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Noncomplex ventricular arrhythmia associated with greater freedom from recurrent ectopy at 1 year after mitral repair surgery.

OBJECTIVE: The effect of mitral valve (MV) surgery on the natural history of ventricular arrhythmia (VA) in patients with arrhythmic MV prol … R, 34-38]). Concomitant procedures included tricuspid valve repair (51/62; 82.3%), cryo-maze ± left atrial appendage exclusion (14/62, 23%), and endocardial cryoablation of VA ectopy (4/62; 6.5%). The 30-day and 1-year freedom from recurrent VA were 98.4% and 75.9%, respectively. Absent VA after mitral repair was uniformly observed in patients with minor VA at bas …

Pattern and Perception of Impact of Wearing Face Masks on Communication Among Health Care Workers During COVID-19 pandemic: An Observational Study.

BACKGROUND: Rheumatic heart disease is a common reason for cardiovascular morbidity and mortality. Plasma levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are known to rise in patients with MS, but the role of this compound as a non-invasive marker of left atrial (LA) dysfunction is yet to be established. The study aim was to correlate levels of NT-proBNP in patients with rheumatic mitral stenosis (MS), with echocardiographic parameters of LA function including tissue Doppler-derived strain/strain rate (S/Sr) indices, hemodynamic parameters of LA function, before and after percut

Transesophageal Echocardiography-Guided WATCHMAN Implantation Without Contrast Use: A Three-Year, Single-Center Experience.

Background It is unclear if the WATCHMAN device (Boston Scientific, St. Paul, Minnesota) can be implanted without contrast to prevent compli … cluded. Efficiency was measured as i) accuracy of device size estimation based on TEE-measured left atrial appendage (LAA) dimensions were determined by the need to change the size of the device initially selected, ii) number of implantation attempts, irrespective of change in device size, iii) whether more than one device was used secondary to inaccurate initial …

Creation of a restrictive atrial communication in heart failure with preserved and mid-range ejection fraction: effective palliation of left atrial hypertension and pulmonary congestion.

BACKGROUND: Left atrial decompression is considered in patients with symptomatic heart failure with preserved ejection fraction (HFpEF). We aimed to evaluate the feasibility and efficacy of transcatheter generation of a restrictive atrial septum communication to manage HFpEF from infancy to adulthood with cardiomyopathy and congenital heart defect. METHODS AND RESULTS: From June 2009 to December 2016, 24 patients (50% with an age less than 16 years) with HFpEF were palliated; NYHA-/Ross class IV (n = 10); median systemic ventricular ejection fraction 64 (range 35-78) %. Cardiomyopathy was cla

Influence of hypoxia on nitric oxide synthase activity and gene expression in children with congenital heart disease: a novel pathophysiological adaptive mechanism.

BACKGROUND: Chronic hypoxia has been shown to modulate nitric oxide (NO) responses in different cell models, but the relationship between hypoxia and NO synthase (NOS) regulation in humans was not studied. We studied the relationship between endothelial and inducible NOS (eNOS and iNOS) activities and expression and chronic hypoxia in children with cyanotic and acyanotic congenital heart defects. METHODS AND RESULTS: Right atrial tissue was excised from 18 patients during cardiac surgery. eNOS and iNOS activities were measured by conversion of L-[H(3)]arginine to L-[H(3)]citrulline. Gene expr

Pathology and pathogenesis of rheumatic heart disease.

Cardiovascular disease is on the rise. In India and other developing countries, rheumatic heart disease (RHD) continues to be a major public … mune reactions both humoral and cell mediated causing RF/RHD. Heart tissues namely the valves, left atrial appendage (LAA) and myocardium reveal variable amounts of infiltration by lymphocytes. Significant endocarditis and valvulitis is observed in these cases. CD4+ T cells are most likely the ultimate effectors of chronic valve lesions in RHD. They can recognize …

Recent advances in the diagnosis and treatment of acute myocardial infarction.

