Circulation. 2006;114:1669
(Circulation. 2006;114:1669.)
© 2006 American Heart Association, Inc.
Issue Highlights
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RESULTS FROM THE LOIRE-ARDÈCHE-DRÒME-ISÈRE-PUY-DE-DÒME (LADIP) TRIAL ON ATRIAL FLUTTER, A MULTICENTRIC PROSPECTIVE RANDOMIZED STUDY COMPARING AMIODARONE AND RADIOFREQUENCY ABLATION AFTER THE FIRST EPISODE OF SYMPTOMATIC ATRIAL FLUTTER, by Da Costa et al.
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Right atrial flutter is often recurrent despite antiarrhythmic
drug therapy. It is effectively managed with catheter ablation,
but atrial fibrillation, which may also warrant antiarrhythmic
therapy, emerges in a substantial portion of patients during
follow-up. Da Costa and colleagues conducted a randomized trial
to compare catheter ablation to chronic therapy with amiodarone
in elderly patients after their first episode of atrial flutter.
Ablation was extremely effective in preventing recurrent atrial
flutter, and was more effective than amiodarone. During follow-up
treatment, amiodarone did not significantly lower the incidence
of atrial fibrillation as compared with catheter ablation of
the atrial flutter. These data support catheter ablation as
a reasonable first line therapy for common right atrial flutter
in the elderly. Whether such an approach would translate into
less antiarrhythmic drug toxicity and fewer hospitalizations
compared with cardioversion or other antiarrhythmic drug therapies
warrants further study. See p
1676.
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GENE TRANSFER OF A SYNTHETIC PACEMAKER CHANNEL INTO THE HEART: A NOVEL STRATEGY FOR BIOLOGICAL PACING, by Kashiwakura et al.
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The use of ion-channel gene therapy for creating biological
pacemakers has been an area of great interest, as electronic
devices have limited longevity and are prone to lead failure,
particularly in younger patients. Recent studies have used either
the natural or genetically-modified hyperpolarization-activated
nucleotide-gated channel gene in different animal models of
sinus node dysfunction or atrioventricular block. In this issue
of
Circulation, Kashiwakura et al report their results of experiments
using a novel bioengineered human Kv1.4 depolarization-activated
potassium channel that functioned as a hyperpolarization-activated
nonselective channel in guinea pigs. They demonstrate spontaneous
electrical activity after transfection into the heart both in
vitro on cellular preparations and in vivo by ECG. This synthetic
pacemaker channel may allow more adaptability in heart rate
control. Although biological pacemakers are not ready to replace
electronic pacemakers, these studies further our understanding
of cardiac impulse generation and demonstrate advances in gene
therapy for electrophysiological abnormalities. See p
1682.
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POTENT REDUCTION OF APOLIPOPROTEIN B AND LOW-DENSITY LIPOPROTEIN CHOLESTEROL BY AN ANTISENSE INHIBITOR OF APOLIPOPROTEIN B, by Kastelein et al.
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Over the last 2 decades, there has been a revolution in our
understanding of gene regulation. Nevertheless, there has been
little application of this understanding to clinical medicine.
In this issue, Kastelein and colleagues describe the use of
a relatively new technique, administration of antisense nucleotides,
to modulate circulating low-density lipoprotein levels. This
report represents an important milestone in the application
of molecular techniques to patient care and cardiovascular medicine.
See p
1729.
Visit http://circ.ahajournals.org:
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Images in Cardiovascular Medicine
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Bilateral Sinus of Valsalva Aneurysms: An Extreme Case. See
p
e542.
Takayasu’s Arteritis: The "Macaroni Sign." See p e544.
Vieussens’ Ring: Combining Computed Tomography Coronary Angiography and Magnetic Resonance Imaging in Assessing Collateral Pathways. See p e545.
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Correspondence
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See p
e547.
Related Articles:
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Bilateral Sinus of Valsalva Aneurysms: An Extreme Case
- Paraskevi A. Vlachou, Ian Loke, Derek Chin, Christina Vlachou, Christos Alexiou, Andrzej W. Sosnowski, Iain B. Squire, and Richard Keal
Circulation 2006 114: e542-e543.
[Extract]
[Full Text]
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Takayasu’s Arteritis: The "Macaroni Sign"
- S. Meini, V. De Franco, A. Auteri, and D. Pieragalli
Circulation 2006 114: e544.
[Extract]
[Full Text]
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Vieussens’ Ring: Combining Computed Tomography Coronary Angiography and Magnetic Resonance Imaging in Assessing Collateral Pathways
- Mark W. Hansen and Naeem Merchant
Circulation 2006 114: e545-e546.
[Extract]
[Full Text]
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Letter by Undas and Jakubowski Regarding Article, "Relationship Between Homocysteine and Mortality in Chronic Kidney Disease"
- Anetta Undas and Hieronim Jakubowski
Circulation 2006 114: e547.
[Extract]
[Full Text]
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Potent Reduction of Apolipoprotein B and Low-Density Lipoprotein Cholesterol by Short-Term Administration of an Antisense Inhibitor of Apolipoprotein B
- John J.P. Kastelein, Mark K. Wedel, Brenda F. Baker, John Su, JoAnn D. Bradley, Rosie Z. Yu, Emil Chuang, Mark J. Graham, and Rosanne M. Crooke
Circulation 2006 114: 1729-1735.
[Abstract]
[Full Text]
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Gene Transfer of a Synthetic Pacemaker Channel Into the Heart: A Novel Strategy for Biological Pacing
- Yuji Kashiwakura, Hee Cheol Cho, Andreas S. Barth, Ezana Azene, and Eduardo Marbán
Circulation 2006 114: 1682-1686.
[Abstract]
[Full Text]
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Results From the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) Trial on Atrial Flutter, a Multicentric Prospective Randomized Study Comparing Amiodarone and Radiofrequency Ablation After the First Episode of Symptomatic Atrial Flutter
- Antoine Da Costa, Jérôme Thévenin, Frédéric Roche, Cécile Romeyer-Bouchard, Loucif Abdellaoui, Marc Messier, Lucien Denis, Emmanuel Faure, Régis Gonthier, Georges Kruszynski, J. Marie Pages, Serge Bonijoly, Dominique Lamaison, Pascal Defaye, J. Claude Barthélemy, Thierry Gouttard, Karl Isaaz for the Loire-Ardèche-Drôme-Isère-Puy-de-Dôme (LADIP) Trial of Atrial Flutter Investigators
Circulation 2006 114: 1676-1681.
[Abstract]
[Full Text]
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RESULTS FROM THE LOIRE-ARDECHE...
GENE TRANSFER OF A...