Failure to defibrillate or cardiovert due to premature truncation of biphasic shocks from implantable defibrillators.

Background: In 2022 and 2023, Medtronic recalled implantable defibrillators because they may deliver less than full-energy shocks. The 2022 problem truncates the second phase of the waveform (SCP-T2), resulting in ∼32-J shocks, and is mitigated by downloadable software. The 2023 malfunction truncates the first phase of the waveform, resulting in 0- to 12-J shocks due to a glassed feedthrough problem (GFT-T1) that might be avoided by programming B>AX shock polarity.

Revascularization and long-term outcomes in high-acuity spontaneous coronary artery dissection.

Background: Spontaneous coronary artery dissection (SCAD) is often treated conservatively due to revascularization risks. Yet, an important number of SCAD patients have high acuity characteristics necessitating revascularization, with uncertain long-term outcomes.

Objectives: Document revascularization utilization and long-term outcomes in high acuity SCAD.

Spontaneous Coronary Artery Dissection and Evidence-Based Medicine.

Spontaneous coronary artery dissection (SCAD) is a relatively newly diagnosed area, and evidence-based medicine (EBM) standards are emerging and currently include an aspirin, β blocker, clopidogrel, angiotensin-converting enzyme inhibitor/angiotensin-receptor blocker for patients with hypertension, vascular abnormality imaging, and cardiac rehabilitation. Because SCAD is an uncommon condition, many providers are unfamiliar with EBM treatment standards which could affect the implementation of recommended treatment. This study documented the frequency of failure to meet EBM SCAD treatment standards and factors contributing to conformance failure.

Multi-institution Assessment of the Accuracy of Cardiac Computed Tomography in Preparation for Superior Cavopulmonary Connection.

Background: Patients with single ventricle (SV) congenital heart disease (CHD) undergo several interventions in the first years of life. Advanced diagnostics are required for interstage assessment of anatomy, but are associated with significant diagnostic risk. We sought to evaluate image quality, risk, and accuracy of cardiac computed tomography (CCT) for evaluation of anatomy prior to superior cavopulmonary connection (SCPC) compared to surgical findings across 2 institutions.

Variation in Advanced Diagnostic Imaging Practice Patterns and Associated Risks Prior to Superior Cavopulmonary Connection: A Multicenter Analysis.

Single ventricle patients typically undergo some form of advanced diagnostic imaging prior to superior cavopulmonary connection (SCPC). We sought to evaluate variability of diagnostic practice and associated comprehensive risk. A retrospective evaluation across 4 institutions was performed (1/1/2010-9/30/2016) comparing the primary modalities of cardiac catheterization (CC), cardiac magnetic resonance (CMR), and cardiac computed tomography (CT).

Multimodality Assessment of Anomalous Aortic Origin of the Right Coronary Artery Presenting With Cardiac Arrest.

Anomalous aortic origin of coronary artery (AAOCA) can range from benign anatomic variants to those presenting with sudden cardiac arrest. This unique case of right AAOCA demonstrates detailed anatomic findings from cardiac computed tomography and the effects of transient acute coronary ischemia by cardiac magnetic resonance. ().

Safety, Efficacy, and Dose Protocol of Metoprolol for Heart Rate Reduction in Pediatric Outpatients Undergoing Cardiac CT Angiography.

Background: Image quality and radiation dose are optimized with a slow, steady heart rate (HR) when imaging the coronary arteries during cardiac computed tomography angiography (CCTA). The safety, efficacy, and protocol for HR reduction with beta blocker medication is not well described in a pediatric patient population.

Objective: Provide a safe and efficient metoprolol dose protocol to be used in pediatric outpatients undergoing CCTA.

Multi-institution assessment of the use and risk of cardiovascular computed tomography in pediatric patients with congenital heart disease.

Background: Cardiac computed tomography (CT) is increasingly used in pediatric patients with congenital heart disease (CHD). Variability of practice and of comprehensive diagnostic risk across institutions is not known.

Methods: Four centers prospectively enrolled consecutive pediatric CHD patients <18 years of age undergoing cardiac CT from January 6, 2017 to 1/30/2020.

Nonatherosclerotic Abdominal Vasculopathies.

Background: Nonatherosclerotic abdominal arterial vasculopathies (NAVs), including mesenteric or renal artery dissection, aneurysm, stenosis, and vasculitis, are rare but have great clinical significance. Patients may present emergently with life-threatening complications such as arterial rupture and hemorrhagic shock. Herein, we present our center's experience with NAVs and provide extensive literature review to close the gap in the scarce, related literature.

Medication adherence, cascade screening, and lifestyle patterns among women with hypercholesterolemia: Results from the WomenHeart survey.

Background: Hypercholesterolemia is a major risk factor for cardiovascular disease. Women with hypercholesterolemia and familial hypercholesterolemia (FH) are a high-risk group often underdiagnosed, undertreated, and unaware of the need for cascade screening.

Objectives: The objectives were to identify the prevalence of hypercholesterolemia and FH in 2 national databases, explore lifestyle/medication adherence, and examine rates of cascade screening (lipid testing in all first-degree relatives) among those with FH.

Motivational interviewing to reduce cardiovascular risk in African American and Latina women.

Cardiovascular disease (CVD) is the leading cause of death for women, and disproportionally so for African American and Latina women. CVD is largely preventable and many risks can be attributable to health behaviors, implementing and sustaining positive health behaviors is a challenge. Motivational interviewing is one promising intervention for initiating behavior change.

The PADQOL: development and validation of a PAD-specific quality of life questionnaire.

Understanding the impact of peripheral artery disease (PAD) requires broad evaluation of how functional limitations of PAD affect patients' perceptions of health-related quality of life (HRQL). The objective of this study was to describe the development, testing, and psychometric properties of the PAD Quality of Life Questionnaire (PADQOL). The PADQOL was developed in three steps: (1) interviews of symptomatic PAD patients provided content of the initial questionnaire; (2) co-administration with the SF-36 (a 36-item short-form health survey), Walking Impairment Questionnaire, and Profile of Mood States examined construct validity; and (3) a three-phased factor analysis identified factors and shortened the questionnaire.

Preventing cardiovascular disease in women: how can we do better?

Purpose Of Review: This review highlights advances in the primary and secondary prevention of cardiovascular disease (CVD) in women in the preceding 12 months.

Recent Findings: The American Heart Association (AHA) has recently published guidelines on the prevention of CVD in women, which brought new attention to this important topic. Limited progress has been made regarding an awareness of CVD among women, and modest progress has been made on the creation of health behavior change programs that effectively reduce smoking, increase physical activity and improve nutrition.