Cardiac CT in the Emergency Department.
Cardiol Clin. 2012 Feb;30(1):117-33
…

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Diagnostic approach to peripheral arterial disease.
Cardiol Clin. 2011 Aug;29(3):319-29
Authors: Azam SM, Carman TL
This article discusses diagnostic imaging techniques used in the evaluation and management of patients…

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Medical management of the patient with intermittent claudication.
Cardiol Clin. 2011 Aug;29(3):363-79
Authors: Vodnala D, Rajagopalan S, Brook RD
Intermittent claudication (IC) due to peripheral arterial disease (PAD) …

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Prosthetic heart valves.
Cardiol Clin. 2011 May;29(2):229-36
Authors: Longnecker CR, Lim MJ
The first prosthetic valve was implanted by Hufnagel in 1952 in a patient with aortic insufficiency. Since then, prosthetic va…

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Epidemiology of cardiorenal syndrome.
Cardiol Clin. 2011 May;29(2):301-14
Authors: Mentz RJ, Lewis EF
The interdependence of cardiac and renal dysfunction has emerged as a focus of intense interest in heart failure man…

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Atrial fibrillation in congestive heart failure: current management.

Cardiol Clin. 2009 Feb;27(1):79-93, viii-ix

Authors: Boyle NG, Shivkumar K

Atrial fibrillation (AF) and congestive heart failure are common conditions and each predisposes to the development of the other. Basic research using animal models of the two conditions continues to yield insights that may improve therapies. The role of medical therapies aimed at the underlying structural changes in AF continues to be a subject of ongoing studies. Cardiac resynchronization therapy is effective in appropriately selected patients with both sinus rhythm and AF. Catheter ablation is emerging as a potential alternative to antiarrhythmic drug therapy, but large randomized trials will be needed to assess its role.

PMID: 19111766 [PubMed - indexed for MEDLINE]

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Anticoagulation: stroke prevention in patients with atrial fibrillation.

Cardiol Clin. 2009 Feb;27(1):125-35, ix

Authors: Waldo AL

It is well recognized that during atrial fibrillation (AF), clots may form in the left atrium, which may embolize and cause ischemic stroke or systemic embolism. The presence of AF confers a fivefold increased risk for stroke. AF is the most common and important cause of stroke. This article considers the risks for and anticoagulation prophylaxis against embolic stroke in patients who have AF.

PMID: 19111769 [PubMed - indexed for MEDLINE]

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Management of heart failure: a brief review and selected update.

Cardiol Clin. 2008 Nov;26(4):561-71

Authors: Unzek S, Francis GS

Despite innovative medications and devices, heart failure (HF) continues to be the leading cause for admission to hospitals in the United States in patients older than 65 years. Many trials have succeeded in improving survival and many have failed. In this article, the authors briefly review the past, describe the present, and speculate about future HF trials.

PMID: 18929231 [PubMed - indexed for MEDLINE]

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Ranolazine: new paradigm for management of myocardial ischemia, myocardial dysfunction, and arrhythmias.

Cardiol Clin. 2008 Nov;26(4):603-14

Authors: Stone PH

Ranolazine, which was approved by the US Food and Drug Administration in January 2006, provides a mechanism of action to treat ischemia that has not hitherto been available. Ranolazine is effective in reducing manifestations of ischemia and angina, and it also holds potential promise to be effective in the management of left ventricular dysfunction, particularly diastolic dysfunction, and arrhythmias. This article provides an update on the available studies concerning the value of ranolazine across the spectrum of cardiovascular disease.

PMID: 18929234 [PubMed - indexed for MEDLINE]

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Anticoagulants in coronary artery disease.

Cardiol Clin. 2008 Nov;26(4):615-28

Authors: Lee LV

Anticoagulant therapy for acute coronary syndromes is becoming more complex as newer agents are added to unfractionated heparin and warfarin. The anticoagulants used in current clinical practice are low molecular weight heparins, direct thrombin inhibitors, and heparinoids. Properties of and recent clinical trial data regarding these newer anticoagulants are reviewed in reference to current American College of Cardiology/American Heart Association guidelines.

PMID: 18929235 [PubMed - indexed for MEDLINE]

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Problems with implantable cardiac device therapy.

