Adjuvant therapy for atrial fibrillation.

Atrial fibrillation (AF) is the most common heart rhythm disorder, with increasing prevalence in the aging US population and affecting more than 2.3 million people. Current approaches for managing AF are rate- or rhythm-control strategies, both using anti-thrombotic therapy to prevent thromboembolism. While great advances have been made in understanding the pathophysiology of AF, few new strategies have shown promise in prevention or treatment of AF. Recent data suggest that non-antiarrhythmic medication may be useful in modifying the substrate that allows AF precipitation and perpetuation. This article reviews the data on the role of these agents in the prevention and management of AF as an adjunct to standard therapy.

Incredibly late thromboses in first generation drug eluting stents: a case series.

BACKGROUND: The drug-eluting stents have decreased the incidence of instent restenosis compared to bare metal stents. But, the incidence of late and very late stent thrombosis has increased with the drug-eluting stents. CASE PRESENTATION: We are here, reporting three cases of incredibly late instent thrombosis, each one occurring after more than 50 months of drug-eluting stent placement. CONCLUSION: The occurrence of stent thrombosis as late as 5 years has been reported in literature. This highlights the importance that there may be no limit to the time duration to the occurrence of very late stent thrombosis and dual antiplatelet therapy with aspirin and clopidogrel may have to be continued indefinitely in patients with drug-eluting stents.