Role of Octaspline Multielectrode Catheter and Unipolar Reference Location for Premature Ventricular Contraction Ablation.

Background: An accurate local activation time (LAT) map is essential during premature ventricular contraction (PVC) ablation. The aim of this study was to evaluate whether the use of a novel octaspline multielectrode catheter, with and without the use of a catheter-embedded unipolar reference, improves LAT mapping during PVC ablation compared to a pre-existing pentaspline mapping catheter.

Methods: This study prospectively assessed 10 consecutive patients referred for PVC ablation from January to June 2023.

Can Pre-Ablation Biomarkers Be Used to Predict Arrhythmia Recurrence after Ablation Index-Guided Atrial Fibrillation Ablation?

Background: Ablation Index (AI) software has allowed better atrial fibrillation (AF) ablation results, but recurrence rates remain significant. Specific serum biomarkers have been associated with this recurrence.

Objectives: To evaluate whether certain biomarkers could be used (either individually or combined) to predict arrhythmia recurrence after AI-guided AF ablation.

Conservative management of pneumopericardium: A case of unexpected success.

A 79-year-old male with severe aortic stenosis was admitted with syncope and cranioencephalic traumatism with major nasal hemorrhage. While being prepared for surgical aortic valve replacement, a high-degree atrioventricular block was detected and a definite pacemaker was implanted.

Mid-term outcomes after catheter ablation in patients with congenital heart disease.

Introduction: Cardiac arrhythmias are a major concern in patients with CHD. The purpose of this study was to evaluate the long-term outcomes in patients with CHD submitted to catheter ablation.

Materials And Methods: Observational retrospective study of patients with CHD referred for catheter ablation from January 2016 to December 2021 in a tertiary referral centre.

Ostial vs. wide area circumferential ablation guided by the Ablation Index in paroxysmal atrial fibrillation.

Aims: Pulmonary vein isolation (PVI) guided by the Ablation Index (AI) has shown high acute and mid-term efficacy in the treatment of paroxysmal atrial fibrillation (AF). Previous data before the AI-era had suggested that wide-area circumferential ablation (WACA) was preferable to ostial ablation. However, with the use of AI, we hypothesize that ostial circumferential ablation is non-inferior to WACA and can improve outcomes in paroxysmal AF.

His bundle pacing and left bundle branch area pacing: Feasibility and safety.

Introduction And Objectives: There has been increasing interest in pacing methods that provide physiological stimulation, such as His bundle pacing (HBP) or left bundle branch area pacing (LBBAP). Our goal was to assess the feasibility and safety of these techniques.

Methods: Prospective observational single-center study evaluating 46 patients with indication for a pacemaker that attempted HBP or LBBAP from July 2020 to November 2021.

Glycoprotein IIb/IIIa inhibitor use in cardiogenic shock complicating myocardial infarction: The Portuguese Registry of Acute Coronary Syndromes.

Introduction And Objectives: Cardiogenic shock (CS) complicates 5-10% of cases of myocardial infarction (MI). Whether glycoprotein IIb/IIIa inhibitors (GPIs) are beneficial in these patients is controversial. Our aim is to assess the prognostic impact of GPI use on in-hospital mortality and outcomes in patients with MI and CS undergoing percutaneous coronary intervention (PCI).

CARDIAC PAPILLARY FIBROELASTOMA: A CASE WITH UNPRECEDENTED SPREAD.

Introduction: Papillary fibroelastomas (PFE) are a rare primary cardiac neoplasm, out of which multifocal PFE constitute a small minority of cases. These benign masses are commonly found on valvular surfaces, particularly the aortic valve.

Clinical Case: We present a patient with a history of embolic stroke and intra-cardiac masses.

Aortic valve intervention for aortic stenosis and cardiac amyloidosis: a systematic review and meta-analysis.

Aortic stenosis with cardiac amyloidosis (CA-AS) is common in the elderly. We provide an overview and a meta-analysis of outcomes after aortic valve (AV) intervention. The primary end point was all-cause mortality.

3D printing for left atrial appendage closure: A meta-analysis and systematic review.

Background: Three-dimensional printing (3D) has emerged as an alternative to imaging to guide left atrial appendage closure (LAAC) device sizing.

