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News tips for Wednesday, Nov. 12, 2003

the Bypass Angioplasty Revascularization Investigation (BARI). Survival after 10 years was lower in diabetic men treated with angioplasty than diabetic men treated with bypass (49 percent vs. 67 percent). But in diabetic women, survival rates were nearly equal for angioplasty (53 percent) and bypass surgery (51 percent). Men's bypass survival advantage appeared limited to those getting an internal mammary artery graft, but use of this conduit didn't improve results in women. Ten-year survival rates remained similar for bypass and angioplasty in diabetic women after adjustments for confounding baseline variables, leading investigators to conclude that risks and benefits of bypass vs. angioplasty "should be reconsidered" in women with diabetes and multi-vessel disease.

10:30 a.m. Abstract #2800 Patients with ICDs should remain physically active. Just how risky is strenuous exercise for patients with implantable cardioverter defibrillators (ICDs)? Current guidelines recommend only low-intensity exercise for ICD patients. Yale researchers surveyed 164 ICD patients (76 percent male, average age 57, 60 percent had coronary artery disease). Most had ventricular rhythm irregularities but no other physical limits to their ability to exercise. The median intensity level of exercises performed any time was 5 METS, with regular exercise ranging from walking (3.5 METS) to tennis and basketball (7 METS). Twenty-eight patients said they engage in more risky activities like biking, skiing or water sports. Twenty-three patients experienced 36 shocks from their ICDs, most during vigorous exercise such as running, doing yard work, competitive sports or biking. Median activity level during a shock episode was 5.5 METS. The first high-energy shock restored sinus rhythm in all ventricular tachycardia and ventricular fibrillation patients, and none caused serious injury. "Sports involving vigorous exercise may be safe in selected ICD patients," the study finds.
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Contact: Carole Bullock
carole.bullock@heart.org
214-706-1279
American Heart Association
12-Nov-2003


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