Faculty Bibliography

INTRODUCTION AND AIMS: Ablation of atrial fibrillation (AF) has evolved rapidly in the decade since its inception. We aimed to review the results of this evolution as reflected in the published literature. METHODS: Publications through 2005 were reviewed, and data included if there was information on the technique used, and follow-up of at least 6 months. RESULTS: More than 23,000 patients met criteria for inclusion. There has been a steady improvement in reported outcomes (P<0.001). Variations on radiofrequency catheter ablation for pulmonary vein isolation result in apparent elimination ("cure") or improvement of AF in 75%, and surgical techniques are even better. CONCLUSIONS: Catheter ablation of AF is now a mainstream procedure. Continuing technical advances are needed to achieve better results with more uniformity and reduced procedure times.

An elevated triglyceride (TG)/high-density lipoprotein (HDL) ratio has been described as a predictor of insulin resistance and cardiovascular events. We evaluated whether a TG/HDL ratio > or = 3.5 was associated with the burden of coronary artery disease (CAD) on cardiac catheterization. A retrospective chart review of 156 consecutive adults presenting to the Montefiore Medical Center Emergency Department with symptoms of unstable angina and no known history of CAD who underwent cardiac catheterization as part of their index hospitalization was performed. TG and HDL data were available in 100 patients within 6 months prior to admission and no more than 24 hours after presentation. A priori, a burden of CAD score was developed. On multivariate analysis, a TG/HDL ratio > or = 3.5 was associated with the burden of CAD (odds ratio, 2.87; 95% confidence interval, 1.03-7.96; p = 0.04). Further study is warranted.