Dalhousie University

FRIDAY, Nov. 22, 2024 -- An initial strategy of catheter ablation leads to a lower risk for a composite primary end point than antiarrhythmic drug therapy among patients with ischemic cardiomyopathy and ventricular tachycardia, according to a study published online Nov. 16 in the New England Journal of Medicine to coincide with the American Heart Association Scientific Sessions 2024, held from Nov. 16 to 18 in Chicago. John L. Sapp, M.D., from Dalhousie University in Halifax, Nova Scotia, Canada, and colleagues randomly assigned 416 patients with previous myocardial infarction and clinically significant ventricular tachycardia to receive antiarrhythmic drug therapy (sotalol or amiodarone) or to undergo catheter ablation, performed within 14 days after randomization. Patients were followed for a median of 4.3 years. The researchers found that a primary end point occurred in 50.7 percent of the 203 patients assigned to catheter ablation and 60.6 percent of the 213 assigned to drug therapy (hazard ratio, 0.75). Among patients in the catheter ablation group, adverse events within 30 days included death and nonfatal adverse events (1.0 and 11.3 percent, respectively). Among patients assigned to drug therapy, adverse events attributed to antiarrhythmic drug treatment included death from pulmonary toxic effects and nonfatal adverse events (0.5 and 21.6 percent, respectively). "Catheter ablation and antiarrhythmic drug therapy can reduce the risk of recurrent ventricular tachycardia and implantable cardioverter-defibrillator shock, but both approaches are associated with adverse events and have imperfect efficacy," the authors write. "Determining when to use these therapies is an important clinical decision." Several authors disclosed ties to pharmaceutical companies, including Johnson & Johnson and Abbott, which provided research grants.

TUESDAY, Nov. 19, 2024 -- New research suggests that a procedure now regarded as Plan B when patients have episodes of rapid heartbeat after a heart attack should be the go-to treatment. Ablation is a minimally invasive procedure to treat abnormal electrical short circuits caused by a heart attack . These episodes -- called ventricular tachycardia (VT) -- are the most common cause of sudden cardiac death. Today, ablation is typically reserved for patients whose VT doesn't improve with medication, but research presented Saturday at an American Heart Association meeting in Chicago and published simultaneously in the New England Journal of Medicine suggests it may be a better first-line option. "For people who have survived a heart attack and developed VT, our findings show that performing a catheter ablation to directly treat the heart's abnormal scar tissue causing the arrhythmia, rather than prescribing heart rhythm medications that can affect other organs as well as the heart, provides better overall outcomes," said lead author Dr. John Sapp , assistant dean of clinical research at Dalhousie University in Halifax, Nova Scotia, Canada. "These results may change how heart attack survivors with ventricular tachycardia are treated." Heart attacks leave scar tissue, which sometimes contains surviving bits of heart muscle that create abnormal electrical circuits in the heart, he explained. These abnormal circuits cause a fast rhythm in the lower chambers of the heart. The rapid heartbeat, in turn, prevents the chambers from filling completely between beats, reducing the flow of blood throughout the body. Some patients are treated with an implantable defibrillator, which delivers a shock to restore a normal rhythm to the heart. While it may be lifesaving, it doesn't prevent VT, and anti-arrhythmia medications may make matters worse or damage other organs, Sapp said. When medication fails to help, ablation is already the go-to remedy. It uses radiofrequency energy to destroy the abnormal tissue causing VT, while leaving the rest of the heart undamaged. "We have previously shown that when a medication is not preventing episodes of BT, ablation has led to better outcomes than increasing the medications," Sapp said in a meeting news release. "Now we know that ablation is a reasonable option for first-line treatment." For the new study, his team followed 416 patients in three countries. All had repeated VT episodes and had implanted defibrillators. One group was prescribed an anti-arrhythmic medication, the other had ablation. They were followed for a median of 4.3 years, meaning half were monitored for less time, half for more. Researchers found that patients who received ablation were 25% less likely to die or have a VT episode requiring a defibrillator shock. This included having three or more VT episodes in one day, as well as those that went undetected by the implant and required hospital care. The study was too small to show a statistically significant effect on every important parameter, Sapp said, but patients treated with ablation had fewer defibrillator shocks for VT, fewer episodes of three or more VT in a single day and fewer VT episodes that the defibrillator missed. "Currently, cathether ablation is often reserved as a last-resort therapy when anti-arrhythmic medications fail or cannot be tolerated," Sapp said. "Now we know that ablation is a reasonable option for first-line treatment." He noted that the study did not determine which patients and characteristics would benefit more from one treatment or another. And, he said, results do not apply to patients whose heart scarring is caused by something other than a blocked artery. "We also note that, despite these treatments, the rate of VT episodes remained relatively high," Sapp added. "We still need more research and innovation to develop better treatments for these patients." Whatever your topic of interest, subscribe to our newsletters to get the best of Drugs.com in your inbox.

