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Clinical Cardiology Alert – December 1, 2018

December 1, 2018

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  • Study Adds Complexity to Post-TAVR Anticoagulation

    In this large contemporary, prospective transcatheter aortic valve replacement registry, oral anticoagulation appears to be protective against valve degeneration but is associated with increased mortality. The strongest predictors of mortality at three years were male gender, renal failure, and atrial fibrillation.

  • Detection of Prosthetic Heart Valve Endocarditis

    A multicenter, retrospective, observational study of patients undergoing 18F-fluorodeoxyglucose PET/CT for prosthetic valve endocarditis or other indications showed that if certain obvious confounders are excluded, this imaging technique offers a high degree of accuracy for diagnosing prosthetic valve endocarditis, especially if performed early in the course of the disease.

  • Mitral Annulus Disjunction and Ventricular Arrhythmias

    A patient cohort with mitral annular disjunction (MAD) identified by echo was characterized clinically and by MRI. Ventricular arrhythmias were common in MAD patients and related to the degree of MAD and papillary muscle fibrosis by MRI but not the presence of mitral valve prolapse.

  • Early Identification of Cardiac Amyloidosis in Carpal Tunnel Surgery Patients

    In a cohort of older patients undergoing carpal tunnel release surgery, an analysis of tenosynovial tissue revealed amyloid deposits in 10% of patients. This development may facilitate early diagnosis of cardiac amyloidosis.

  • A Review of Updated Guidelines Regarding Bradycardia and Cardiac Conduction Delay

    The American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society have established updated guidelines on the evaluation and management of patients with bradycardia and conduction delays. Many key elements remain largely unchanged from prior guideline recommendations on pacemakers published in 2008 and 2012, but there also are important new definitions, recommendations, and areas of emphasis.