The Third Universal Definition of Myocardial Infarction (MI) requires cardiac myocyte necrosis with an increase and/or a decrease in a patie … renewal, and heparin which decreases BMC migration. In contrast, cardiac stem cells from the right atrial appendage and ventricular septum and apex in the SCIPIO and CADUCEUS Trials appear to reduce patient MI size and increase viable myocardium. Additional clinical studies with cardiac stem cells are in progress.

Cytolytic cross-reactive antibodies directed against the cardiac membrane and viral proteins in coxsackievirus B3 and B4 myocarditis. Characterization and pathogenetic relevance.

BACKGROUND: Coxsackievirus B3 and B4 (CVB) myocarditis was assessed by a more than twofold change in titer of the microneutralization tests … gularly. METHODS AND RESULTS: In this study, for the first time adult human myocytes isolated from atrial appendages during open-heart surgery were used as antigen in the indirect immunofluorescence test: nine of 10 sera of patients with CVB myocarditis demonstrated AMLAs of the homologous type in titers of 1:40-1:320, whereas eight of 10 reacted with rat myocyte …

Coronary angiography by electron beam tomography.

Electron Beam Tomography (EBT), a non-invasive imaging method with very high spatial and temporal resolution, is well suited for cardiac ima … y due to motion artifacts and close correlation to venous structures such as the coronary sinus and atrial appendages. In a subgroup of 30 patients in which EBT results were compared to quantitative coronary angiography, the correlation of the vessel diameter in EBT and quantitative angiography was 0.82. Twelve out of 14 high-grade stenoses and 5/5 occlusions of t …

Arrhythmic Risk Stratification in Cardiac Amyloidosis: A Review of the Current Literature.

Cardiac amyloidosis is the most frequent infiltrative disease caused by the deposition of misfolded proteins in the cardiac tissue, leading to heart failure, brady- and tachyarrhythmia and death. Conduction disorders, atrial fibrillation (AF) and ventricular arrhythmia (VA) significantly impact patient outcomes and demand recognition. However, several issues remain unresolved regarding early diagnosis and optimal management. Extreme bradycardia is the most common cause of arrhythmic death, while fast and sustained VAs can be found even in the early phases of the disease. Risk stratification an

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… Left atrial appendage occlusion after thromboembolic events or left atrial appendage sludge during anticoagulation therapy: Is two better than one? Real-world experience from a tertiary care hospital J. Arrhythm. 2023 39 395 404 10.1002/joa3.12838 37324751 PMC10264741 110. Piccini J.P. Sievert H. … Feasibility of Left Atrial Appendage Occlusion in Left Atrial Appendage Thrombus: A Systematic Review JACC Clin. Electrophysiol. 2020 6 414 424 10.1016/j.jacep.2019.11.017 32327075 112. Preda A. Montalto C. Galasso M. Munafò A. Garofani I. Baroni M. Gigli L. Vargiu S. Varrenti M. Colombo G. …

Prevalence of Atrial Fibrillation and Intervention Therapy in Cardiac Amyloidosis.

Atrial fibrillation (AF) is a common and serious arrhythmia that frequently complicates cardiac amyloidosis (CA), a rare condition characterized by amyloid deposits in the heart. The coexistence of AF in CA patients significantly increases the risk of heart failure, stroke, and other life-threatening complications; however, the therapeutic approach to managing AF in CA patients remains underexplored. Thus, this review discusses the features of AF in CA patients, recent research on the development of effective treatment options, and strategies for future therapies. A comprehensive review of the

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… Left atrial appendage closure (LAAC) or left atrial appendage occlusion (LAAO) are traditional interventions to reduce the risk of thrombosis in patients with AF. Recent studies have demonstrated its efficacy in AF with a high risk of bleeding. … Cardiac amyloidosis and left atrial appendage closure. The CAMYLAAC study. Revista Espanola De Cardiologia (English Ed.) . 2023;76:503–510. doi: 10.1016/j.rec.2022.08.001. …

Crosslink between atrial fibrillation and cancer: a therapeutic conundrum.

