precipitants of Ventricular Arrhythmia

Anger and physical activity can trigger ventricular arrhythmias in patients with ICDs. Future investigations of therapies aimed at blocking a response to these stressors may decrease ventricular arrhythmias and shocks in these patients.

Predictors of normotension on withdrawal of antihypertensive drugs in elderly patients: prospective study in second Australian national blood pressure study cohort

Age, blood pressure control, and the number of antihypertensive drugs are important factors in the clinical decision to withdraw drug treatment. Because of consistent rates of return to antihypertensive treatment, all patients from whom such treatment is withdrawn should be monitored indefinitely to detect a recurrence of hypertension.

Prognostic Significance of Nonsustained Ventricular Tachycardia Identified Postoperatively After Coronary Artery Bypass Surgery in Patients with Left Ventricular Dysfunction

In this population of patients with CAD and LV dysfunction, the occurrence of postoperative NSVT, especially within 10 days after CABG, portends a far better outcome than when it occurs in nonpostoperative settings. This suggests that in a such setting, NSVT represents a less specific risk factor for future events and should be considered when assigning risk and treatment of similar patients.

Is alternate daily dose of atorvastatin effective in treating patients with hyperlipidemia? The Alternate Day Versus Daily Dosing of Atorvastatin Study (ADDAS)

Although higher doses of atorvastatin were used on alternate days, these results suggest that the alternate-day administration of atorvastatin can produce a reduction in LDL-C comparable to that of daily administration in patients with hypercholesterolemia, and yet provide some cost savings.

Determinants of Successful Ablation of Idiopathic Ventricular Tachycardias with Left Bundle Branch Block Morphology from the Right Ventricular Outflow Tract

Some VTs with LBBB and inferior or normal axis cannot be ablated from the RVOT. The presence of an R wave in lead V1 associated with a precordial transition zone at lead V3 suggest that some VTs may not arise from the RVOT. 

Combined Use of Morphology Discrimination, Sudden Onset, and Stability as Discriminating Algorithms in Single Chamber Cardioverter Defibrillators

In single chamber ICDs a wide range of SE/SP ratios may be obtained by use of multiple discriminators, but use of the algorithm in a 2 of 3 diagnostic logic may achieve a SP of 90.9% and a SE of 96.0%. 

Septal q waves as an indicator of risk of mortality in elderly patients with chronic heart failure

Absence of the normal septal q wave on 12-lead electrocardiography, which may indicate structural heart disease and myocardial fibrosis, is an independent predictor of poor prognosis in elderly patients with CHF.

Addition of a Left Ventricular Lead to Conventional Pacing Systems in Patients with Congestive Heart Failure: Feasibility, Safety, and Early Results in 60 Consecutive Patients

Modification of RV pacing to a biventricular system using commercially available leads and adapters can be performed effectively and safely. The early results of this study suggest patients may benefit from this procedure with improved functional status and quality of life. 

Clinical benefits of low serum digoxin concentrations in heart failure

The beneficial effects of digoxin on common clinical end points in patients with HF were similar, regardless of SDC.

 Perspective: These findings confirm similar observations from the Digoxin Investigators Group (DIG) Trial. They demonstrate a clinical benefit of low serum levels, which lessens the risk/benefit relationship that has been ascribed to digoxin.

Efficacy and temporal stability of reduced safety margins for ventricular defibrillation. primary results from the low-energy safety study (LESS)

In patients with a contemporary biphasic, active-can ICD, a defibrillation safety margin of approximately 5 J above the DFT++ is safe and effective.

Perspective: Initial ICD shocks that have a relatively low energy but that are effective have the advantage of prolonging battery life and reducing the charge time, thereby decreasing the probability of syncope prior to delivery of a shock. However, because of the rigorous testing needed to arrive at a safety margin of 4–6 J, the results of this study may not have much impact on clinical practice.

Natural history of Brugada Syndrome. Insights for risk stratification and management

PVS is not useful for risk stratification in the BS. An ICD is appropriate for patients with the BS who have spontaneous ST-segment elevation in leads V1–V3 and who have had syncope.

Perspective: The results of this study differ markedly from the results of a recently-published study (Circulation 2002;105:73–8) in which PVS was found to be useful for risk stratification in the BS. Therefore, while it is clear that an ICD is appropriate for patients with syncope or cardiac arrest, the appropriate management of asymptomatic patients with the BS remains disconcertingly enigmatic.

