Echocardiography as a Useful Tool for Differentiating Acute Pulmonary Embolism From Acute Coronary Syndrome: A Case Report.

Both acute coronary syndrome (ACS) and pulmonary embolism (PE) are life-threatening medical emergencies with overlapping symptoms and laboratory findings. Differentiating these two emergencies and initiating proper treatment are of paramount importance for good outcomes. In this report, we present the case of a 60-year-old male with a history of seizure disorder and hyperlipidemia, who presented to the emergency department (ED) after a syncopal episode preceded by three days of brief episodes of chest pain.

Low-Power Long-Duration Versus High-Power Short-Duration Radiofrequency Ablation of the Atrioventricular Node.

Background: Atrioventricular node (AVN) radiofrequency (RF) ablation is a highly effective treatment of atrial tachyarrhythmias that are resistant to other management modalities. To date, there is limited research that compares the properties of different RF ablation catheters. The current study aims to compare the effectiveness of several types of RF catheters in AVN ablation.

Sinus Node Dysfunction Triggered by Tonsillar Abscess: Effects of Vagal Nerve Compression.

BACKGROUND Compression of the vagus nerve by a pharyngeal mass is a well-documented condition that can result in sinus node dysfunction (SND). However, there is scarce literature on extrinsic vagal nerve compression from a tonsillar abscess. CASE REPORT A 59-year-old woman with a history of asthma and chronic throat discomfort presented to the Emergency Department with bradycardia, palpitations, and voice changes.

Successful Percutaneous Coronary Intervention in a Patient With Absent Right Coronary Artery Ostium: A Case Report and Literature Review.

Coronary artery anomalies present unique interventional challenges, particularly when associated with significant coronary artery disease. This case report contributes to the limited literature on congenital coronary artery anomalies, emphasizing the need for tailored approaches to optimize patient care. We present a case of a 70-year-old male with refractory angina and a rare congenital coronary anomaly characterized by the absence of the right coronary artery ostium, necessitating reliance on the left coronary system for myocardial perfusion.

A Case Report of Brugada Syndrome Associated With Physical Trauma.

Brugada syndrome is an autosomal dominant channelopathy that usually affects healthy young males without apparent structural heart disease. It is associated with a spectrum of variable and dynamic clinical manifestations, high risk of life-threatening ventricular arrhythmias, and sudden cardiac death. Our patient demonstrated transient and dynamic EKG changes of both type 1 (coved) and type 2 (saddleback) ST elevation, suggestive of the Brugada pattern that was associated with physical chest trauma and stressful situations.

Idiopathic Ventricular Tachycardia in the Presence of Triple-Vessel Coronary Artery Disease: A Case Report.

Exercise-induced ventricular tachycardia undergoes ischemia evaluation; however, it is important to identify idiopathic ventricular tachycardia in patients with concomitant coronary artery disease and radiofrequency ablations can be lifesaving. We report a case of exercise-induced right and left ventricular outflow tract ventricular tachycardia in a patient with triple vessel coronary artery disease.

Embolic Phenomena of Libman-Sacks Endocarditis and Antiphospholipid Syndrome.

Patients with systemic lupus erythematosus (SLE) and antiphospholipid antibody syndrome (APS) are at high risk of developing arterial or venous thromboembolism and a state of systemic hypercoagulability. Libman-Sacks endocarditis (LSE) is a type of non-bacterial endocarditis usually seen in patients with systemic lupus erythematosus and antiphospholipid antibody syndrome. These vegetations dislodge easily and can cause profound neurological and systemic complications in the form of emboli.

Comparative Effectiveness of Various Radiofrequency Ablation Catheters in the Ablation of Typical Atrial Flutter.

Introduction: Although ablation of typical atrial flutter (AFL) can be easily achieved with radiofrequency energy (RF), no studies compare the effectiveness of different ablation catheters. Our study aimed to compare the efficacy of various types of ablation catheters in treating typical AFL.

Methods: We analyzed patients with AFL who underwent RF ablation by a single operator at our institution.

Transthyretin Cardiac Amyloidosis Presenting as Bradycardia, Renal Failure, Atrioventricular-Nodal Blockade, Shock, and Hyperkalemia (BRASH) Syndrome: A Case Report.

BRASH syndrome involves the chain of events resulting from the collective effects of radycardia, enal failure, trioventricular (AV)-nodal blockade, hock, and yperkalemia. BRASH syndrome can rapidly progress to cardiac arrest. Early recognition is crucial.

A Rare Case of a Panic Attack Inducing a Junctional Escape Rhythm on ECG.

We present a unique and rare case of a young female patient who presented with complaints typical of her prior panic attacks and was found to have a junctional escape rhythm on ECG. Upon resolution of her symptoms, a repeat ECG demonstrated a return to normal sinus rhythm. Given that alternative etiologies had been ruled out, it was postulated that her panic attack induced a transient junctional escape rhythm.

Extremally rare cause of AV block during typical atrial flutter ablation not related to conduction tissue injury.

Background: 51-year-old female with extensive prior atrial surgery involving myxoma resection and patch septum repair and prior typical atrial flutter as well as peripatch reentry underwent redo radiofrequency ablation of typical atrial flutter.

Methods: After high density mapping was performed, and gap in the prior typical flutter line was ablated.

Result: During the ablation transient atrioventricular (AV) block was noted.

Sleep Apnea as a Risk Factor for Diastolic Dysfunction: A Systematic Review and Meta-Analysis.

