Distal His Pacing Promotes Reverse Remodeling in a Child With Conventional Pacing-Induced Ventricular Dysfunction.

Children with indications of pacing often require epicardial pacemakers with generators implanted in the abdominal wall due to small body size or challenging anatomy because of congenital heart diseases. However, left ventricle (LV) systolic dyssynchrony induced by epicardial pacing may result in adverse remodeling and LV dysfunction. Recently, distal His bundle pacing (dHBP) has been shown to restore normal ventricular function in adult patients with pacemaker induced ventricular dysfunction.

Age as a Prognostic Factor in Patients with Acute Coronary Syndrome undergoing Urgent/Emergency Cardiac Surgery.

Background: Patients presenting with acute coronary syndrome (ACS) who require urgent/emergency coronary artery bypass grafting (CABG) are increasing, as is the complexity of their clinical characteristics, one of which is advanced age. We evaluated the prognostic role of age in patients undergoing urgent/emergency cardiac surgery for ACS.

Methods: From January to December 2013, 452 consecutive patients underwent CABG at our institution.

Discordances originated by multiple meta-analyses on interventions for myocardial infarction: a systematic review.

Objectives: To clarify the impact of multiple (covering the same population, intervention, control, and outcomes) systematic reviews (SRs) on interventions for myocardial infarction (MI).

Study Design And Setting: Clinical Evidence (BMJ Group) sections and related search strategies regarding MI were used to identify multiple SRs published between 1997 and 2007. Multiple SRs were classified as discordant if they featured conflicting results or interpretation of them.

Role of electrophysiological study and catheter ablation for recurrent ventricular tachycardia complicating myocarditis.

Here we report the case of a 31-year-old man admitted to our hospital with echocardiografic and Cardiac Magnetic Resonance signs of myocarditis complicated by ventricular tachycardia, initially resolved with direct current shock. After the recurrence of ventricular tachycardia the patient was submitted to electrophysiological study revealing a re-entrant circuit at the level of the medium segment of interventricular septum, successfully treated with transcatheter ablation. This case highlights how the presence of recurrent ventricular arrhythmias at the onset of acute myocarditis, suspected or proven, could be associated with a pre-existing arrhythmogenic substrate, therefore these patients should be submitted to electrophysiological study in order to rule out the presence of arrhythmogenic focuses that can be treated with transcatheter ablation.

Minimal invasive surgery for atrial fibrillation: an updated review.

Aims: Despite its proven efficacy, the Cox-Maze III procedure did not gain widespread acceptance for the treatment of stand-alone atrial fibrillation (SA-AF) because of its complexity and technical difficulty. Surgical ablation for SA-AF can now be successfully performed utilizing minimally invasive surgery (MIS). This study provides an overview of state-of-the-art MIS for the treatment of SA-AF.

Emergency surgery for native mitral valve endocarditis: the impact of septic and cardiogenic shock.

Background: Limited information exists about the real impact of the etiology of shock on early and late outcome after emergency surgery in acute native mitral valve endocarditis (ANMVE). This multicenter study analyzed the impact of the etiology of shock on early and late outcome in patients with ANMVE.

Methods: Data were collected in eight institutions.

Treatment of lone atrial fibrillation: a look at the past, a view of the present and a glance at the future.

Despite its proven efficacy, the Cox-Maze III procedure did not gain widespread acceptance for the treatment of lone atrial fibrillation (LAF) because of its complexity and technical difficulty. Surgical ablation for LAF can now be successfully performed utilizing minimally invasive techniques. This article provides an overview of the current state of the art in the surgical treatment of LAF.

Refractory spasm of coronary arteries and grafted conduits after isolated coronary artery bypass surgery.

Background: Refractory vascular spasm (RVS) concomitantly involving the entire coronary artery system and grafted conduits after coronary artery bypass grafting (CABG) surgery is a rare, but dreadful event. No consensus exists in terms of appropriate management.

Methods: Between 1986 and 2009, 5,762 patients underwent isolated CABG at our institution, and 7 patients experienced RVS involving the coronary arteries and implanted conduits.

Intraaortic balloon pump: incidence and predictors of complications in the Florence registry.

Background: The intraaortic balloon pump (IABP) is the most commonly used mechanical circulatory support for patients with acute coronary syndromes and cardiogenic shock. Nevertheless, IABP-related complications are still frequent and associated with a poor prognosis.

Hypothesis: To prospectively assess the incidence and predictors of complications in patients treated with IABP.

Impact of preoperative anterior leaflet tethering on the recurrence of ischemic mitral regurgitation and the lack of left ventricular reverse remodeling after restrictive annuloplasty.

Background: The aim of this multicenter study was to investigate the impact of the preoperative anterior mitral leaflet tethering angle, α', on the recurrence of mitral regurgitation (MR) and left ventricular (LV) reverse remodeling (LVRR) after undersized mitral ring annuloplasty.

Methods: The study population consisted of 362 patients, who were divided into two groups by baseline α': group 1, α' < 39.5° (n = 196), and group 2, α' ≥ 39.

A new post-PCI scoring system for in-hospital mortality in STEMI patients.

Objective: To develop a scoring system for predicting in-hospital mortality among ST-elevation myocardial infarction (STEMI) patients submitted to percutaneous intervention (PCI) on intensive cardiac care unit admission by using early and readily available clinical, angiographic and laboratory data.

Design: Prospective monocentric observational study in which we used discriminant analysis to develop a final scoring system, with prospective validation.

Setting: Intensive cardiac care unit in Florence, a tertiary center.