Post-Op Atrial Fibrillation Treatment Methods Deemed Equally Efficient

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jamie stanos cardiac surgery

One of the most common complications that patients endure after undergoing cardiac surgery is postoperative atrial fibrillation. The unfortunate reality is that the condition can occur in up to 50% of post-op patients, and it can lead to everything from multiple hospitalizations to long-term mortality. There are currently two different approaches that cardiologist can take when addressing postoperative atrial fibrillation.

The two methods are rate control and  rhythm control, and researchers at the Cleveland Clinic recently carried out a large-scale randomized control clinical trial to determine which of the two methods was more effective.

Postoperative atrial fibrillation is a common complication of cardiac surgery and adversely affects patient recovery. In patients with postoperative atrial fibrillation, one strategy does not appear to have a net clinical advantage over the other, but there are clinical differences between these strategies. The results of this trial fill an important knowledge gap and should better inform therapeutic decisions for this common complication,”  – Annetine C. Gelijns, Ph.D.

When the rate control method is implemented, the heart rate is slowed down via medication.

When the rhythm control method is being used, the heart’s normal rhythm is restored through electrical shock.

Through their research, they determined that neither was better; the rate control and rhythm control methods are equally effective. Marc Gillinov, MD of the Sydell and Arnold Miller Family Heart & Vascular Institute noted that these results create a case for creating a standardized strategy of starting with rate control first, to avoid the toxicity risk related to the rhythm control agents.

Dr. Gillinov and his team studied 2,109 patients that elected to have cardiac surgery. 40% of the patients had coronary artery disease, 40% had heart valve disease, and the remaining 20% had a combination of the two conditions.  696 of the patients developed post-op atrial fibrillation, and 75% of those patients received randomized treatment (rhythm or rate control).

The results for both treatments were interesting:

  • The number of dates that all of the patients stayed in the hospital after receiving the treatment was equivalent
  • If the patients experienced serious adverse effects, they were similar between the two methods.
  • The differences that did occur between the two treatments ended up cancelling eachother out:
    • The rhythm control medication worked more quickly, but the side effects were so harsh that patients needed to switch treatments
    • Rate control treatment had a higher re-occurance rate

But, neither could be deemed more effective than the other.

 

To see the source article for this blog post click: here

 

New Sequencing Panel Allows For Detection of 174 Genes Related to Heart Disease

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genetics

 

From a genetic standpoint, one of the most commonly inherited diseases is heart diseased. Nearly 1% of the population is affected by inherited heart disease, but up until now, the testing process for the inherited genes has been extraordinarily difficult.

A sequencing panel has been developed that has the potential to change the face of cardiology for the better. In the past, testing for genetic signals of heart disease was a costly and unwieldy process. When trying to determine whether or not a patient’s heart conditions were genetic (or to determine what the genetics were that caused an inherited condition), medical professionals were limited to very specific tests that only focused on singular genes. It was impossible to efficiently test, and if the specific tests were inconclusive, then researchers and doctors would be forced to “serial test”, with the hopes of stumbling upon a solution.

The company Illumina has eliminated some of that inherent struggle with their development of TruSight. TruSight is sequencing panel that focuses specifically on genes that are associated with heart conditions. Trusight Cardio has made 174 genes associated with cardiac conditions available to be tested for, and Illumina has worked to include casual variants of the genes as well. This means that both “core genes” and genes that were considered emerging genes were included in the panel.

The senior product manager for Illumina’s generic health business was quoted saying:

“Existing gene panels for profiling genes related to inherited cardiac conditions tend to be smaller in size, leading to revalidation of bespoke panels, or having to send out tests when a particular set of genes are not available”.

Ilumina’s goal was to create a more flexible space for cardiologists and researchers.  With their new sequencing panel, clinical researchers now have the ability to see as many genes as they felt were necessary for the research situation at hand. Not only was there an increase in the availability of genes, but Illumina in the year of development, they also successfully created TruSight to have a quick turnaround in labs, and a reasonably low price point.

TruSight will make for a much more effective diagnosis process, and will inevitably save a great deal of time, money, and lives in the long term.

 

To see the articles that were used as resources, click here & here