Joseph Trotta Cardiology Page 2006

Dr. A. John Camm of St. George's Hospital Medical School, London, United Kingdom,
states:

"........More recently it has been realized that Atrial Fibrillation accounts for a very high proportion of thromboembolic strokes and aggravated heart failure. It is probably associated with a 50% increase in the risk of death, is often highly symptomatic and is associated with a distinct degradation of the quality of life. AF is therefore a disease rather than a second-best alternative to sinus rhythm......"

Dr. Carl Timmermans, Luz-Maria Rodriguez, and Harry J. G. M. Crijins
of University Hospital Maastricht, Masstricht, The Netherlands,
said:
"For more than 40 years, electrical cardioversion, or the discharge of electrical energy synchronized on the R wave of atrial fibrillation (AF), has been the most effective and safest method of restoring sinus rhythm. Only recently, new technical developments, a reappraisal of the initial energy settings, pretreatment with antiarrhythmic drugs, and a better identification of the different types of postshock recurrences have further refined the technique and improved the outcome of cardioversion. Also, our understanding of stroke risk in relation to cardioversion and the development of new antithrombotic strategies, including cardioversion guided by transesophageal echocardiography, have improved the speed and safety of cardioversion."

"Synchronization of shock delivery with the R wave of the QRS complex is essential during cardioversion. Although properly synchronized shocks rarely, if ever, induce ventricular fibrillation, unsynchronized shocks may be delivered in the ventricular vulnerable period of the preceding beat (near the apex of the T wave) and result in ventricular fibrillation. The lead with the highest R-wave amplitude should be selected for synchronization. The appropriateness of synchronization of each shock delivery should always be verified, since a large or tall T or P wave, artifacts, or noise can be misidentified as the R wave. Improper synchronization may also occur when the QRS complex shows a right bundle branch block configuration with a tall secondary R wave. Electrocardiographic tracings derived from paddle electrodes may produce motion artifacts and errors in R-wave sensing."

"Ventricular arrhythmias are the most common complications after electrical cardioversion. They are related to the presence of hypokalemia, digitalis toxicity, severity of heart disease, improper synchronization, and the repeated use of high levels of energy. If atrioventricular conduction disturbances are suspected - for example, a slow ventricular response to atrial fibrillation without antiarrhythmic drug treatment - cardioversion should be avoided, as asystole may result or should be performed after the insertion of a temporary transvenous pacing lead. Atropine should always be available before cardioversion."

Professor Kalman's research examining the role of the electrophysiology of the heart has led to a greater understanding of the causes of arrhythmias and methods for their correction.

Professorial Fellow Jonathan Kalman,
winner of the 2006 Susman Prize,
which is awarded by the Royal
Australasian College of Physicians for
outstanding contribution to
cardiovascular research

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Ross Waller wins Premier's Award for medical research (7/6/00) Friday, 9 June 2000 Compiled by - Graeme Walker DHS Media Unit.
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DATE: Wednesday, June 7, 2000

The Premier, Mr Steve Bracks, today announced that Mr Ross Waller Bsc (Hons)
from the University of Melbourne School of Botany is the winner of the 2000
Premier's Award for Medical Research.

Mr Waller was presented with the Award for research into a component of the
parasite which causes malaria.

Mr Bracks said the Premier's Award for Medical Research recognised outstanding
achievement by young people in any area of medical research.

"There are few things more important to our community than medical research,"
Mr Bracks said.

"The Premier's Award seeks to change that by giving public recognition to the
work of young Victorian scientists, raising the profile of their work and encouraging
them to continue in their research."

Mr Bracks said this year's Award added to an impressive list of diverse and
important research projects by previous Award winners including, blood diseases,
viruses, DNA, sleep research, genetic testing, epilepsy, birth defects and
immunology.

"In addition to Mr Waller's work with malaria, three other Victorians were awarded
commendations for research into bone remodelling, cell death in the immune
system and heart rhythm problems," he said.

· Dr Nicole Horwood PhD - St Vincent's Institute of Medical Research.
· Dr Kim Newton PhD - Walter and Eliza Hall Institute of Medical Research.
· Dr Paul Sparks MBBS PhD FRACP - Dept of Cardiology, Royal Melbourne
Hospital.

"This year's winners demonstrate the depth of young scientific talent we have in
Victoria and the importance of rewarding and nurturing that talent," Mr Bracks
said.
"They also remind us why we must continue to invest in research and development
and build on our capacity to translate new technological and scientific
developments into useable products and practical health care.

"That is why the Victorian Government has increased funding for medical research
infrastructure and is making significant investment in science, technology and
innovation.

"But we must also build strong partnerships between the public and private sector
in driving forward with new research - and in making sure we do not lose talent,
jobs and products to other countries.

"The Premier's Award for Medical Research plays an important part in achieving
that goal."