Aims: We assessed the usefulness of 3D printing compared to a standard imaging-only approach for LAAC.

Methods: We identified studies comparing an imaging-only with a 3D printing approach in LAAC.

Computed tomography coronary angiography as the noninvasive in stable coronary artery disease? Long-term outcomes meta-analysis.

To compare outcomes of coronary computed tomography angiography (CCTA) with that of functional testing (FT) in stable coronary artery disease. We searched PubMed, Embase, and Cochrane for randomized controlled trials (RCTs). A random-effects meta-analysis targeting all-cause death and nonfatal acute coronary syndromes was performed.

Transbasilic Approach for Percutaneous Closure of an Atrial Septal Defect.

Atrial septal defect (ASD) closure is indicated in the presence of a significant left-to-right shunt. In the case of an interrupted inferior vena cava (IVC), the standard percutaneous approach can be troublesome. The authors report a case of a 55-year-old female patient with an ostium secundum ASD with a significant left-to-right shunt at rest (Qp/Qs, 1.

Valvular Disease Begets Valvular Disease.

In acute severe aortic regurgitation, an inversion of pressure gradient from the left ventricle to the left atrium causes the classical sign of end-diastolic mitral regurgitation. Here we present a case of mid-diastolic mitral regurgitation in a 51-year-old man with severe aortic regurgitation secondary to infective endocarditis. ().

Chronic kidney disease in acute coronary syndromes: real-world data of long-term outcomes.

Patients with chronic kidney disease (CKD) are at increased cardiovascular risk. Patients with acute coronary syndrome were retrospectively allocated to three groups (stage 3A, stage 3B or stage 4) based on the Kidney Disease Improving Global Outcomes classification formulas: the CKD Epidemiology Collaboration (CKD-EPI; N = 401) and the modification of diet in renal disease (n = 355). The primary end point was all-cause mortality (median follow-up time, 32 months [15-70]).

Glycoprotein IIb/IIIa inhibitors for cardiogenic shock complicating acute myocardial infarction: a systematic review, meta-analysis, and meta-regression.

Background: Cardiogenic shock complicates 5-10% of myocardial infarction (MI) cases. Data about the benefit of glycoprotein IIb/IIIa inhibitors (GPI) in these patients is sparse and conflicting.

Methods: We performed a systematic review, meta-analysis, and meta-regression of studies assessing the impact of GPI use in the setting of MI complicated cardiogenic shock on mortality, angiographic success, and bleeding events.

Left Ventricular Thrombus Therapy With Direct Oral Anticoagulants Versus Vitamin K Antagonists: A Systematic Review and Meta-Analysis.

Background: Current guidelines recommend vitamin K antagonists (VKAs) for left ventricular thrombus (LVT) resolution. Direct oral anticoagulants (DOACs) are increasingly evaluated as alternatives to the standard of care in anticoagulation.

Methods: We performed a systematic review and meta-analysis to assess the use of DOACs vs VKAs for LVT treatment.

Global longitudinal strain in chronic asymptomatic aortic regurgitation: systematic review.

Chronic aortic regurgitation (AR) patients typically remain asymptomatic for a long time. Left ventricular mechanics, namely global longitudinal strain (GLS), has been associated with outcomes in AR patients. The authors conducted a systematic review to summarize and appraise GLS impact on mortality, the need for aortic valve replacement (AVR) and disease progression in AR patients.

A Spleen Complication After an Acute Myocardial Infarction.

We highlight the potential risk of combined antithrombotic therapy as a rare cause of spontaneous splenic hemorrhage. Conservative management is possible and reintroduction of the antithrombotic therapy is safe after the acute event. ().

Percutaneous Occlusion of Paravalvular Aortic Leaks: A Single-Center Experience Focused on Intracardiac Echocardiography.

Objectives: To describe our initial experience with an intracardiac echocardiography (ICE) for guidance of aortic percutaneous paravalvular leak occlusion (PPVLO) and to assess the outcomes after aortic PPVLO.

Background: PPVLO has emerged as an alternative to cardiac surgery for patients with symptomatic PVLs. ICE is an appealing alternative to transesophageal echocardiography (TEE) for guidance of percutaneous structural interventions, but experience with ICE for PPVLO guidance is limited.