Two Limitations of Subcutaneous Implantable Cardioverter Defibrillator in the Same Patient Warranting Its Explant.

BACKGROUND A subcutaneous implantable cardioverter defibrillator (S-ICD) is preferred over a transvenous implantable cardioverter defibrillator (TV-ICD) in selected cases owing to a lower rate of lead-related complications such as infections and venous thrombosis. However, the S-ICD has its own limitations, including inappropriate shocks due to oversensed events, and the inability to treat ventricular tachycardia (VT) below a heart rate of 170 beats per minutes (bpm). We present a patient case which showed manifestations of both of these limitations, warranting explant of the device.

Association between red blood cell distribution width and mortality and severity among patients with COVID-19: A systematic review and meta-analysis.

Emerging evidence has underscored the potential usefulness of red blood cell distribution width (RDW) measurement in predicting the mortality and disease severity of COVID-19. This study aimed to assess the association of the plasma RDW levels with adverse prognosis in COVID-19 patients. A comprehensive literature search from inception to September 2020 was performed to harvest original studies reporting RDW on admission and clinical outcomes among patients hospitalized with COVID-19.

COVID-19: A double threat to takotsubo cardiomyopathy and spontaneous coronary artery dissection?

Coronavirus disease 2019 (COVID-19) is an ongoing pandemic that has affected millions of individuals worldwide. Prior studies suggest that COVID-19 may be associated with an increased risk for various cardiovascular disorders, such as myocardial injury, arrhythmia, acute coronary syndrome, and venous thromboembolism. Early reports of non-COVID-19 patients have described the concurrence of takotsubo cardiomyopathy (TTC) and spontaneous coronary artery dissection (SCAD).

Venous Thromboembolism among Hospitalized Patients with COVID-19 Undergoing Thromboprophylaxis: A Systematic Review and Meta-Analysis.

Background: Preliminary evidence indicates that prophylactic-dose thromboprophylaxis may be inadequate to control the increased risk of venous thromboembolism (VTE) in patients hospitalized for coronavirus disease 2019 (COVID-19) infection. Additionally, it remains unclear whether the D-dimer measurement is useful for VTE risk stratification among COVID-19 patients. This study aimed to offer benchmark data on the incidence of VTE and to examine the difference in D-dimer levels among anticoagulated COVID-19 patients with and without VTE incident.

Extended Thromboprophylaxis With Betrixaban or Rivaroxaban for Acutely Ill Hospitalized Medical Patients: Meta-Analysis of Prespecified Subgroups.

Background: Betrixaban and rivaroxaban are the direct anticoagulants approved in the United States for extended venous thromboembolism (VTE) prophylaxis among acutely ill medical patients. The efficacy and safety in specific subgroups remain unclear.

Methods: A meta-analysis of 3 randomized trials involving extended thromboprophylaxis with betrixaban or rivaroxaban versus enoxaparin for medically ill patients was performed to compare VTE (composite of asymptomatic proximal and symptomatic deep vein thrombosis, pulmonary embolism, or VTE-related death) and major bleeding in subgroups by baseline D-dimer, age, sex, and major medical illness on hospitalization.

Vehicle Make and Model Recognition using Bag of Expressions.

Vehicle make and model recognition (VMMR) is a key task for automated vehicular surveillance (AVS) and various intelligent transport system (ITS) applications. In this paper, we propose and study the suitability of the bag of expressions (BoE) approach for VMMR-based applications. The method includes neighborhood information in addition to visual words.

Spontaneous coronary artery dissection managed with a conservative or revascularization approach: a meta-analysis.

Background: The optimal treatment approach for spontaneous coronary artery dissection (SCAD) remains unclear.

Objectives: The study aims to compare in-hospital and long-term clinical outcomes of SCAD patients initially managed with medical therapy (conservative approach) versus percutaneous coronary intervention or coronary artery bypass grafting (revascularization approach) based on published data.

Methods: We identified relevant studies by performing a systematic search in the Ovid MEDLINE and Embase databases.

Spontaneous coronary artery dissection and associated myocardial bridging: Current evidence from cohort study and case reports.

Spontaneous coronary artery dissection (SCAD) is a relatively uncommon and under-diagnosed disease characterized by the dissociation of intima and media of coronary artery wall due to an intimal tear or intramural hemorrhage. The exact pathophysiology of SCAD remains elusive and may involve multiple predisposing or precipitating factors including genetic abnormalities, inherited or acquired vasculopathies, hormonal influences, inflammation, intense exercise, emotional stress, and recreational drugs. Accruing reports, including five case reports and one cohort study, have recently addressed the concurrence of SCAD and myocardial bridging (MB), an anatomic variant in which a segment of the epicardial coronary descends and traverses in the myocardium.

Effect of intensive versus standard blood pressure control on major adverse cardiac events and serious adverse events: A bivariate analysis of randomized controlled trials.

Background: Intensive blood pressure (BP) lowering may offer protective effects against major adverse cardiac event (MACE) but is also associated with a greater risk of a serious adverse event (SAE). The risk-benefit profile of intensive versus standard BP control has not been comprehensively assessed.

Methods: Four studies were identified from a systematic literature search for randomized controlled trials comparing intensive versus standard BP lowering that reported both MACE and SAE endpoints.

Dual antithrombotic plus adjunctive antiinflammatory therapy to improve cardiovascular outcome in atrial fibrillation patients with concurrent acute coronary syndrome: A triple-pathway strategy.

The concurrence of atrial fibrillation and acute coronary syndrome poses a conundrum in the antithrombotic management as intensification of anticoagulation or antiplatelet therapy inevitably comes at the price of an increased bleeding risk. Various antithrombotic combinations have been attempted to prevent the recurrent cardiovascular events, however, there has been limited success in effective risk reduction for this high risk population. Given the overarching effect of interleukin 1β-driven inflammation on the arrhythmogenesis, thrombogenesis, and hypercoagulability, we hypothesize that the triple-pathway strategy (i.

Intercellular adhesion molecule-1 in diabetic patients with and without microalbuminuria.

Background: Nephropathy is a major complication of type 2 diabetes mellitus (T2DM) and is heralded by the insidious development of microalbuminuria (MA). It is suggested that the serum levels of Intercellular Adhesion Molecule-1 (ICAM-1) is correlated with diabetic nephropathy. In this cross-sectional study, we evaluated serum ICAM-1 level in diabetic patients with and without MA.

Development and evaluation of cesarean section surgical training using computer-enhanced visual learning.

Background: Skilled performance of cesarean deliveries is essential in obstetrics and gynecology residency. A computer-enhanced visual learning module (CEVL Cesarean) was developed to teach cesarean deliveries.

Methods: An online module presented cesarean deliveries as a series of components using text, audio, video and animation.