A Retrospective Case Study to Assess the Value of the Implantable Loop Recorder for the Investigation of Undiagnosed Syncope

The implantable loop recorder was effective in making a cardiological or noncardiological diagnosis for unexplained syncope or presyncope in 52.1% of the patients. 

Cardiovascular effects of sildenafil during exercise in men with known or probable coronary artery disease: a randomized crossover trial

Implantable defibrillator event rates in patients with idiopathic dilated cardiomyopathy, nonsustained ventricular tachycardia on Holter and a left ventricular ejection fraction below 30%

Is electrical stimulation during administration of catecholamines required for the evaluation of success after ablation of atrioventricular node re-entrant tachycardias?

Oral contraceptives and the risk of myocardial infarction

Embolic complications of direct current cardioversion of atrial arrhythmias: association with low intensity of anticoagulation at the time of cardioversion

Improved suppression of recurrent atrial fibrillation with dual-site right atrial pacing and antiarrhythmic drug therapy

Myocardial Infarction in Parents Who Lost a Child: A Nationwide Prospective Cohort Study in Denmark

Warfarin, Aspirin, or Both after Myocardial Infarction

Incidence and Prognosis of Syncope

Management of Vasovagal Syncope: Controlling or Aborting Faints by Leg Crossing and Muscle Tensing

Wine Drinking and Risks of Cardiovascular Complications After Recent Acute Myocardial Infarction

Prognostic value of baseline electrophysiology studies in patients with sustained ventricular tachyarrhythmia: The Antiarrhythmics Versus Implantable Defibrillators (AVID) trial

Management and outcome of patients with atrial fibrillation during acute myocardial infarction: the GUSTO-III experience

Role of echocardiography in the evaluation of syncope: a prospective study

Final Reports from the AHRQ Sudden Death Patient Outcomes Research Team: Risk of sudden versus non-sudden cardiac death in patients with coronary artery disease

Final Reports from the AHRQ Sudden Death Patient Outcomes Research Team: Life after a ventricular arrhythmia

Final Reports from the AHRQ Sudden Death Patient Outcomes Research Team: Overview of randomized trials of antiarrhythmic drugs and devices for the prevention of sudden cardiac death

Effect of Treatment for Chlamydia pneumoniae and Helicobacter pylori on Markers of Inflammation and Cardiac Events in Patients With Acute Coronary Syndromes South Thames Trial of Antibiotics in Myocardial Infarction and Unstable Angina (STAMINA)

Perceived Mental Stress and Mortality From Cardiovascular Disease Among Japanese Men and Women The Japan Collaborative Cohort Study for Evaluation of Cancer Risk Sponsored by Monbusho (JACC Study)

Nonexcitatory Stimulus Delivery Improves Left Ventricular Function in Hearts with Left Bundle Branch Block

Prevention of Ventricular Fibrillation by Cilostazol, an Oral Phosphodiesterase Inhibitor, in a Patient with Brugada Syndrome

Walking Compared with Vigorous Exercise for the Prevention of Cardiovascular Events in Women

Natural History of Asymptomatic Mitral Valve Prolapse in the Community

Coronary Sinus-Ventricular Accessory Connections Producing Posteroseptal and Left Posterior Accessory Pathways Incidence and Electrophysiological Identification

A Randomized and Controlled Pilot Trial of β-blockers for the Treatment of Recurrent Syncope in Patients with a Positive or Negative Response to Head-Up Tilt Test

Postpacemaker Implant Pericarditis: Incidence and Outcomes with Active-Fixation Leads

Prognostic Significance of Nonsustained Ventricular Tachycardia After Revascularization

Risk of Sudden Death After Successful Accessory Atrioventricular Pathway Ablation in Resuscitated Patients with Wolff-Parkinson-White Syndrome

Criteria for Pacemaker Explant in Patients Without a Precise Indication for Pacemaker Implantation

Clinical Study of the Laser Sheath for Lead Extraction: The Total Experience in the United States

Comparison of Stenting with Minimally Invasive Bypass Surgery for Stenosis of the Left Anterior Descending Coronary Artery

Long-Term Follow-Up After Radiofrequency Catheter Ablation of Ventricular Tachycardia: A Successful Approach?

Development of an Echocardiographic Method for Choosing the Best Fitting Single-Pass VDD Lead

Importance of Using Standard Rather Than Torso Surface Electrocardiographic Leads for Pacemapping at the Right Ventricular Outflow Tract

Irrigated Tip Catheter Ablation in Right Posteroseptal Accessory Pathways Resistant to Conventional Ablation