Cardiol Clin. 2008 Aug;26(3):441-58, vii

Authors: Kowalski M, Huizar JF, Kaszala K, Wood MA

Implantable cardioverter-defibrillators (ICDs) improve survival in patients who have left ventricular dysfunction; however, they are associated with numerous problems at implant and during follow-up. The diagnosis and management of these problems is usually straightforward, but more difficult problems may include the management of patients who have elevated energy requirements to terminate ventricular fibrillation or of those who have postoperative device infections. Long-term issues in ICD patients include the occurrence of inappropriate or frequent appropriate shocks. ICD generators and leads are more prone to failures than are pacing systems alone; management of patients potentially dependent on “recalled” devices to deliver life-saving therapy is a particularly complex issue. The purpose of this article is to review the diagnosis and management of these more troublesome ICD problems.

PMID: 18538190 [PubMed - indexed for MEDLINE]

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A comprehensive approach to management of ventricular arrhythmias.

Cardiol Clin. 2008 Aug;26(3):481-96, vii

Authors: Kusumoto F

This review presents five cases that highlight the complexity of taking care of patients with ventricular arrhythmias. Three of the cases discuss management of patients with nonsustained ventricular tachycardia in the setting of structural heart disease: dilated cardiomyopathy, hypertrophic cardiomyopathy, and after myocardial infarction. A fourth case asks whether data from implantable cardioverter defibrillator (ICD) trials can be extrapolated to older patients, and the fifth case discusses management of recurrent ventricular arrhythmias in a patient with an ICD.

PMID: 18538192 [PubMed - indexed for MEDLINE]

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Ventricular arrhythmias in normal hearts.

Cardiol Clin. 2008 Aug;26(3):367-80, vi

Authors: Latif S, Dixit S, Callans DJ

Ventricular tachycardia in the structurally normal heart accounts for approximately 10% of cases. Although the overall prognosis is relatively good, with a benign course in most patients, these arrhythmias can lead to significant symptoms. Our understanding of these arrhythmias has progressed significantly, leading to effective therapies targeting their underlying mechanism. In many cases, catheter ablation is successful and the therapy of choice in patients who have sufficient symptoms. This article reviews outflow tract, idiopathic left ventricular, and automatic ventricular tachycardias.

PMID: 18538185 [PubMed - indexed for MEDLINE]

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Ventricular arrhythmias in heart failure patients.

Cardiol Clin. 2008 Aug;26(3):381-403, vi

Authors: Lo R, Hsia HH

Ventricular arrhythmia represents a significant cause of mortality and morbidity. Its pathophysiologic mechanisms and electroanatomic substrates are slowly being elucidated. Clinical management in patients with heart failure has progressed from antiarrhythmic drugs to device therapy. Catheter ablation is an effective adjunct in the management of ventricular arrhythmia but remains a significant challenge. Advances in robotic and magnetic catheter manipulation may shorten procedural time and increase safety. Incorporation of imaging technologies such as CT, MRI, or ultrasound with electroanatomic mapping can enhance the ability to map and ablate ventricular arrhythmia. Novel imaging modalities may provide rapid characterization of the substrate for ventricular dysfunction and arrhythmia development and the capacity for serial assessment of the disease progression, improving risk stratification for ventricular dysfunction and arrhythmia development and the capacity for serial assessment of the disease progression, improving risk stratification.

PMID: 18538186 [PubMed - indexed for MEDLINE]

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Role of drug therapy for sustained ventricular tachyarrhythmias.

Cardiol Clin. 2008 Aug;26(3):405-18, vi

Authors: Mitchell LB

Antiarrhythmic drug therapy, broadly defined, is the mainstay of treatment and prevention of ventricular tachycardia (VT)/ventricular fibrillation (VF), which can lead to sudden death. This article evaluates the evidence for and appropriate use of class I antiarrhythmic drugs, class III antiarrhythmic drugs, beta-blockers, nondihydropyridine calcium-channel blockers, statins, angiotensin enzyme inhibitors, angiotensin receptor blockers, aldosterone blockers, and digoxin for antiarrhythmic benefits in patients who have a propensity for VT/VF and therefore are at risk of sudden death.

PMID: 18538187 [PubMed - indexed for MEDLINE]

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