Annals of Internal Medicine tip sheet for Nov. 2, 2004

November 01, 2004

Annals of Internal Medicine is published by the American College of Physicians, an organization of 116,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information. For an embargoed copy of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656. Leave fax or e-mail and article topics.

1. Treating Atrial Fibrillation: Control Heart Rate or Heart Rhythm?

A study of two common therapies for atrial fibrillation found that using drugs to slow heart rate (rate control) was more cost-effective than using drugs to restore normal heart rhythm (rhythm control) (Article, p. 653). The researchers used data from a major trial of treatment for atrial fibrillation to calculate the cost-effectiveness of rate and rhythm control. Rate control was more cost-effective.

In an accompanying article, other writers note that the major studies of atrial fibrillation have not included significant numbers of the people who are most likely to benefit from controlling heart rhythm with anti-arrhythmic drugs (Perspective, p. 720). They discuss the drugs and typical patient profiles.

Finally, editorial writers comment that although heart rate control is safe, less costly and is the preferred first treatment option for atrial fibrillation, rhythm control is still appropriate for some people. They note that new therapies, such as catheter ablation, are emerging as effective non-drug therapy (Editorial, p. 727).

2. New Study Says U.S. Will Need 200,000 More Doctors by 2020

Using a model based on long-term economic and demographic trends, a writer says that the United States now faces a shortage of physicians and will need 200,000 more physicians by 2020. (Medicine and Public Issues, p.705).

"In simple numeric terms, the number of physicians is no longer keeping up with population growth." The current situation has been disguised by growth in the number of nonphysician clinicians, international medical graduates and osteopathic physicians.

Editorial writers say the future need for physicians is very unpredictable and will be affected by many trends: older people who may be healthier than their ancestors and so need fewer services, new technologies that can prevent subsequent illness and disability, trends toward higher health insurance deductibles that will cause patients to be more concerned about price when deciding to seek care.

They also say that the "plausible but unproven link" between physician supply and the volume of medical care could mean that more doctors will generate more medical services and therefore higher health expenditures.

For all these reasons, the editorial writers say, "even when we have done our homework, increasing the supply of physicians gradually, in small increments -- ones that would not require major new investments in capital or teaching personnel -- is a prudent strategy."

3. Screen High Risk Adults for HCV Infection? Yes! No, No Evidence. 2 Views (In the Balance, p. 715)

4. Meta-analysis: ARBs Suitable Alternative to ACE Inhibitors for Heart Illnesses (Review, p. 693.)

5. In-Depth Study of SARS Outbreak in Hong Kong in 2003 Finds Patterns (Article, p. 662.)
-end-


American College of Physicians

Related Atrial Fibrillation Articles from Brightsurf:

Atrial fibrillation less deadly than it used to be, but still cause for concern: BU study
A first-of-its-kind study by researchers from the Boston University School of Public Health (BUSPH) shows a decline in deaths related to atrial fibrillation (irregular heartbeat) over the last 45 years.

Postoperative atrial fibrillation does not impact on overall survival after esophagectomy
Volume 11, Issue 25 of Oncotarget reported that Administration of landiolol hydrochloride was found to be associated with reduced incidence of atrial fibrillation after esophagectomy for esophageal cancer in our previous randomized controlled trial.

People with atrial fibrillation live longer with exercise
More than 100,000 Norwegians have atrial fibrillation. They should be actively exercising for their health.

Atrial fibrillation among overweight people is not due to fat
In a recently published study, researchers from Aarhus University document that the risk of atrial fibrillation is not linked to the amount of body fat, but instead to large muscle mass, or more precisely, a high fat-free weight

Eating more protein could help ward off atrial fibrillation in women
Women who ate slightly more than the recommended daily amount of protein were significantly less likely to develop atrial fibrillation (AFib), a dangerous heart rhythm disorder that can lead to stroke and heart failure, when compared with those who consumed less protein, according to research being presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Zebrafish teach researchers more about atrial fibrillation
Genetic research in zebrafish at the University of Copenhagen has surprised the researchers behind the study.

Personalized medicine for atrial fibrillation
The study, published in Europace, uses signals from implantable devices -- pacemakers and defibrillators -- to analyze electrical signals in the heart during episodes of atrial fibrillation.

Prescribing anticoagulants in the ED for atrial fibrillation increases long-term use by 30%
Patients prescribed anticoagulants after a diagnosis of atrial fibrillation in the emergency department are more likely to continue long-term use of medications to treat the condition, according to research published in CMAJ (Canadian Medical Association Journal).

Anticoagulant benefits for atrial fibrillation decrease with age
The net clinical benefit of anticoagulants for atrial fibrillation (AF) -- one of the most important causes of irregular heartbeats and a leading cause of stroke -- decreases with age, as the risk of death from other factors diminishes their benefit in older patients, according to a study led by researchers at UC San Francisco.

Research improves understanding of mechanism of atrial fibrillation
Mouse model studies show that noncoding DNA regions linked to atrial fibrillation risk can display long-range regulatory functions directed at Pitx2 gene and in this way predispose to the condition.

Read More: Atrial Fibrillation News and Atrial Fibrillation Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.