From the great Hospital Medicine Quick Hits blog:

This was in NEJM this week--I like the concept of "lenient" atrial fibrillation control as easier to achieve and no worse for patients than strict control of heart rate.  Looks like 110 is the new speed limit in atrial fibrillation.

Seemingly big news today in cardiology: patients with hard-to-control atrial fibrillation were better off getting a catheter ablation than trying different medical therapy.

Unexpected development: a small study reports good efficacy of a cage-like device implanted in the hearts of patients with atrial fibrillation. Right now we give people a medicine coumadin to prevent strokes from atrial fibrillation (a common heart arrhythmia). A company has introduced a device that evidently accomplishes the same goal. Complications were up around 7% which is more toxic than coumadin which has about a 1% per year serious bleed risk (about the same as aspirin). The Reuter's article calls coumadin "notoriously difficult to manage " as if it were some sort of villain.

I'm sorry to ask a profound question but what exactly is fish oil? Is it an antiarrhythmic or is it a cholesterol drug?

The word on the street is that patients who take fish oil have better cardiac outcomes not because of the effects on cholesterol or triglycerides but because of prevention of cardiac arrhythmias.  But in 2008 a meta-analysis came out in BMJ that throws cold water on that concept at least in retrospective studies.

A prospective study OMEGA is evidently finished recruiting and hopefully will publish soon.

Patients who take bisphosphonates for osteoporosis could face higher risks of serious atrial fibrillation (AF) or irregular heartbeats claim a new study. The study presented at the 74th annual international scientific assembly of the American College of Chest Physicians (ACCP) or “CHEST 2008” shows that people using alendronate or zoledronic acid two common medications to slow or prevent the development of osteoporosis had significantly greater chances of encountering serious AF including hospitalization or death when compared with placebo.