Shifting from pharmacological to systematic mechanical reperfusion therapy for acute myocardial infarction via a cooperating network: impact on reperfusion rate and in-hospital mortality.

Background: Primary percutaneous transluminal coronary angioplasty is the preferred reperfusion strategy for acute ST-elevation myocardial infarction in selected settings. Limited data are available about the clinical impact of the implementation of a systematic primary angioplasty infarct reperfusion program in the real world.

Methods And Results: We organized a comprehensive district network allowing the coordinated and timely transfer of patients with acute ST-elevation myocardial infarction to the hub hospital with catheterization facilities in order to expand the use of mechanical reperfusion.

VDD pacemaker replacement is safe and reliable independently of the previously implanted lead: a prospective and controlled study.

Unlabelled: Theoretically, replacement of a VDD device requires using a similar pacemaker to provide the best match between the filtering characteristics of the pacemaker and the atrial dipole of the lead. This study evaluated the performance of newly implanted Vitatron VDD pacemakers connected to dedicated leads and compared the results with those of the same Vitatron pacemakers used as replacement but connected to a variety of nondedicated leads.

Methods: 23 consecutive patients (15 M, 8 F, 78 +/- 6 years) in Group 1 underwent pacemaker replacement with a VDD(R) Saphir 3 (Vitatron BV, Arnhem, The Netherlands) device designed for an 8.

Randomized comparison of upstream tirofiban versus downstream high bolus dose tirofiban or abciximab on tissue-level perfusion and troponin release in high-risk acute coronary syndromes treated with percutaneous coronary interventions: the EVEREST trial.

Objectives: We aimed to compare the effects of upstream tirofiban versus downstream high-dose bolus (HDB) tirofiban and abciximab on tissue level perfusion and troponin I release in high-risk non-ST-segment elevation acute coronary syndrome (ACS) patients treated with percutaneous coronary intervention (PCI).

Background: Optimal timing and dosage of glycoprotein IIb/IIIa inhibitors for ACS remain to be explored.

Methods: We randomized 93 high-risk ACS patients undergoing PCI to receive upstream (in the coronary care unit) tirofiban, downstream (just prior to PCI) HDB tirofiban, and downstream abciximab.

Elevations in troponin I after percutaneous coronary interventions are associated with abnormal tissue-level perfusion in high-risk patients with non-ST-segment-elevation acute coronary syndromes.

Background: In the setting of non-ST-segment-elevation (NSTE) acute coronary syndromes (ACS), the pathophysiological mechanisms underlying post-percutaneous coronary intervention (PCI) cardiac troponin I (cTnI) elevation remain unclear.

Methods And Results: We evaluated the relationship between troponin elevation and tissue-level perfusion using the TIMI flow grade, corrected TIMI frame count, TIMI myocardial perfusion grade (TMPG), and myocardial contrast enhancement by intracoronary myocardial contrast echocardiography (MCE) before and immediately after PCI performed within 24 to 48 hours of hospital admission in 42 high-risk (angina at rest, unequivocal ST-segment depression, and cTnI elevation) patients with NSTE-ACS. All patients were treated with glycoprotein IIb/IIIa inhibitors (27 with tirofiban and 15 with abciximab) and had successful PCI.

Heart rate regularisation in patients with permanent atrial fibrillation implanted with a VVI(R) pacemaker.

Unlabelled: Irregularity of ventricular cycles is a cause of haemodynamic impairment and symptoms in patients with atrial fibrillation (AF).

Aim Of The Study: Aim of the study was to determine the optimal pacing rate to stabilise ventricular cycle length at rest in patients with chronic AF, bradycardiac symptoms and VVI pacing.

Methods: The compensatory pause (CP) in AF, as defined by Langendorf, was used as a reference value in pacing the heart.

VDD pacemaker replacement independently of the implanted lead: a prospective study.

Background: Single-lead VDD pacing is effective, safe and reliable. The only still open, practical issue is represented by the theoretical need of replacing each device with a similar one compatible with the already implanted lead to guarantee the performance of the system. The aim of our study was to investigate the atrial sensing performance of VDD pacemakers working in combination with non-dedicated chronic leads.