EATONTOWN, N.J., Oct. 28, 2024 /PRNewswire/ -- Prominently featured in The Inner Circle, Christopher C. Gillis, MD, FRCSC, FAANS is acknowledged as a Pinnacle Professional Member Inner Circle of Excellence for his contributions in Revolutionizing Spine Surgery with Minimally Invasive Techniques. Continue Reading Christopher C Gillis MD FRCSC FAANS Dr. Christopher C. Gillis, MD, FRCSC, FAANS, a prominent leader in spine surgery, is redefining the landscape of spinal health with his innovative approach to minimally invasive spine treatments and advanced spine navigation. Known for his expertise in motion-sparing spine treatments and spine deformity corrections, Dr. Gillis is at the forefront of a transformative era in spinal healthcare. Dr. Gillis's journey in medicine began with a Bachelor of Science in Biology from Dalhousie University, followed by an MD from the Schulich School of Medicine at the University of Western Ontario in 2008. His residency at the University of British Columbia laid a strong foundation for his career, which was further enhanced by advanced training in minimally invasive and complex spine surgery through a clinical fellowship at Rush University Medical Center in Chicago. His educational background equips him with a comprehensive understanding of spine surgery, from fundamental principles to cutting-edge techniques. As a Fellow of the Royal College of Surgeons of Canada (FRSCS) and the American Association of Neurological Surgeons (FAANS), Dr. Gillis is deeply involved in professional circles dedicated to advancing neurological and spinal health. His affiliations with the Congress of Neurological Surgeons (CNS) and its Spine and Peripheral Nerve subsection reflect his commitment to staying at the forefront of his field. Dr. Gillis has distinguished himself through pioneering work in minimally invasive spine techniques and his specialization in addressing spine deformities with minimal surgery. His dedication to advancing surgical methods is evident in his role as Spine Programs Medical Director and Assistant Professor at the Division of Neurosurgery, University of Nebraska Medical Center. Additionally, he serves as a Clinical Assistant Professor in the Department of Neurosurgery at New York University, where he contributes to the education and training of future neurosurgeons. With 26 peer-reviewed publications, 16 book chapters, and 12 international presentations, Dr. Gillis is recognized globally for his contributions to spine surgery. His research and insights are pivotal in shaping the future of spinal health, and his work continues to inspire and inform the medical community. Dr. Gillis's personal interests include playing bass guitar in a classic rock band, showcasing his diverse talents and interests beyond the operating room. His mentors, Dr. Dvorjak, Dr. Fessler, and Dr. Traynelis, have been instrumental in his professional development, guiding him towards excellence in his field. Married to Estelle, Dr. Gillis is grateful for her unwavering support throughout his career. As he looks to the future, Dr. Gillis remains dedicated to furthering advancements in minimally invasive spine surgery and spine robotics, always with a focus on achieving the best results with minimal intervention. Contact: Katherine Green, 516-825-5634, [email protected] SOURCE The Inner Circle WANT YOUR COMPANY'S NEWS FEATURED ON PRNEWSWIRE.COM? 440k+ Newsrooms & Influencers 9k+ Digital Media Outlets 270k+ Journalists Opted In GET STARTED