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(Circulation. 2006;114:869.)
© 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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SELECTIVE ATRIAL VAGAL DENERVATION GUIDED BY EVOKED VAGAL REFLEX TO TREAT PATIENTS WITH PAROXYSMAL ATRIAL FIBRILLATION, by Scanavacca et al. |
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Atrial fibrillation is a complex, multifaceted arrhythmia. Autonomic factors are involved in the initiation of some paroxysmal atrial fibrillation. Cardiac ganglionated plexuses containing sympathetic and parasympathetic nerves are clustered in epicardial fat pads where their injury has been suggested to contribute to the success of wide-area encircling pulmonary vein ablation. Using electrical stimulation during endocardial and percutaneous epicardial catheter mapping, Scanavacca and colleagues selectively targeted ganglionated plexuses for ablation in 10 selected patients who had clinical features of "vagally-mediated" atrial fibrillation. This approach was effective in 2 patients. The present study shows that ablation targeted to achieve autonomic modulation is feasible, and it provides perspective on the challenges involved. Further investigation and technological improvements will determine whether ablation will become an option for some types of atrial fibrillation. See p 876.
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THE ECONOMIC BURDEN OF ANGINA IN WOMEN WITH SUSPECTED ISCHEMIC HEART DISEASE: RESULTS FROM THE NATIONAL INSTITUTES OF HEALTH–NATIONAL HEART, LUNG, AND BLOOD INSTITUTE–SPONSORED WOMEN’S ISCHEMIA SYNDROME EVALUATION, by Shaw et al. |
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With spiraling health care costs, there is increasing interest in characterizing resource consumption of various groups as a means of directing policy-based interventions to improve care. Until recently, women with heart disease were a generally overlooked group, and recent studies are indicating that women with coronary artery disease frequently require repetitive care and have a substantial risk of adverse outcomes. To provide perspective on the resource consumption of this group, investigators from the National Institutes of Health–National Heart, Lung, and Blood Institute–sponsored Women’s Ischemia Syndrome Evaluation (WISE) study estimated the societal economic burden for coronary artery disease care for women enrolled in their study. They also examined the importance of the absence of obstructive coronary disease in predicting
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