Anti-arrhythmic properties of n-3 polyunsaturated fatty acids, at least in part mediated by anti-oxidant, anti-inflammatory and anti-fibrotic power, have been widely proved. Effect of fish oil on atrial fibrillation, ...Anti-arrhythmic properties of n-3 polyunsaturated fatty acids, at least in part mediated by anti-oxidant, anti-inflammatory and anti-fibrotic power, have been widely proved. Effect of fish oil on atrial fibrillation, both in primary and in secondary prevention and after cardiac surgery, are controversial, mostly due to lack of homogeneity between studies but also due to individual variability in response to fatty acids administration. Inclusion of measurement of incorporation of fish oil into cell membranes, appears to be essential in future studies, to assess their antiarrhythmic effect.展开更多
AIM: To compare the utility of the partners-heart failure(HF) algorithm with the care alert strategy for remote monitoring,in guiding clinical actions oriented to treat impending HF.METHODS: Consecutive cardiac resync...AIM: To compare the utility of the partners-heart failure(HF) algorithm with the care alert strategy for remote monitoring,in guiding clinical actions oriented to treat impending HF.METHODS: Consecutive cardiac resynchronizationdefibrillator recipients were followed with biweekly automatic transmissions. After every transmission,patients received a phone contact in order to check their health status,eventually followed by clinical actions,classified as "no-action","non-active" and "active". Active clinical actions were oriented to treat impending HF. The sensitivity,specificity,positive and negative predictive values and diagnostic accuracy of the partners-HF algorithm vs care alert in determining active clinical actions oriented to treat pre-HF status and to prevent an acute decompensation,were also calculated.RESULTS: The study population included 70 patients with moderate to advanced systolic HF and QRS duration longer than 120 ms. During a mean follow-up of 8 ± 2 mo,665 transmissions were collected. No deaths or HF hospitalizations occurred. The sensitivity and specificity of the partners-HF algorithm for active clinical actions oriented to treat impending HF were 96.9%(95%CI: 0.96-0.98) and 92.5%(95%CI: 0.90-0.94) respectively. The positive and negative predictive values were 84.6%(95%CI: 0.82-0.87) and 98.6%(95%CI: 0.98-0.99) respectively. The partners-HF algorithm had an accuracy of 93.8%(95%CI: 0.92-0.96) in determining active clinical actions. With regard to active clinical actions,care alert had a sensitivity and specificity of 11.05%(95%CI: 0.09-0.13) and 93.6% respectively(95%CI: 0.92-0.95). The positive predictive value was 42.3%(95%CI: 0.38-0.46); the negative predictive value was 71.1%(95%CI: 0.68-0.74). Care alert had an accuracy of 68.9%(95%CI: 0.65-0.72) in determining active clinical actions.CONCLUSION: The partners-HF algorithm proved higher accuracy and sensitivity than care alert in determining active clinical actions oriented to treat impending HF. Future studies in larger populations should evaluate partners-HF ability to improve HF-related clinical outcomes.展开更多
文摘Anti-arrhythmic properties of n-3 polyunsaturated fatty acids, at least in part mediated by anti-oxidant, anti-inflammatory and anti-fibrotic power, have been widely proved. Effect of fish oil on atrial fibrillation, both in primary and in secondary prevention and after cardiac surgery, are controversial, mostly due to lack of homogeneity between studies but also due to individual variability in response to fatty acids administration. Inclusion of measurement of incorporation of fish oil into cell membranes, appears to be essential in future studies, to assess their antiarrhythmic effect.
文摘AIM: To compare the utility of the partners-heart failure(HF) algorithm with the care alert strategy for remote monitoring,in guiding clinical actions oriented to treat impending HF.METHODS: Consecutive cardiac resynchronizationdefibrillator recipients were followed with biweekly automatic transmissions. After every transmission,patients received a phone contact in order to check their health status,eventually followed by clinical actions,classified as "no-action","non-active" and "active". Active clinical actions were oriented to treat impending HF. The sensitivity,specificity,positive and negative predictive values and diagnostic accuracy of the partners-HF algorithm vs care alert in determining active clinical actions oriented to treat pre-HF status and to prevent an acute decompensation,were also calculated.RESULTS: The study population included 70 patients with moderate to advanced systolic HF and QRS duration longer than 120 ms. During a mean follow-up of 8 ± 2 mo,665 transmissions were collected. No deaths or HF hospitalizations occurred. The sensitivity and specificity of the partners-HF algorithm for active clinical actions oriented to treat impending HF were 96.9%(95%CI: 0.96-0.98) and 92.5%(95%CI: 0.90-0.94) respectively. The positive and negative predictive values were 84.6%(95%CI: 0.82-0.87) and 98.6%(95%CI: 0.98-0.99) respectively. The partners-HF algorithm had an accuracy of 93.8%(95%CI: 0.92-0.96) in determining active clinical actions. With regard to active clinical actions,care alert had a sensitivity and specificity of 11.05%(95%CI: 0.09-0.13) and 93.6% respectively(95%CI: 0.92-0.95). The positive predictive value was 42.3%(95%CI: 0.38-0.46); the negative predictive value was 71.1%(95%CI: 0.68-0.74). Care alert had an accuracy of 68.9%(95%CI: 0.65-0.72) in determining active clinical actions.CONCLUSION: The partners-HF algorithm proved higher accuracy and sensitivity than care alert in determining active clinical actions oriented to treat impending HF. Future studies in larger populations should evaluate partners-HF ability to improve HF-related clinical outcomes.
