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New and updated news items for
Medical Professionals Arrhythmia
Updated June 2009

NEW MADIT II CLINICAL DATA ANALYSIS SHOWS LONG-TERM SURVIVAL BENEFIT FOR IMPLANTABLE DEFIBRILLATOR THERAPY

Natick, MA (May 14, 2009) – Boston Scientific Corporation (NYSE: BSX) today announced that an analysis of long-term data from the MADIT II clinical study demonstrates that the life-saving benefits of implantable cardioverter defibrillator (ICD) therapy remain sustainable at eight years. This is the first time long-term data have been presented regarding the life-saving benefits of ICDs in a primary prevention population. The analysis was presented during a late-breaking session at the Heart Rhythm Society Scientific Sessions in Boston.

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Study finds link between atrial fibrillation and an increased risk of death in diabetic patients

Results from a large, international, randomised, controlled trial have shown that there is a strong link between diabetics who have an abnormal heart rhythm (atrial fibrillation) and an increased risk of other heart-related problems and death. The findings are published in Europe's leading cardiology journal, the European Heart Journal [1] today (Thursday 12 March).

The ADVANCE [2] study of 11,140 patients with type 2 diabetes found that patients who had atrial fibrillation (AF) at the start of the trial had a 61% increased risk of dying from any cause, a 77% increased risk of dying from cardiovascular causes such as a heart attack or stroke, and a 68% increased risk of developing heart failure or other cerebrovascular problems such as stroke, when compared with diabetic patients who did not have AF.

However, the study also found that if clinicians gave more aggressive treatments to the diabetic AF patients – in this study they treated them with a combination blood pressure lowering drugs, (perindopril and indapamide) – the risk of dying or developing any of these complications was reduced. It was also reduced in diabetic patients without AF who were given the same treatment.

Professor Anushka Patel, Director of the Cardiovascular Division at The George Institute for International Health (University of Sydney, Australia) and an Associate Professor in the Faculty of Medicine at the university, who led the study, said: "Active treatment produced similar relative benefits to patients with and without AF. However, because of their higher risk at the start of the study, the absolute benefit associated with active treatment was greater in patients with AF than without. We estimate that five years of active treatment would prevent one death among every 42 patients with AF and one death among every 120 patients without AF."

The findings have important implications for the management of diabetics and for policy in this area. Diabetes is a major global health problem, with an estimated worldwide prevalence of 2.8% in 2000, projected to increase to 4.4% in 2030. Atrial fibrillation is common in diabetic patients.

Prof Patel said: "The prevalence of AF varies greatly according to the population's age and other health problems. It ranges between 4% in primary care settings to 15% in hospitalised patients. In our study, 847 (7.6%) of the 11,140 patients had AF at baseline and a further 352 patients developed AF over an average follow-up of 4.3 years. The overall prevalence in this population was about 11%. There are data to suggest that the prevalence of AF in people with diabetes is about twice that among people without diabetes.

"The number of diabetic patients is projected to increase to 380 million at 2025. We might expect that about 40 million of these will also have AF. Thus the study findings have direct implications for a large number of individuals globally.

"This study informs clinicians that AF is a marker of greater risk of cardiovascular events and mortality among diabetics, both men and women. Such patients should have their cardiovascular risk factors, such as blood pressure and cholesterol, controlled more aggressively. This is a separate issue to rate and rhythm control (or the use of anticoagulants to prevent thromboembolic events), which is the usual therapeutic focus in patients with AF. These issues are important, but we believe our data suggest that heightened awareness and management of overall cardiovascular risk is also important.

"An example of this comes from the results of the blood pressure intervention in ADVANCE. Routine administration of a fixed combination of perindopril and indapamide to patients with type 2 diabetes resulted in 18% reduction of cardiovascular death and 14% reduction of death from any cause in both patients with and without AF. However, because of their higher baseline risks, patients with AF benefited more, in absolute terms."

The study also found that there was a significantly stronger association between AF and deaths from cardiovascular disease in women compared with men. Women with AF were twice as likely to die than women without AF, whereas men with AF were 50% more likely to die then men without AF. As healthy women normally have a lower risk of death from heart disease than do men of a similar age, this increased risk in diabetic women with AF meant that the women's rates of death matched those of the men.

Prof Patel pointed out that AF was frequently undetected in diabetic patients. "The current analysis highlights the importance of actively evaluating diabetic patients for the presence of AF, to identify those at particularly high risk of cardiovascular events. Routine administration of blood pressure-lowering treatment, as well as greater use of antiplatelet or anticoagulant agents and statins, may be expected to reduce the incidence of a broad range of adverse outcomes in these patients."

Notes:

[1] "Risks of cardiovascular events and effects of routine blood pressure lowering among patients with type 2 diabetes and atrial fibrillation: results from the ADVANCE study". European Heart Journal. doi:10.1093/eurheartj/ehp055.

