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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EPatients who survive an acute myocardial infarction with diminished left ventricular function experience frequent and treatable arrhythmias, according to findings from the Cardiac Arrhythmias and Risk Stratification after Myocardial Infarction [CARISMA] observational study. Moreover, high-degree atrioventricular block appears to independently predict cardiac death in the post-MI patient population.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Earrhythmias\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Emyocardial infarction clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EPatients who survive an acute myocardial infarction (MI) with diminished left ventricular (LV) function experience frequent and treatable arrhythmias, according to findings from the Cardiac Arrhythmias and Risk Stratification after Myocardial Infarction (CARISMA) observational study. Moreover, high-degree atrioventricular (AV) block appears to independently predict cardiac death in the post-MI patient population.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003E\u201cThe insertable ECG loop recorder is a diagnostic tool that should be considered to guide medical and device therapy in patients who survive myocardial infarction,\u201d said Poul Erik Bloch Thomsen, MD, Gentofte University Hospital, Copenhagen, Denmark, principal investigator of the CARISMA trial.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003ECARISMA is the first long-term observational study to examine implantable loop recorder data among post-MI patients. The study was designed to determine the risk of tachyarrhythmia and sudden death in patients who do not meet the criteria for an implantable cardioverter defibrillator (ICD) despite mild to moderate structural damage following an acute MI.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EIn CARISMA, investigators implanted insertable loop recorders in 297 patients an average of 11 days after MI. All patients had a low ejection fraction (EF\u0026lt;40%), and none had an ICD. During a 2-year follow-up, the loop recorders provided information every 4 months on the incidence of any arrhythmias: sinus bradycardia, sinus arrest, atrial fibrillation (AF), second or third degree AV block, ventricular tachycardia (VT), and fibrillation.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EAfter a mean follow-up of 1.9 years, 137 patients (46%) had evidence of at least one of the pre-specified arrhythmias, of which only 14% was symptomatic.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003ENew AF (\u2265125 bpm), the most frequent arrhythmia, was documented in 27% of patients. Sinus bradycardia (\u0026lt;30 bpm), AV block (\u0026lt;30 bpm), non-sustained VT (\u2265125 bpm, \u226516 beats), and sustained VT (\u2265125 bpm, \u226530 seconds) were each observed in approximately 17% of patients.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EIn a univariate analysis, AV block (HR 7.0; p=0.0004), sinus bradycardia (HR 5.8; p=0.004), and non-sustained VT (HR 3.4; p=0.025) appeared to predict cardiac death. However, by multivariate analysis, high-degree AV block remained the only independent predictor of cardiac death (HR 4.8; p\u0026lt;0.001).\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EDespite the highly significant correlation between AV block and death, differentiating between all-cause cardiac death and sudden cardiac death secondary to ventricular arrhythmias is difficult, Dr. Thomsen said. To investigate this issue, CARISMA investigators are performing additional analyses to further explore the relationship between baseline left bundle branch block and subsequent risk of fatal ventricular arrhythmias and AV block.\u003C\/p\u003E\n         \u003Cp id=\u0022p-10\u0022\u003EIn summary, findings from the CARISMA observational study suggest that an implantable ECG loop recorder\u2014typically used to identify the cause of syncope\u2014may help clinicians risk-stratify patients with reduced LV function following acute MI.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2008 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/8\/2\/17.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmghd\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}