[Premature ventricular complexes: what to do?].

Premature ventricular complexes (PVCs) are frequently encountered arrhythmias in the general population. They can occur in the context of an underlying structural heart disease (SHD) of ischemic, hypertensive or inflammatory cause and therefore be a prognostic factor. Some PVCs can appear in the context of inherited arrhythmic syndromes while others are seen as idiopathic in the absence of an underlying heart condition and are considered benign.

Deglutition-Induced Atrial Tachycardia.

While bradyarrhythmia is the most common arrhythmia during deglutition, tachycardias are considered to be a very rare condition with approximately 50 cases documented worldwide. The subjects are usually men with no structural heart disease or gastrointestinal pathology, and symptoms may vary from palpitations to lightheadedness or syncope. Management is based on adapting alimentary habits in combination with agents such as beta-blockers, calcium channel blockers, and class IA, IC, and III drugs.

[Pacemakers and defibrillators: what the non-specialist needs to know].

Cardiologists are in charge of the follow-up of patients equipped with pacemakers and defibrillators. In many situations, however, the non-specialist will have to take care of these patients. It is therefore essential that the practitioner understands the basics of how these devices work, the potential complications and the situations in which the cardiologist's intervention is necessary.

Case report of an unusual combination of purulent pericarditis and false aneurysm of the ascending aorta.

Background: Purulent pericarditis is an uncommon entity, which is, in very rare cases, associated to infection of the aorta.

Case Presentation: We present the case of a 42-year-old male patient, who was admitted to hospital complaining of tiredness, diarrhea and leg edema. Clinical examination revealed a hypotensive and obviously shocked patient.

Performance of highly sensitive cardiac troponin T assay to detect ischaemia at PET-CT in low-risk patients with acute coronary syndrome: a prospective observational study.

Background: Highly sensitive troponin T (hs-TnT) assay has improved clinical decision-making for patients admitted with chest pain. However, this assay's performance in detecting myocardial ischaemia in a lowrisk population has been poorly documented.

Purpose: To assess hs-TnT assay's performance to detect myocardial ischaemia at positron emission tomography/CT (PET-CT) in low-risk patients admitted with chest pain.

Assessment of quality performance measures for primary percutaneous coronary intervention: A report from a tertiary referral centre in Switzerland.

Aims: The present study aimed to document a local pattern of care in consecutive patients undergoing primary percutaneous coronary intervention for ST-elevation myocardial infarction (STEMI) in a tertiary centre in Switzerland.

Methods: A retrospective study was conducted at the University Hospital of Lausanne, Switzerland. A total of 389 consecutive patients undergoing primary percutaneous coronary intervention for STEMI between 2009 and 2010 were studied.

Relationship between time of day and periprocedural myocardial infarction after elective angioplasty.

Objectives: To test if the time of day significantly influences the occurrence of type 4A myocardial infarction in elective patients undergoing percutaneous coronary intervention (PCI).

Background: Recent studies have suggested an influence of circadian rhythms on myocardial infarction size and mortality among patients with ST-elevation myocardial infarction. The aim of the study is to investigate whether periprocedural myocardial infarction (PMI) is influenced by the time of day in elective patients undergoing PCI.

Association of biomarkers of lipid modification with functional and morphological indices of coronary stenosis severity in stable coronary artery disease.

Biomarkers of blood lipid modification and oxidative stress have been associated with increased cardiovascular morbidity. We sought to determine whether these biomarkers were related to functional indices of stenosis severity among patients with stable coronary artery disease. We studied 197 consecutive patients with stable coronary artery disease due to single vessel disease.

Myocardial no-reflow treatment.

No-reflow phenomenon is a consequence of percutaneous coronary intervention (PCI) which arises most of the time in the setting of myocardial infarction, but can be also the consequence of PCI in stable angina patients (rotatablator ablation technique or angioplasty in saphenous vein grafts). In this review, we summarize two ways of treating the no-reflow according to the current literature. First through the pharmacological approach where several compounds have been assessed like adenosine, nitroprusside, verapamil, nicorandil, dipyridamole, epinephrine or cyclosporine.

St. John's Wort in patients non-responders to clopidogrel undergoing percutaneous coronary intervention: a single-center randomized open-label trial (St. John's Trial).

We assessed if St. John's Wort (SJW) improves platelet response in patients (pts) resistant to clopidogrel after percutaneous coronary intervention (PCI). Stable angina pts non-responders to 600 mg clopidogrel (P2Y12 reaction units (PRU) >240) were randomized (2:1) to SJW (n = 15) or placebo (n = 8).

Pressure-diameter relationship in human coronary arteries.

Background: To quantify the changes in arterial dimensions after the acute changes in pressure associated with percutaneous coronary intervention (PCI).

Methods And Results: Forty-eight patients with one angiographically moderate-to-severe stenosis were included in the study. The pressure proximal and distal to the stenosis and the arterial diameter proximal and distal to the stenosis were measured at baseline, after intracoronary nitrates, and after stent PCI.

Circadian variations of ischemic burden among patients with myocardial infarction undergoing primary percutaneous coronary intervention.

