9 a.m. – Abstract #1788 – Do women with implantable defibrillators have fewer arrhythmias than men? In population studies, women with coronary artery disease (CAD) have a lower rate of sudden cardiac death (SCD) than men with CAD. Researchers wondered if female CAD patients with an implantable cardioverter-defibrillator (ICD) also have fewer arrhythmias – ventricular tachycardia or fibrillation (VT/VF). Comparing data on 59 women and 340 men, they found that sustained VT/VF occurred in 52 percent of men and 34 percent of women. Men also had more shocks from ICDs. "Gender independently predicted VT/VF endpoints after adjustment for clinical factors," reported the scientists, who found that women were less likely to experience VT/VF than men. "This study suggests that differing susceptibility to arrhythmia may underlie the known differences in SCD rates between men and women," they concluded. Also see Abstract #1807 (Monday, 9:15 a.m.) for a report showing that women undergoing coronary artery bypass surgery have "significantly lower" death rates and fewer complications when the operation is performed "off-pump."
9:30 a.m. – Abstract #1808 – Robotic assisted coronary bypass: good as conventional surgery. Initial results are in from the first U.S.-approved prospective multi-center trial of "robotic assisted endoscopic coronary anastomosis" – a minimally invasive closed-chest technique using robotic technology to perform micro-vascular coronary bypass surgical tasks. Twenty-four patients were randomized into either conventional or robotic assisted surgery. After one patient was excluded, 13 had standard open-chest surgery while 10 underwent a beating-heart bypass. Clinical results were similar in both groups, with all patients asymptomatic at 10 weeks except one who required additional angioplasty. There were no device-related complications and blood vessel function was similar in the two groups. Coronary vessel hookups with robotic assistance took longer than in conventional surgery.
2 p.m. – Abstract #3333 – Reversing sudden cardiac death in health clubs: shocking success. A new study finds automated external defibrillators (AEDs) are being put to good use in a large chain of 76 health clubs. In a 12-month surveillance after instituting emergency preparedness procedures according to American Heart Association guidelines, eight (five men, three women) of the 48,560 adult members experienced sudden cardiac death (SCD) while exercising. Only one of them had known heart problems. In each case trained staff used an AED plus CPR before paramedics arrived. SCD was reversed at the health club in six of the eight victims, and four of the eight survived hospital discharge neurologically intact. While their data suggest that SCD in such settings is extremely rare, researchers say they've also shown that "the likelihood of surviving a cardiac arrest in facilities with an AED program is considerably higher than the success rate reported for most out-of-hospital witnessed cardiac arrests." Their findings support AHA recommendations to implement AED programs in preventive exercise settings, they said. Also See Abstract #P1510 (8:30 a.m.) for results from the North American Public Access Defibrillation Trial showing that trained lay volunteers "responded appropriately" in more than half of out-of-hospital cardiac arrest episodes, giving CPR or using AEDs.