At doses similar to those tested clinically, vernakalant dose-dependently prolonged atrial refractoriness, prolonged AV nodal conduction and refractoriness, and slightly prolonged QRS duration, but it had no effect on ventricular refractoriness.
This type of symptom severity scale, like the New York Heart Association Functional Class for heart failure symptoms and the CCS Functional Class for angina symptoms, trades precision and comprehensiveness for simplicity and ease of use at the bedside. A common language to quantify AF severity may help to improve patient care.
This article addresses the feasibility and safety of ICD therapy in patients >80 years of age. Recent trials have expanded the indication for ICD implantation to include an increasing number and variety of patients. The feasibility of ICD implantation in elderly patients has not been adequately studied. A prospectively collected single center ICD database was analyzed to assess the safety and feasibility of ICD implantation in elderly patients. Patients were divided based on age into two groups (group 1: 70-79 years of age, n = 183; group 2: >or=80 years of age, n = 29). The two groups were similar in gender distribution, NYHA class, and indication for implantation. The actuarial survival was not significantly different between groups 1 and 2 (P > 0.05; primary endpoint), with a 1-year survival of 91% and 93% in groups 1 and 2, respectively, (P = NS). The complication rates at the time of ICD implantation were similar in groups 1 and 2 (6.6% and 13.1%, respectively, P = 0.16). Age alone may not be sufficient criteria to exclude ICD implantation. The current consensus guidelines for ICD implantation appear to be generalizable to treating octogenarians who are otherwise medically fit.
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