DANISH with your Coffee? ICDs for Non-Ischemic Cardiomyopathy and Effects of High Dose Caffeine on Cardiac Arrhythmias


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It’s arrhythmia week on The Rounds Table! Should heart failure patients give up a caffeine jolt in the morning? How can we better identify appropriate patients for ICDs? Paxton Bach, fellow in General Internal Medicine at UBC, joins Kieran to discuss two exciting studies:

Studies that inform practice toward the best medical treatments are of utmost importance. But, arguably, studies that inform day to day lifestyle choice are those that provide real meaning to patients. For example, does a patient with a heart condition need to give up coffee? Kieran and Paxton discuss a study which examines whether, in patients with decreased ejection fraction, caffeine increases cardiac arrhythmias.

Next, Kieran takes listeners through the DANISH trial. The benefit of an implantable cardioverter-defibrillator (ICD) in patients with symptomatic systolic heart failure caused by ischemic heart disease has been well documented. However, before the DANISH trial, the evidence for implantation of an ICD for primary prophyalxis in patients with non-ischemic cardiomyopathy was limited. Tune in for highlights from the trial!

Finally, the Good Stuff segment. This week, Paxton takes listeners through the story of the original Patient Zero. Then, Kieran talks about real world placebos: who knew they were so common?!

Like what you hear? Rate us on iTunes! Follow us on Twitter  @roundstable and tweet at this week’s hosts directly @kieranlquinn and @paxbach.

The Papers

1. Caffeine: http://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2569283

2. DANISH Trial: http://www.nejm.org/doi/full/10.1056/NEJMoa1608029

Good Stuff

1. Patient Zero: https://www.theguardian.com/science/2016/oct/26/patient-zero-gaetan-dugas-not-source-of-hivaids-outbreak-study-proves

2. Placebo Control: http://mobile.nytimes.com/2016/10/28/us/placebo-buttons-elevators-crosswalks.html?_r=0&referer=

Music Credits (Creative Commons)

In your Robotic Heart – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/in-your-robotic-heart

Drive – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/drive-fresh-upbeat-pop-background-music

Vintage Dream – Nicolai Heidlas https://soundcloud.com/nicolai-heidlas/vintage-dream-loungejazzy-background-music

All tracks have been modified for the purposes of this podcast.

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