A real-world experience of subcutaneous and transvenous implantable cardiac defibrillators-comparison with the PRAETORIAN study.

Background: PRAETORIAN is the first randomized controlled trial that demonstrated the noninferiority of subcutaneous ICD (S-ICD) in comparison with transvenous ICD (TV-ICD). We retrospectively reviewed electronic records of patients with ICD implanted over the past 6 years, with the primary objective to compare our real-world single tertiary center experience with the randomized data from the PRAETORIAN study.

Methods: Seventy S-ICD patients were compared with 197 TV-ICD patients, from July 2014 to June 2020 retrospectively, over a median period of 1304 days (296-2451 days).

What is the role of the cardiologist in future management of stroke prevention in atrial fibrillation?

Atrial fibrillation (AF) is becoming increasingly common in an ageing population. Much of the morbidity and mortality in AF is due to stroke and thromboembolism. Awareness of stroke risk and the need for prevention is well recognized but is far from satisfactory in the real world.

Recent progress in antithrombotic therapy for atrial fibrillation.

Atrial fibrillation (AF) is becoming a major health care burden as elderly populations increase. The increased risk of stroke and thromboembolisms in patients with AF is well documented and anti-coagulation with adjusted-dose warfarin is highly effective in reducing stroke risk, being superior to antiplatelet agents. Despite recognition of the epidemiological problem and the sound evidence base for thromboprophylaxis, as well as major guidelines recommending treatment, anticoagulation use is still suboptimal, given the dis-utility and limitations associated with warfarin.