[2] ADVANCE stands for Action in Diabetes and Vascular Disease: preterAx and diamicroN-MR Controlled Evaluation. The ADVANCE trial is the largest clinical trial on diabetes ever conducted. It is a multi-centre, randomised, placebo controlled study and involves 11,140 patients with type 2 diabetes from over 20 different countries in Asia, Australasia, Europe and North America.

ESC Congress 2008

A Selection of Webcasts from the ESC Congress
Realising that it is impossible to attend all of the Sessions on offer during the Congress, we have made a selection available online, which will be posted as they become available. Click here to view them all, including: Acute Coronary Syndromes , Heart Failure , Non-invasive imaging and much more.

News From Around the Congress

Channelopathies: Which Way to Go?
The management of channelopathies, which arise from mutations in the genes which encode for ion channels and which predispose individuals to potentially lethal ventricular tacharrhythmias, were the subject of a Seminar at the Congress.

Discussed were four cardiac channelopathies: Long QT syndrome, Brugada syndrome, Short QT and Catecholaminergic polymorphic ventricular tachycardia (CVPT). Read the full report here .

ESC Congress and Awards
As well as an opportunity to learn all you need to know about the latest developments in cardiology, the Congress is also a chance to recognise and celebrate the achievements of leaders in their respective fields. Several awards, including the Gold Medals, Moderated Poster Winners and the Atie Immink Award are all handed out .  

Video News
These videos offer you an overview of some of the main scientific information presented in Munich during the ESC Congress 2008. View highlights of Saturday 30 and Sunday 31 August, including Hot Line I Sessions BEAUTIFUL and GISSI-HF and cardiovascular imaging. Kim Fox and Jeroen Bax also point out the key points of ESC Congress 2008. More .

Press Releases:

• Antiangiogenic and Anti-Inflammatory Drugs: Are They Safe?
• Intima Media Thickness of the Carotid Artery  
• Transapical Aortic Valve Implantation  
• Biomarkers For Ischaemia and Necrosis - Simple Blood Tests to Detect Myocardial Infarction  
• Does Treatment of Depression Improve Prognosis After Heart Attack?  
• Impact of School Based Programs  

New ESC Guidelines

Heart Failure Guidelines: ESC Educational Course
Learn all about the new 2008 ESC Guidelines on Heart Failure. The HFA presents an educational course to take place on 16 and 17 October 2008 at the European Heart House in Sophia Antipolis, France. View the new guidelines here .  

• ESC Congress 2008 News: Contains a Selection of "ESC Congress News" Articles
• ESC Congress Reports: Hot Line Sessions and Clinical Trial Updates

OTHER NEWS

BIOTRONIK to Supply ICD Technology to Cardio3 BioSciences for C ...
PresseBox (Pressemitteilung) - Germany
... in wireless remote monitoring technology for patients with cardiac devices, ... an implantable cardioverter defibrillator (ICD) with Home Monitoring®. ...

MP3 player headphones may hinder pacemakers
Canada.com - Don Mills, Ontario , Canada
By Will Dunham, Reuters WASHINGTON (Reuters) - Headphones used with MP3 digital music players like the iPod may interfere with heart pacemakers and ...

St Jude Medical wins CE Mark for new cardiac pacemakers
TMC Net - Norwalk , CT , USA
In addition, the Anthem RF cardiac resynchronization therapy pacemaker and Accent RF pacemaker include advanced automatic features that help to promote ...

New HRS/EHRA recommendations for ablation of ventricular arrhythmias
TheHeart.Org - New York , NY , USA
The recommendations, from a task force of the Heart Rhythm

Medtronic warns of defect with 37000 pacemakers
Washington Post - United States
AP WASHINGTON -- Medtronic is warning doctors that 37000 of its pacemakers may have wiring defects that can cause them to malfunction. ...

Medtronic Plans Job Cuts as Earnings Decline 69%
Wall Street Journal - USA
Leerink Swann analyst Rick Wise said the defibrillator and pacemaker business suffers a "hangover from product recalls" and that the spine business "has ...

Medtronic Drops on Pacemaker Warning, Job Cuts, Profit Forecast
Bloomberg - USA
By Shannon Pettypiece May 19 (Bloomberg) -- Medtronic Inc. fell the most in two months in New York trading after warning some heart pacemakers may have to ...

Medtronic Warns of Potential Pacemaker Problems
Attorney at Law - USA
Medtronic Inc., a leading maker of pacemakers and defibrillators, is warning about the potential for problems from faulty wiring in about 37000 of its older ...

Warning issued on faulty pacemakers
News.gov.hk - Hong Kong
The Department of Health warns some Medtronic Kappa and Sigma pacemakers may fail due to wire separation. Medtronic International said the models in ...