Atrial fibrillation (AF) is more common in patients with malignancies than in general population. The pathophysiological processes include the pro-inflammatory condition and the exaggerated inflammatory reaction to chemotherapy, radiotherapy, and surgery interventions. Thus, it is pivotal to decrease morbidity and mortality in this group by providing appropriate care and prevention. In this subset, the risk of thromboembolic and bleeding events is high and the common risk score such as CHA2DS2-VASc and HAS-BLED employed in non-oncologic patients have limited evidence in cancer patients. A pauc

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… Percutaneous left atrial appendage (LAA) closure According to ESC guidelines [ 33 ], individuals with a high embolic hazard and conditions that exclude long-term anticoagulation (i.e., high bleeding risk) may consider percutaneous left atrial appendage closure as a secure and efficacious alternative … In individuals with a high embolic hazard and conditions that exclude long-term anticoagulation consider percutaneous left atrial appendage closure as a secure and efficacious alternative. …

Trends of Cardiovascular Interventions Stratified by Body Mass Index: An Analysis of the 2016-2020 Nationwide Inpatient Sample Population.

Background There is a scarcity of studies delineating the trends of cardiovascular interventions in the hospitalized population stratified b … ) for mitral valve replacement (MVRr), 12 (17.1%) for mitral valve repair (MVR), 79 (2.2%) for left atrial appendage (LAA) closure, and 3390 (5.2%) for percutaneous coronary intervention (PCI). The OV group had 1049 (8.9%) hospital admissions for AVRs, 42 (9%) for AVRr, 461 (10%) for MVRr, four (5.7%) for MVR, 307 (8.6%) for LAA closure, and 5703 (8.8%) for PCIs. …

The BNP-to-Albumin Ratio (BAR) as a Predictor of All-Cause Mortality in Elderly Patients with Atrial Fibrillation.

BackgroundThis study aimed to evaluate the prognostic value of the BNP-to-albumin ratio (BAR) for all-cause mortality in AF patients aged ≥60 years.MethodsThis single-center retrospective study included clinical data from 1458 AF patients treated at the First Affiliated Hospital of Kunming Medical University between December 2019 and December 2023. Using the optimal cutoff value determined by the restricted cubic spline, patients were divided into a low BAR group (BAR ResultsThe study ultimately included 842 patients with AF. Kaplan‒Meier analysis revealed that among elderly AF patients, the a

EHA Guidelines on Management of Antithrombotic Treatments in Thrombocytopenic Patients With Cancer.

In cancer patients, thrombocytopenia can result from bone marrow infiltration or from anticancer medications and represents an important limitation for the use of antithrombotic treatments, including anticoagulant, antiplatelet, and fibrinolytic agents. These drugs are often required for prevention or treatment of cancer-associated thrombosis or for cardioembolic prevention in atrial fibrillation in an increasingly older cancer population. Data indicate that cancer remains an independent risk factor for thrombosis even in case of thrombocytopenia, since mild-to-moderate thrombocytopenia does n

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… Left atrial appendage occlusion in AF According to the EHRA/EAPCI expert consensus statement on catheter-based left atrial appendage occlusion (LAAO), there are possible clinical scenarios in which LAAO may be a reasonable option for the prevention of stroke and embolism in patients with TP 113 ; however … For patients who may not tolerate any (S)APT, either an epicardial catheter approach or thoracoscopic clipping of the left atrial appendage might be options, whereas an endocardial device should not be implanted. …

Clinical outcomes of conventional surgery versus MitraClip® therapy for moderate to severe symptomatic mitral valve regurgitation in the elderly population: an institutional experience.

