Catheter ablation may be more effective at easing persistent atrial fibrillation (AF) in heart failure patients than treatment with amiodarone, according to the preliminary results of a small randomized trial presented at the American Heart Association's 2010 Scientific Sessions.
Although catheter ablation is becoming a more frequently-used treatment of persistent AF in patients with heart failure, authors indicate no data exists comparing the efficacy of ablation versus amiodarone, an antiarrhythmic agent with a number of potentially serious side effects.
Study Finds Catheter Ablation Superior to Amiodarone in Treating AFib in HF Patients
The following analysis was written by Brian Maher in The Pipeline, the Advisory Board's technology blog.
New guidelines regarding appropriate use criteria for coronary CT angiography (CCTA) have recently been published by the American College of Cardiology (JACC, subscription may be required), in conjunction with several other cardiology and radiology organizations. Updating the guidelines from 2006, authors note the improvements in technology and clinical utilization which have led to an expansion of approved indications. The largest area of expansion includes the approval of indications for nearly all symptomatic patients with low-to-intermediate pre-test probability of coronary artery disease. The 2010 guidelines maintain that CCTA is still inappropriate to use as a screening tool in asymptomatic patients and in nearly all cases of individuals with high pre-test probability. While direct comparison with the previous 2006 guidelines is difficult due to the changes in wording and numbering of clinical scenarios, the authors contend the 2010 guidelines represent a more comprehensive set of indications for CCTA. While clinical guidelines certainly play a key role in determining how physicians will order exams, questions of how CCTA is introduced into current care pathways, procedure economics, and referral patterns play even greater roles.
Professional Societies Build Stronger Case for CCTA with Revised Appropriate Use Criteria
Today's cardiovascular marketplace is characterized by unprecedented competition, complex referral dynamics, and specialist shortages. These challenges have been further intensified by the economic recession. To gain insight into how these forces are affecting demand for cardiovascular services, we launched the Cardiovascular Roundtable 2010 Volumes Trends Survey. The survey compares volumes in the first half of 2010 with those from the first half of 2009 while exploring perceptions of how reform policies will impact future demand and profitability. We featured key findings below. For a more detailed analysis of the results, please attend the 2010 Cardiovascular Roundtable national meeting series.
Findings from the 2010 Cardiovascular Volumes Trends Survey