200 e-Letters

published between 2007 and 2010

  • Assessing aortic strain and stiffness: don't forget the physics and engineering
    Bart Bijnens

    There is more and more evidence that the mechanical properties of the aorta, and arterio-ventricular coupling, are of great clinical importance in cardiovascular diseases. Therefore, we have read the manuscript of Vitarelli et. all with great interest [1]. Whereas, given the recent evolution of ultrasound equipment and processing tools, the idea to assess the aorta using velocity and deformation information is interesting,...

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  • CT or MRI for post-procedural aortic stenting?
    Damien P Kenny

    To the Editor: We thank Dr Rosenthal and Bell for their insightful editorial comments 1 relating to our study. 2 There is little doubt that until we have longer follow-up on the incidence of potential adverse events following coarctation stenting, some form of advanced imaging is required and this is endorsed by ongoing large follow-up studies. 3 Although we agree that with specific imaging techniques MRI may provide inf...

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  • Pacemaker-mediated tachycardia
    Sern Lim

    Ullah and Stewart present a case of pacemaker-mediated tachycardia (PMT). There are 2 specific issues that require clarification. Firstly, the authors suggest that this was a pacemaker malfunction. I would contend that the pacemaker was functioning appropriately as programmed (ie: it is the programming of the pacemaker that resulted in the PMT). Hence, programming changes can often prevent, detect and terminate PMT....

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  • Registry study does not inform us abut management of ACS
    Brett Forge
    Chew et al claim that their registry study six month survival benefits associated with clinical guideline recommendations in acute coronary syndromes 1â₁“suggests that invasive management resulting in revascularisation does provide a reduction in mortality, reinforcing clinical trial data that have relied upon composite ischaemic end points that have at times been inconsistent".

    The very best that...

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  • Justification for complete revascularisation at the time of primary angioplasty? Not yet!
    Nick West

    We read with great interest the article by Politi et al. (1) on revascularisation of patients presenting with ST-elevation myocardial infarction (STEMI) in the context of multivessel coronary disease, and its accompanying Editorial. Whilst the data are interesting and hypothesis- generating, they fall short of demanding any change in current practice owing to a potential flaw in the study design and in the findings as pre...

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  • The case of the missing endpoints
    Michael Soljak

    Dear Editor

    The publication of not one but two reviews of catheter ablation for atrial fibrillation (AF) in this week's edition of Heart is very welcome.(1,2) The English and Welsh guidance from the National Institute for Clinical and Public Health Excellence (NICE) was published in 2006,(3) but a great deal of new comparative effectiveness evidence has been published recently. However there is a significant gap...

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  • Malfunction or malprogramming?
    Hoong Sern Lim

    Ullah and Stewart present a case of pacemaker-mediated tachycardia (PMT) and described it as a "malfunction of dual chamber pacing". However, I would contend that the pacemaker is functioning appropriately, ie: it is sensing atrial activity in the atrium and pacing (capturing) the ventricle. The problem in PMT is the retrograde atrial activation beyond the PVARP as described and appropriate programming of the PVARP based o...

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  • NICE guidance on the investigation of chest pain
    Andrew P. Davie

    Sir, As a "jobbing cardiologist", I am grateful for the NICE guidance on the investigation of stable chest pain. I am grateful for the emphasis on clinical assessment, and I am grateful for the shift away from exercise testing. I am astonished, however, that the guideline does not say one word about the utility of a therapeutic trial in cases of uncertainty, and nor does the editorial by Fox & McLean. Every cardiol...

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  • Prediction of risk; not all risk is mortality.
    Mamas A Mamas

    The recent editorial of Fox and Mclean concludes â₁“The NICE guidance on chest pain provides a series of important advances over the current status of investigation and triage of chest pain and should be welcomed by the profession 1. One of the key recommendations of the recently published National Institute for Health and Clinical excellence (NICE) guidelines for the early management of unstable...

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    Magda Heras

    Dear editor,

    The avoidance of redundant publication is the core of the editorial task; therefore editors have established clear policies posted in their instructions for authors. The term Redundant publication has always been used for research reported by the same author and sent to two or more different journals. We report here a different situation that also results in unplanned redundant publication....

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