Irregular heartbeat linked to increase risk of dementia: researchers
Telegraph.co.uk - United Kingdom
People with both atrial fibrillation and dementia were 61 per cent more likely to die during the five year study than dementia patients without the heart ...

eCardio Launches NEW Atrial Fibrillation Information System (AFIS(TM))
PR Newswire (press release) - New York,NY,USA
AFIS(TM) is an informatics solution that presents a longitudinal view of atrial fibrillation and tachyarrhythmic patients for teaching, research or clinical ...

MEDICAL DEVICE ALERT
DEVICE: Automatic external defibrillator: Welch Allyn AED 10 (previously branded as MRL JumpStart). Specific serial numbers are affected.
Used in hospitals, ambulances and public places.

US-based St. Jude Medical to release 20 devices in Japan in 2009
Trading Markets (press release) - Los Angeles,CA,USA
JUDE MEDICAL INC. plans to introduce 20 new pacemakers and implantable cardioverter defibrillator (ICD) products in Japan during 2009. One such new product, ...

Boston Scientific CEO Expects Heart -Failure Study Success
CNNMoney.com - USA
The "Madit-CRT" study could be done in time for results to be released at the Heart Rhythm Society's conference in mid-May, company CEO Jim Tobin added ...

UTMC doctor helps diagnose and treat sudden fainting spells

Transient loss of consciousness 1: causes and impact of misdiagnosis
Nursing Times - UK
A more serious type of syncope can occur in children, although it is rare - reflex anoxic seizures or reflex asystolic syncope (RAS), also referred to as ...

MHRA - Faulty Equipment?
Do you have any equipment that you have bought yourself or that has been given or
supplied to you by a GP’s surgery, hospital, pharmacy,optometrist or clinic?
If it goes wrong ...... the MHRA need to know
View poster

Medtronic Data Presented at American Heart Association Scientific ...
Earthtimes (press release) - London,UK
Several landmark clinical trials have proven the benefits of ICD therapy; most recently, the Medtronic-supported SCD-HeFT ( Sudden Cardiac Death in Heart ...

Medtronic Announces Key Activities at American Heart Association ...
PR-Inside.com (Pressemitteilung) - Wien,Austria
Implantation of the Medtronic Melody Transcatheter Pulmonary Valve in Patients with Dysfunctional Right Ventricular Outflow (RVOT) Conduits: Procedural and ...

Launch Of The Sudden Cardiac Death Pathology Database, UK
Medical News Today (press release) - UK
In most middle-aged and older adults, sudden cardiac death is caused by coronary artery disease. In contrast, sudden cardiac death in individuals aged less ..

Pacemaker that is recharged by the heart is developed by scientists
Daily Mail - UK
By David Derbyshire A pacemaker that gets some of its power from the heart it is helping has been developed by British scientists. ...
The media release entitled "Launch Of The Sudden Cardiac Death Pathology Database, UK " will be published on two of our websites:
http://www.medicalnewstoday.com
http://www.medilexicon.com

Other links for the media release entitled "Launch Of The Sudden Cardiac Death PathoIogy Database UK currently running in the media reporting on the potential for MP3 player headphones to interfere with implanted pacemakers and ICDs are:
http://www.reuters.com/article/marketsNews/idINN0940463220081109?rpc=44
http://www.dailymail.co.uk/health/article-1084346/MP3-earphones-prove-fatal-heart-patients-says-report.html
http://www.telegraph.co.uk/news/newstopics/politics/health/3411300/Personal-headphones-could-cause-pacemakers-to-malfunction-study-warns.html

Below is Medtronic's information on MP3 players.

Medtronic Data Presented at American Heart Association Scientific ...
PR-USA.net (press release) - Varna , Bulgaria
Amiodarone or an implantable cardioverter-defibrillator for congestive heart failure. N Engl J Med 2005;352:225-37. [Erratum, N Engl J Med 2005;352:2146. ..

Launch Of The Sudden Cardiac Death Pathology Database, UK
Medical News Today (press release) - UK
Chapter 8 of the Department of Health's National Service Framework for CHD, launched in 2005 and covering arrhythmias and sudden cardiac death, ...

Key Opinion:

BEAUTIfUL
By: Sidney Goldstein
The importance of the bradycardic effect of beta blockade in heart failure is now being tested with the development of drugs such as ivabradine that can slow the heart by inhibiting the If current in the sinoatrial node. Sidney Goldstein discusses the results of the BEAUTIfUL trial, which provides insight into the potential of these drugs in the treatment of patients with heart failure.

Editorial:

Chest compression-only for cardiac arrest?
By: Douglas Chamberlain
The long-held norm for the resuscitation of cardiac arrest victims has involved both chest compressions and mouth-to-mouth ventilation. However, recent evidence has questioned whether compression-only resuscitation should be taught. Douglas Chamberlain, Honorary Professor of Resuscitation Medicine, Cardiff University , UK , reviews the arguments relevant to this controversy.