Background: Several parameters of cardiovascular physiology and pathophysiology exhibit circadian rhythms. Recently, a relation between infarct size and the time of day at which it occurs has been suggested in experimental models of myocardial infarction. The aim of this study is to investigate whether circadian rhythms could cause differences in ischemic burden in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI).

Long-term follow-up after fractional flow reserve-guided treatment strategy in patients with an isolated proximal left anterior descending coronary artery stenosis.

Objectives: This study sought to evaluate the long-term clinical outcome of patients with an angiographically intermediate left anterior descending coronary artery (LAD) stenosis in whom the revascularization strategy was based on fractional flow reserve (FFR).

Background: When revascularization is based mainly on angiographic guidance, a number of hemodynamically nonsignificant stenoses will be revascularized.

Methods: In 730 patients with a 30% to 70% isolated stenosis in the proximal LAD and no significant valvular disease, FFR measurements were obtained to guide treatment strategy.

Transcriptional fingerprint of human whole blood at the site of coronary occlusion in acute myocardial infarction.

Aims: Transcriptome patterns associated with acute myocardial infarction at the site of coronary occlusion are largely unknown. The aim of this study was to decipher the angiogenic, atherosclerotic, and inflammatory mRNA profiles in whole blood samples collected at the site of coronary occlusion in patients with ST-elevation myocardial infarction (STEMI).

Methods And Results: In five consecutive patients with STEMI, blood was sampled at the site of occlusion (local) and in the systemic circulation (peripheral) during primary percutaneous coronary intervention.

Relationship between peripheral arterial reactive hyperemia and residual platelet reactivity after 600 mg clopidogrel.

Clopidogrel reduces long-term ischemic events in patients with acute coronary syndrome or stable angina (SA) undergoing percutaneous coronary intervention (PCI). Endothelial function improvement has been proposed, among other factors, for this beneficial effect of clopidogrel, but whether this might be associated to its anti-platelet action remains unclear. We tested the hypothesis that clopidogrel improvement of peripheral vascular endothelial function might be associated with inhibition of platelet aggregation.

Fractional flow reserve for the assessment of nonculprit coronary artery stenoses in patients with acute myocardial infarction.

Objectives: We investigated the reliability of fractional flow reserve (FFR) of nonculprit coronary stenoses during percutaneous coronary intervention (PCI) in acute myocardial infarction.

Background: Assessing the hemodynamic severity of the nonculprit coronary artery stenoses at the acute phase of a myocardial infarction could improve risk stratification and shorten the diagnostic work-up.

Methods: One hundred one patients undergoing PCI for an acute myocardial infarction (n = 75 with ST-segment elevation myocardial infarction [STEMI], and n = 26 with non-ST-segment elevation myocardial infarction) were prospectively recruited.

Translesional pressure gradients to predict blood pressure response after renal artery stenting in patients with renovascular hypertension.

Background: In previous studies on the effect of renal stenting on arterial hypertension, patients were selected mainly on the basis of angiographic parameters of the renal artery stenosis. The aim of the present study was to evaluate whether translesional pressure gradients could identify the patients with renal artery stenosis who might benefit from stenting.

Methods And Results: A total of 53 consecutive hypertensive patients with unilateral RAS scheduled for renal artery intervention were recruited.

Comparison of 600 versus 300-mg Clopidogrel loading dose in patients with ST-segment elevation myocardial infarction undergoing primary coronary angioplasty.

The aim of the present study was to compare 600- and 300-mg clopidogrel loading doses in patients with ST-segment elevation myocardial infarctions who underwent primary percutaneous coronary intervention (PCI). Two hundred fifty-five consecutive patients presenting with ST-segment elevation myocardial infarctions who underwent primary PCI were enrolled. Patients were divided into 2 groups on the basis of the loading dose of clopidogrel received before the procedure (600 vs 300 mg).

Effective radiation dose, time, and contrast medium to measure fractional flow reserve.

Objectives: This study sought to define the additional effective radiation dose, procedural time, and contrast medium needed to obtain fractional flow reserve (FFR) measurements after a diagnostic coronary angiogram.

Background: The FFR measurements performed at the end of a diagnostic angiogram allow the obtaining of functional information that complements the anatomic findings.

Methods: In 200 patients (mean age 66 +/- 10 years) undergoing diagnostic coronary angiography, FFR was measured in at least 1 intermediate coronary artery stenosis.

Thrombus aspiration in primary percutaneous coronary intervention in high-risk patients with ST-elevation myocardial infarction: a real-world registry.

Objectives: To evaluate the effect of thrombus aspiration in a real-world all-comer patient population with STEMI undergoing primary PCI.

Background: Catheter thrombus aspiration in primary PCI was beneficial in randomized clinical trials.

Methods: We enrolled 313 STEMI patients presenting with TIMI Flow Grade 0 or 1 in the infarct related artery at baseline angiogram undergoing primary PCI.

Practical tips and tricks for the measurement of fractional flow reserve.

Coronary pressure measurement has emerged as one of the most promising tool to assist interventional cardiologist to make accurate clinical decisions. Fractional flow reserve (FFR) is a simple way of reliably assessing the functional consequences of coronary atherosclerosis. The training in FFR is easy, and coronary pressure measurements can be obtained swiftly in the catheterization laboratory.