2 Minute Medicine Rewind

In this section, we will highlight the some of the key high-impact studies, updates, and analyses published in the past week.

ADVANCE III Trial: Effect of Long-Detection Interval vs Standard-Detection Interval for Implantable Cardioverter-Defibrillators on Antitachycardia Pacing and Shock Delivery

An international RCT suggests that implantable cardioverter-defibrillators (ICDs) programmed to respond only to ventricular arrhythmias of longer duration (30 – 40 intervals, vs. 18 – 24 intervals in standard detection) had similar efficacy in preventing mortality and arrhythmic syncopal episodes while decreasing the number of pacing episodes (58% compared to standard detection) and shocks (77% compared to standard detection).

BRUISE CONTROL Trial: Pacemaker or Defibrillator Surgery without Interruption of Anticoagulation

An international RCT suggests that high-risk patients on long term anticoagulation with warfarin do not need to temporarily bridged with heparin prior to pacemaker or defibrillator surgery. This study was stopped early at 66% enrollment (n = 681) as 16.0% of patients on heparin developed device-pocket hematoma while only 3.5% of patients on warfarin (P < 0.001).

TOPPS Trial: A No-Prophylaxis Platelet-Transfusion Strategy for Hematologic Cancers

An international RCT compared the outcome of patients with hematologic cancers depending on whether or not they were given prophylactic platelet transfusion when their platelet count is less than 10. This study suggests patients with prophylactic platelet transfusions have fewer bleeding episodes (43% vs. 50%) and had a longer time to first bleeding episode (17.2 days vs. 19.5 days).

Chemotherapy-induced bone marrow nerve injury impairs hematopoietic regeneration

The relationship between hematopoietic regeneration and neuronal innervation is poorly understood, however it is known that many chemotherapeutic agents like cisplatin can cause sensory neuropathy. Using mouse models, researchers show that loss of adrenergic innervation of the bone marrow alters hematopoietic regeneration after insult and neuroprotective factors can enhance bone marrow recovery after injury.

By David Ouyang