Regional Antibiotic Delivery for Implanted Cardiovascular Electronic Device Infections.

Background: Present guidelines endorse complete removal of cardiovascular implantable electronic devices (pacemakers/defibrillators), including extraction of all intracardiac electrodes, not only for systemic infections, but also for localized pocket infections.

Objectives: The authors evaluated the efficacy of delivering continuous, in situ-targeted, ultrahigh concentration of antibiotics (CITA) into the infected subcutaneous device pocket, obviating the need for device/lead extraction.

Methods: The CITA group consisted of 80 patients with pocket infection who were treated with CITA during 2007-2021.

Arrhythmogenic Effects of Cardiac Memory.

Cardiac memory is the term used to describe an interesting electrocardiographic phenomenon. Whenever a QRS complex is wide and abnormal, such as during ventricular pacing, the T waves will also be abnormal and will point to the opposite direction of the wide QRS. If the QRS then normalizes, such as after cessation of ventricular pacing, the T waves will normalize as well, but at a later stage.

Polymorphic Ventricular Tachycardia: Terminology, Mechanism, Diagnosis, and Emergency Therapy.

Polymorphic ventricular tachyarrhythmias are highly lethal arrhythmias. Several types of polymorphic ventricular tachycardia have similar electrocardiographic characteristics but have different modes of therapy. In fact, medications considered the treatment of choice for one form of polymorphic ventricular tachycardia, are contraindicated for the other.

Reconstruction of the left atrium for atrial fibrillation ablation using the machine learning CARTO 3 m-FAM software.

Purpose: Atrial fibrillation (AF) ablation requires a precise reconstruction of the left atrium (LA) and pulmonary veins (PV). Model-based FAM (m-FAM) is a novel module recently developed for the CARTO system which applies machine learning techniques to LA reconstruction. We aimed to evaluate the feasibility and safety of a m-FAM-guided AF ablation as well as the accuracy of LA reconstruction using the cardiac computed tomography angiography (CTA) of the same patient LA as the gold standard, in 32 patients referred for AF ablation.

Continuous Heart Rate Monitoring for Automatic Detection of Life-Threatening Arrhythmias With Novel Bio-Sensing Technology.

Assessing the effectiveness of novel bio-sensing technology (CardiacSense), for accuracy and reliability of automatic detection of life-threatening arrhythmias. This prospective study consisted of Eighteen patients (13 males and 5 females, mean age 59.4 ± 21.

Pulmonary Vein Isolation With Ablation Index via Single Transseptal Crossing: Critical Role of Carina Isolation.

Aim: Reconnection of the pulmonary veins (PVs) is the most common reason for the recurrence of atrial fibrillation (AF). The ablation index is a marker of ablation lesion quality that achieves high percentages of first-pass isolation and improved AF ablation results. Most operators use a double transseptal approach with confirmation of PV isolation with a circular mapping catheter.

Continuous heart rhythm monitoring using mobile photoplethysmography in ambulatory patients.

Background: Wearable devices using photo-plethysmography (PPG) can accurately detect heart beats and may be useful for heart rate measurement and diagnosis of arrhythmias such as atrial fibrillation (AF). A previous study of a new portable PPG sensor (CardiacSense) showed high accuracy in heart rate measurement and AF detection in resting patients. We report a trial done to test the same device in active ambulatory patients with diverse characteristics.

Grapefruit juice prolongs the QT interval of healthy volunteers and patients with long QT syndrome.

Background: The list of medications linked to drug-induced long QT syndrome (LQTS) is diverse. It is possible that food products too have QT-prolonging potential.

Objective: We tested the effects of grapefruit juice on the QT interval with the methodology used by the pharmaceutical industry to test new drugs.

Continuous heart rate monitoring for automatic detection of atrial fibrillation with novel bio-sensing technology.

Background: Asymptomatic atrial fibrillation [AF] is an important cause of fatal or disabling stroke. A continuous heart-rate monitoring device, comfortable enough to be worn continuously and reliable enough to detect AF, would allow for prompt initiation of anticoagulation therapy to prevent stroke.

Methods: We studied a new custom-made wearable photo-plethysmograph [PPG] wrist-watch sensor, specifically designed for continuous heart rate monitoring and incorporating contact and motion noise-filters.

Sustained Elevation of Vascular Endothelial Growth Factor and Angiopoietin-2 Levels After Transcatheter Aortic Valve Replacement.

Background: Transcatheter aortic valve replacement (TAVR) exposes the systemic vasculature to increased mechanical forces. Endothelial adaptation to mechanical stimuli is associated with angiogenic activation through various growth factors. We studied the potential angiogenic shift evoked by TAVR.

Forced diuresis with matched hydration in reducing acute kidney injury during transcatheter aortic valve implantation (Reduce-AKI): study protocol for a randomized sham-controlled trial.

Background: Acute kidney injury (AKI) is observed in up to 41% of patients undergoing transcatheter aortic valve implantation (TAVI) and is associated with increased risk for mortality. The aim of the present study is to evaluate whether furosemide-induced diuresis with matched isotonic intravenous hydration using the RenalGuard system reduces AKI in patients undergoing TAVI.

Methods/design: Reduce-AKI is a randomized sham-controlled study designed to examine the effect of an automated matched hydration system in the prevention of AKI in patients undergoing TAVI.

Long-term clinical and echocardiographic follow-up of the freestyle stentless aortic bioprosthesis: the Tel Aviv Medical Center experience.

Background: Stentless aortic bioprostheses were designed to provide improved hemodynamic performance and potentially better survival.

Objectives: To report the outcomes of patients after aortic valve replacement with the Freestyle stentless bioprosthesis at the Tel Aviv Medical Center followed for < or = 15 years.

Methods And Results: Between 1997 and 2011, 268 patients underwent primary aortic valve replacement with a Freestyle bioprosthesis, 211 (79%) of them in the sub-coronary position.

Hemodynamic performance and outcome of percutaneous versus surgical stentless bioprostheses for aortic stenosis with anticipated patient-prosthesis mismatch.

Objectives: We aimed to compare the performance and midterm survival of transcutaneous aortic valve replacement (TAVR) and surgically implanted stentless aortic valve replacement (SAVR) for severe aortic stenosis in patients anticipated to have patient-prosthesis mismatch (PPM).

Methods: A retrospective analysis was performed of 86 and 49 consecutive TAVR and SAVR patients with severe aortic stenosis and calculated minimal effective orifice area larger than the best projected effective orifice area. Cox hazard analyses were used to assess the effect of TAVR versus SAVR on outcome.