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(Circulation. 2006;114:2089.)
© 2006 American Heart Association, Inc.
Issue Highlights
An extract of the first 250 words of the full text is provided, because this article has no abstract. |
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GENOTYPE-SPECIFIC ONSET OF ARRHYTHMIAS IN CONGENITAL LONG-QT SYNDROME: POSSIBLE THERAPY IMPLICATIONS, by Tan et al. |
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Mutations in a variety of different proteins cause the long-QT syndrome (LQTS), which may result in syncope or sudden death because of the polymorphic ventricular tachycardia, torsade de pointes. It has long been recognized that a pause that further lengthens the QT interval initiates some but not all episodes of torsade de pointes. In this issue of Circulation, Tan and colleagues analyzed spontaneous initiation of torsade de pointes in genotyped LQTS subjects. Interestingly, in the 2 most common forms of LQTS, a pause-dependent onset was characteristic of LQT2 but was often absent for LQT1. The abnormal current (IKr) in LQT2 is also the most common target of drug-induced torsade de pointes, which is typically pause dependent. This heterogeneity suggests different arrhythmia mechanisms in the 2 most common forms of congenital LQTS and has potential implications for clinical recognition of the genotype and for therapy, such as pacing, to prevent torsade de pointes. See p 2096.
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CONTEMPORARY IMPACT OF STATE CERTIFICATE-OF-NEED REGULATIONS FOR CARDIAC SURGERY: AN ANALYSIS USING THE SOCIETY OF THORACIC SURGEONS’ NATIONAL CARDIAC SURGERY DATABASE, by DiSesa et al. |
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Certificate-of-need regulation is an approach employed by some states to control the utilization of high-cost procedures. Investigators DiSesa et al have made use of the Society for Thoracic Surgeons’ National Cardiac Surgery Database to determine whether certificate-of-need regulations influence coronary bypass surgery volumes and risk-adjusted mortality rates. The investigators compared 26 states and the District of Columbia, which had certificate-of-need regulations during 2000–2003, with the other nonregulated states. The authors report that certificate-of-need regulation was associated with a higher operation volume per hospital, but was not associated with a reduction in
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