Background: This meta-analysis assessed the relationship between obstructive sleep apnea (OSA) and echocardiographic parameters of diastolic dysfunction (DD), which are used in the assessment of heart failure with preserved ejection fraction.

Methods: We searched the databases including Ovid MEDLINE, Ovid Embase, Scopus, Web of Science, Google Scholar, and EBSCO CINAHL from inception up to December 26, 2020. The search was not restricted to time, publication status, or language.

Heart failure with preserved ejection fraction update: A review of clinical trials and new therapeutic considerations.

Between 2013 and 2016 there were approximately 6.2 million adults in the United States living with heart failure; nearly half had an ejection fraction that was preserved. Despite the high prevalence of heart failure with preserved ejection fraction (HFpEF), our understanding of this disease is limited and it still carries significant morbidity and mortality worldwide.

Treatment of Sleep Apnea with Positive Airway Pressure and Its Association with Diastolic Dysfunction: A Systematic Review and Meta-Analysis.

Background: This meta-analysis assessed the effect of long-term (>6 weeks) noninvasive positive airway pressure (PAP) on diastolic function in patients with obstructive sleep apnea (OSA).

Methods: We searched the databases for randomized clinical trials including Ovid MEDLINE, Ovid Embase Scopus, Web of Science, Google Scholar, and EBSCO CINAHL from inception up to December 20, 2019. The search was not restricted to time, publication status, or language.

Novel oral anticoagulants in intracardiac thrombosis resolution: a case series.

Background: Vitamin K antagonists (VKAs) have been regarded as the therapy of choice for intracardiac thrombosis for decades based mostly on observational data. The advent of direct oral anticoagulants (DOACs) has displaced VKAs as the first-line therapy for multiple thrombotic disorders but not for intracardiac thrombosis. Although limited, there is growing evidence that DOACs are effective for intracardiac thrombosis and some data suggest that thrombus resolution might be superior to that with warfarin.

Unusual Venous Access for Device Implantation.

BACKGROUND Cardiac implantable electronic devices (CIED) are mainstay therapy for a variety of patients with bradyarrhythmia as well as those at risk of sudden cardiac death and heart failure. At present, commonly used venous access are axillary, cephalic cutdown, and subclavian puncture. However, there are situations when these approaches cannot be employed because cannulation is not possible due to small size, spasm, absence, or occlusion of the vein.

Frequency of Complete Atrioventricular Block Complicating ST-Elevation Myocardial Infarction in Patients Undergoing Primary Percutaneous Coronary Intervention.

Objectives: ST-segment elevation myocardial infarction (STEMI) can be associated with many conduction disturbances including complete atrioventricular block (CAVB). CAVB complicating STEMI resulted in an increased mortality before the modern era of primary percutaneous coronary intervention (PCI). The aim of this study was to ascertain the rate and risk factors for CAVB in STEMI patients undergoing rapid reperfusion with PCI.

Use of Barbed Suture for Wound Closure in Electrophysiology Device Procedures.

Background: Barbed suture use in surgical fields such as gynecology and orthopedic surgery has been associated with faster wound closure, improved cosmesis, increased cost-effectiveness and potentially decreased rates of infection. However, the use of barbed suture in electrophysiology device procedures has not been reported.

Objective: This study aims to (1) investigate the safety and effectiveness of barbed suture in wound closure in patients after EP implantable cardioverter defibrillators and loop recorders (CIED) procedures, (2) to determine whether these sutures have an advantage in device implant procedures by improving incision integrity, (3) and to find out whether these sutures would potentially lead to lower rates of infections compared to non-barbed sutures.

Early Hemodynamic Changes during Head-Up Tilt Table Testing Can Predict a Neurocardiogenic Response in an African-American Patient Population.

Background: Head-up tilt table testing (HUTT) is time-consuming and associated with increased patient morbidity. Hemodynamic changes that occur during the early phase of HUTT may be predictive of neurocardiogenic syncope.

Methods: A retrospective chart review was performed in 119 consecutive African Americans ( 57 ± 19) who underwent HUTT for evaluation of syncope of unknown etiology.

Use of vascular closure device is safe and effective in electrophysiological procedures.

Purpose: Little is known about the usefulness and safety of vascular closure devices (VCDs) in electrophysiological procedures. We present a retrospective analysis of our experience assessing the utility and outcomes of collagen vascular closure device (Angioseal) in patients that required periprocedural anticoagulation and multiple vascular access sites.

Methods: An retrospective chart review of patients who have undergone the deployment of VCD following electrophysiological procedures.

Simplified automated right ventricular overdrive pacing for rapid diagnosis of supraventricular tachycardia.

Objectives: The purpose of this study was to prospectively evaluate the feasibility and diagnostic value of right ventricular overdrive pacing (RVOP) during supraventricular tachycardia (SVT) using a 2-catheter approach with automatic pacing from the right ventricular inflow (RVIT) and outflow tract (RVOT).

Methods: One hundred and thirty-six consecutive patients (with 138 arrhythmias, mean age 36 ± 20 years, range 4-95) were enrolled in this study. Only coronary sinus and ablation catheters were used.

Influence of atrioventricular optimization on hemodynamic parameters and quality of life in patients with dual chamber pacemaker with ventricular lead in right ventricular outflow tract.

Background: The aim of this study was to ascertain whether individual atrioventricular delay (AVD) optimization using impedance cardiography (ICG) offers beneficial hemodynamic effects as well as improved exercise tolerance and quality of life in patients with requiring constant right ventricular pacing.

Methods: There were 37 patients with advanced AV block included in the study. Several examinations were performed at the beginning.