Constrictive pericarditis in the modern era: novel criteria for diagnosis in the cardiac catheterization laboratory.

Objectives: This study sought to determine the clinical utility of a new catheterization criterion for the diagnosis of constrictive pericarditis (CP).

Background: The finding of early rapid filling and equalization of end-diastolic pressures obtained by cardiac catheterization are necessary for the diagnosis of CP, but these findings are also present in patients with restrictive myocardial disease (RMD). Enhanced ventricular interaction is unique to CP.

Estimation of left ventricular filling pressure with exercise by Doppler echocardiography in patients with normal systolic function: a simultaneous echocardiographic-cardiac catheterization study.

Background: Doppler echocardiography is now used to evaluate left ventricular filling pressures in patients at rest. However, the clinical use of Doppler echocardiography in the determination of filling pressures with exercise has been less well studied.

Objective: The aim of this prospective study was to confirm the validity of an accepted Doppler parameter (ratio of transmitral E velocity to Doppler tissue annular e' velocity [E/e']) as a measure of filling pressure in patients with normal systolic function during rest and exercise.

Alcohol septal ablation versus surgical septal myectomy: comparison of effects on atrioventricular conduction tissue.

Objectives: This study was designed to evaluate the effect of septal reduction therapies on the conduction system for patients with hypertrophic cardiomyopathy (HCM).

Background: Heart block is a potential complication of both catheter-based and surgical procedures to relieve left ventricular outflow tract obstruction in HCM, but it is important to understand the different effects of these treatments on the conduction system.

Methods: The electrocardiograms and postoperative course of patients who underwent percutaneous alcohol septal ablation or surgical myectomy at Mayo Clinic between 1999 and 2003 were reviewed.

Constrictive pericarditis in 26 patients with histologically normal pericardial thickness.

Background: Traditionally, increased pericardial thickness has been considered an essential diagnostic feature of constrictive pericarditis. Although constriction with a normal-thickness pericardium has been demonstrated clinically by noninvasive imaging, the details of clinicopathological correlates have not been described.

Methods And Results: A total of 143 patients with proven constriction underwent pericardiectomy at Mayo Clinic between 1993 and 1999.

The use of radiofrequency catheter ablation to extract a chronic permanent pacemaker lead after failed laser extraction.

Even with the latest advances in pacemaker lead extraction techniques, successful lead extraction via percutaneous techniques still cannot be achieved in up to 2% of procedures at qualified centers reiterating the need for further development in this area. We present an example of a novel technique using radiofrequency (RF) energy delivered with a steerable ablation catheter to facilitate lead removal using an 8-french guiding sheath (SRO, Daig corporation) and a bidirectional steerable 4 mm tip ablation catheter (EPT). With a short series of RF ablations, the pacemaker lead tip was successfully freed without complications.

Endocrine Heart Disease.

With the increasing prevalence of obesity and diabetes mellitus in the United States, associated cardiovascular disease is reaching epidemic proportions with staggering economic and societal impact. Numerous studies have demonstrated the poorer prognosis associated with chronic coronary artery disease and acute coronary syndromes in patients with diabetes compared with nondiabetic patients. Although the therapeutic strategy is largely the same for the two populations, proper management of the diabetic patient with cardiovascular disease must account for the associated metabolic disturbances.

Influence of wall motion score on mortality after coronary bypass surgery in the CABG-patch trial.

Background: It was hypothesized that a wall motion score (WMS) of
Methods And Results: One hundred and eighty-nine patients from the trial with a LVEF of 16% (n=108), respectively, calculated from a preoperative RAO ventriculogram.