http://www.biomedcentral.com/bmccardiovascdisord/ The editor's pick of recent articles published by BMC Cardiovascular Disorders 2013-01-23T00:00:00Z Background: Atrial arrhythmia (AA) is the most common complication after coronary artery bypass grafting (CABG). Only beta-blockers and amiodarone have been convincingly shown to decrease its incidence. The effectiveness of magnesium on this complication is still controversial. This meta-analysis was performed to evaluate the effect of magnesium as a sole or adjuvant agent in addition to beta-blocker on suppressing postoperative AA after CABG. Methods: We searched the PubMed, Medline, ISI Web of Knowledge, Cochrane library databases and online clinical trial database up to May 2012. We used random effects model when there was significant heterogeneity between trials and fixed effects model when heterogeneity was negligible. Results: Five randomized controlled trials were identified, enrolling a total of 1251 patients. The combination of magnesium and beta-blocker did not significantly decrease the incidence of postoperative AA after CABG versus beta-blocker alone (odds ratio (OR) 1.12, 95% confidence interval (CI) 0.86-1.47, P = 0.40). Magnesium in addition to beta-blocker did not significantly affect LOS (weighted mean difference −0.14 days of stay, 95% CI −0.58 to 0.29, P = 0.24) or the overall mortality (OR 0.59, 95% CI 0.08-4.56, P = 0.62). However the risk of postoperative adverse events was higher in the combination of magnesium and beta-blocker group than beta-blocker alone (OR 2.80, 95% CI 1.66-4.71, P = 0.0001). Conclusions: This meta-analysis offers the more definitive evidence against the prophylactic administration of intravenous magnesium for prevention of AA after CABG when beta-blockers are routinely administered, and shows an association with more adverse events in those people who received magnesium. http://www.biomedcentral.com/1471-2261/13/5 Xiaosan Wu Congxia Wang Jinyun Zhu Chunyan Zhang Yan Zhang Yanhua Gao BMC Cardiovascular Disorders 2013, 13:5 2013-01-23T00:00:00Z 10.1186/1471-2261-13-5 Magnesium and adverse events following CABG <p>Prophylactic administration of intravenous magnesium to prevent atrial arrhythmia, in patients who have undergone coronary artery bypass grafting (CABG), is associated with an increase in adverse events, as shown in a meta-analysis.</p> /content/figures/1471-2261-13-5-toc.gif BMC Cardiovascular Disorders 1471-2261 13 5 2013-01-23T00:00:00Z XML Background: Heart failure (HF) patients have a high risk of death, and implantable cardioverter defibrillators (ICDs) are effective in preventing sudden cardiac death (SCD). However, a certain percentage of patients may not be immediate candidates for ICDs, particularly those having a short duration of risk or an uncertain amount of risk. This includes the newly diagnosed patients, as well as those on the cardiac transplant list or NYHA class IV heart failure patients who do not already have an ICD. In these patients, a wearable cardioverter defibrillator (WCD) may be used until long term risk of SCD is defined. The purpose of this study was to determine the incidence of SCD in this population, and the efficacy of early defibrillation by a WCD. Methods: Ten enrolling centers identified 89 eligible HF patients who were either listed for cardiac transplantation, diagnosed with dilated cardiomyopathy, or receiving inotropic medications. Data collected included medical history, device records, and outcomes (including 90 day mortality). Results: Out of 89 patients, final data on 82 patients has been collected. Patients wore the device for 75±58 days. Mean age was 56.8±13.2, and 72% were male. Most patients (98.8%) were diagnosed with dilated cardiomyopathy with a low ejection fraction (<40%) and twelve were listed for cardiac transplantation. Four patients were on inotropes. There were no sudden cardiac arrests or deaths during the study. Interestingly, 41.5% of patients were much improved after WCD use, while 34.1% went on to receive an ICD. Conclusions: In conclusion, the WCD monitored HF patients until further assessment of risk. The leading reasons for end of WCD use were improvement in left ventricular ejection fraction (LVEF) or ICD implantation if there was no significant improvement in LVEF. http://www.biomedcentral.com/1471-2261/12/123 Andrew C Kao Steven W Krause Rajiv Handa Darshak Karia Guillermo Reyes Nicole R Bianco Steven J Szymkiewicz the Wearable defibrillator use In heart Failure (WIF) Investigators BMC Cardiovascular Disorders 2012, 12:123 2012-12-12T00:00:00Z 10.1186/1471-2261-12-123 Non-invasive monitoring in heart failure <p>Congestive heart failure patients were successfully monitored by a wearable cardioverter defibrillator (WCD) until further risk assessment was possible, suggesting that WCDs may be a safe alternative for patients unable to use implantable cardioverter defibrillators.</p> /content/figures/1471-2261-12-123-toc.gif BMC Cardiovascular Disorders 1471-2261 12 123 2012-12-12T00:00:00Z XML