BACKGROUND: The aim of this study was to compare treatment of moderate to severe symptomatic mitral regurgitation (MR) with either conventio … ventional surgical group were myocardial revascularization 38%, pulmonary vein ablation 23.8%, left atrial appendage resection 52.4% and PFO occlusion 11.9%. RESULTS: Patients who underwent MitraClip treatment were though slightly older but the differences did not attain statistical significance (mean, 82.2 ± 1.65 vs 81.7 ± 1.35 years, p = 0,100), had lower LVEF …

Infarcts and ischemia in the abdomen: an imaging perspective with an emphasis on cross-sectional imaging findings.

Infarcts and ischemia of abdominal organs may present with acute abdominal pain, and early diagnosis is crucial to prevent morbidity and mortality. Unfortunately, some of these patients present in poor clinical conditions to the emergency department, and imaging specialists are crucial for optimal outcomes. Although the radiological diagnosis of abdominal infarcts is often straightforward, it is vital to use the appropriate imaging modalities and correct imaging techniques for their detection. Additionally, some non-infarct-related abdominal pathologies may mimic infarcts, cause diagnostic con

Dual Antiplatelet Therapy and Cancer; Balancing between Ischemic and Bleeding Risk: A Narrative Review.

Cardiovascular (CV) events in patients with cancer can be caused by concomitant CV risk factors, cancer itself, and anticancer therapy. Since malignancy can dysregulate the hemostatic system, predisposing cancer patients to both thrombosis and hemorrhage, the administration of dual antiplatelet therapy (DAPT) to patients with cancer who suffer from acute coronary syndrome (ACS) or undergo percutaneous coronary intervention (PCI) is a clinical challenge to cardiologists. Apart from PCI and ACS, other structural interventions, such as TAVR, PFO-ASD closure, and LAA occlusion, and non-cardiac dis

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… appendage occlusion”. … Keller K. 5-Year Experience of In-Hospital Outcomes After Percutaneous Left Atrial Appendage Closure in Germany JACC. Cardiovasc. Interv. 2019 12 1044 1052 10.1016/j.jcin.2019.04.002 31171280 98. Chen S. Weise F.K. Chun K.R.J. Schmidt B. …

Epigenetic Mechanism and Therapeutic Implications of Atrial Fibrillation.

Atrial fibrillation (AF) is the most common arrhythmia attacking 1. 5-2.0% of general population worldwide. It has a significant impact on morbidity and mortality globally and its prevalence increases exponentially with age. Therapies like catheter ablation or conventional antiarrhythmic drugs have not provided effective solution to the recurrence for AF over the past decades. Over 100 genetic loci have been discovered to be associated with AF by Genome-wide association studies (GWAS) but none has led to a therapy. Recently potential involvement of epigenetics (DNA methylation, histone modific

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… appendage; LAA, left atrial appendage; HDAC, histone deacetylase; VPA, Valproic Acid; ECM, extracellular matrix; MEF2, myocyte enhancer factor-2; AERP, atrial effective refractory period; RyR2, ryanodine receptor; HopX, homeo-domain-only protein; PV, pulmonary vein; SAN, sinoatrial node; RAP, rapid … Identification and characterization of circular RNAs in atrial appendage of patients with atrial fibrillation. Exp Cell Res. (2020) 389: 111821. 10.1016/j.yexcr.2020.111821 56. Liu T, Zhang G, Wang Y, Rao M, Zhang Y, Guo A, et al. …

Is the femoral cannulation for minimally invasive aortic valve replacement necessary?

INTRODUCTION: Minimally invasive cardiac surgery through a small transverse sternotomy is a new promising technique that can be considered a … ng aorta assessed by chest X-ray films. By convention, cannulation of the ascending aorta and right atrial appendage was performed as usual. In contrast, in one patient (5.5%), cannulation was placed in the superior vena cava and right common femoral vein into the inferior vena cava. In the present series, 15 mechanical prostheses and eight bioprostheses whose use …