LATEST IN ARRYTHMIA

ARRHYTHMIAS
The choice between rhythm control and rate control for patients with atrial fibrillation (AF) and heart failure can be challenging. In a trial of 81 patients with class II or III heart failure and symptomatic, drug-refractory atrial fibrillation (AF), ablation of the AF focus via pulmonary vein isolation (PVI) resulted in significant improvements in LVEF, exercise capacity, and symptoms compared with a rate control strategy employing AV node ablation and biventricular pacing .Myocardial infarction and pulmonary embolus are common causes of sudden cardiac death, and this has raised the question of whether fibrinolytic therapy should be incorporated into the cardiopulmonary resuscitation (CPR) protocol for cardiac arrest. A randomized placebo-controlled trial of 1050 patients with witnessed out-of-hospital cardiac arrest failed to show significant survival benefit of tenecteplase administered during CPR.Several antipsychotic medications block the cardiac myocyte's repolarizing potassium currents and prolong the QT interval. Their widespread use (including for conditions such as dementia, agitation, and affective disorders) and the potential for sudden death from torsades de pointes has led to concerns about the safety of these agents. Although "typical" antipsychotic drugs such as haloperidol and thioridazine have received much attention, a large retrospective cohort study found that treatment with "atypical" antipsychotics similarly increased the risk of sudden death in patients with psychosis .