Short-Term Synchronization of an Intracardiac Leadless Pacemaker With a Transvenous Atrial Pacemaker in a Sedentary Patient.

We herein describe a case of successful atrioventricular synchrony at an 8-week follow-up in a patient who received a leadless pacemaker for recurrent right ventricular lead failures and had a pre-existing atrial transvenous pacemaker. Given the significant hemodynamic improvements, careful initial programming and adjustments during follow-up are needed.

Single- Versus Dual-Chamber Implantable Cardioverter-Defibrillator for Primary Prevention of Sudden Cardiac Death in the United States.

Background Routine addition of an atrial lead during an implantable cardioverter-defibrillator (ICD) implantation for primary prevention of sudden cardiac death, in patients without pacing indications, was not shown beneficial in contemporary studies. We aimed to investigate the use and safety of single- versus dual-chamber ICD implantations in these patients. Methods and Results Using the National Inpatient Sample database, we identified patients with no pacing indications who underwent primary-prevention ICD implantation in the United States between 2015 and 2019.

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.

Left atrial appendage exclusion in atrial fibrillation.

Although oral anticoagulants (OACs) are first-line therapy for stroke prevention in patients with atrial fibrillation (AF), some patients cannot be treated with OACs due to absolute or relative contraindications. Left atrial appendage (LAA) exclusion techniques have been developed over the years as a therapeutic alternative for stroke prevention. In this paper, we review the evolution of surgical techniques, employed as an adjunct to cardiac surgery or as a stand-alone procedure, as well as the recently introduced and widely utilized percutaneous LAA occlusion techniques.

The Obesity Paradox in Real-World Nation-Wide Cohort of Patients Admitted for a Stroke in the U.S.

Background: Obesity has been associated with increased incidence and severity of various cardiovascular risk factors and increased risk for stroke. However, the evidence of its effect on outcomes in stroke victims have been equivocal. We aimed to investigate the distribution of BMI in a nation-wide cohort of individuals, admitted for a stroke, and the relationship between BMI and in-hospital mortality.

The Impact of Obesity on Sudden Cardiac Death Risk.

Purpose Of Review: We aimed to describe the epidemiology of sudden cardiac death (SCD) in the obese, elaborating on the potential pathophysiological mechanisms linking obesity, SCD, and the outcomes in SCD survivors, as well as looking into the intriguing "obesity paradox" in these patients.

Recent Findings: Several studies show increased mortality in patients with BMI > 30 kg/m admitted to the hospital following SCD. At the same time, other studies have implied that the "obesity paradox," described in various cardiovascular conditions, applies to patients admitted after SCD, showing lower mortality in the obese compared to normal weight and underweight patients.

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.

Incidence, characteristics and outcomes in very young patients with ST segment elevation myocardial infarction.

Objective: ST-segment elevation acute myocardial infarction (STEMI) in very young adults is uncommon. Many studies have focused on the cutoff of 45-50 years old to define young patients with STEMI leaving limited data on the group of very young patients aged less than 35 years old. We investigated the incidence of STEMI in different subgroups of young patients and focused on the characteristics, possible pathogenesis and outcomes in very young patients aged less than 35 years old.

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.

Acute renal impairment in older adults treated with percutaneous coronary intervention for ST-segment elevation myocardial infarction.

Background: Elderly individuals ( ≥ 75 years) constitute an increasing proportion of patients presenting with myocardial infarction treated with primary percutaneous coronary intervention (PCI), but only limited data are available regarding the incidence and prognostic implications of acute kidney injury (AKI) in this group of patients.

Objective: To evaluate the incidence and prognostic implications of AKI in older adults ( ≥ 75 years) with ST-segment elevation myocardial infarction (STEMI) treated with primary PCI.

Patients And Methods: A retrospective cohort, observational, single-center study of consecutive 416 older patients with STEMI (≥ 75 years) treated with primary PCI between January 2008 and August 2017 was conducted.

Prolonged Hyperglycemia and Renal Failure after Primary Percutaneous Coronary Intervention.

Background: There are limited data regarding the effect of long-standing hyperglycemia on the occurrence of acute kidney injury (AKI) in ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI).

Methods: We retrospectively studied 723 STEMI patients undergoing primary PCI. Patients were stratified into two groups according to glycated hemoglobin (HbA1c) levels as a marker of prolonged hyperglycemia: those with HbA1c < 7% and those with HbA1c ≥7%.

Relation of Clinical Presentation of Aortic Stenosis and Survival Following Transcatheter Aortic Valve Implantation.

Although the natural history of aortic stenosis (AS) depends on the severity of symptoms, the prognostic significance of AS clinical progression in patients who underwent aortic valve replacement is less clear. Here, we studied the correlation between the severity of AS presenting symptoms and survival after transcatheter aortic valve implantation (TAVI). We evaluated long-term survival of a consecutive cohort of severe AS patients (n = 862, mean Society of Thoracic Surgeons score 4.

Long-term renal outcomes and mortality following renal injury among myocardial infarction patients treated by primary percutaneous intervention.

Objectives: Limited data are present on persistent renal impairment following acute kidney injury (AKI) among ST elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI). We evaluated the incidence and prognostic implications of acute kidney disease (AKD), defined as reduced kidney function for the duration of between 7 and 90 days after exposure to an AKI initiating event, as well as long-term renal outcomes among STEMI patients undergoing primary PCI who developed AKI.

Patients And Methods: We retrospectively studied 225 consecutive STEMI patients who developed AKI.

Outcomes of early and reversible renal impairment in patients with ST segment elevation myocardial infarction undergoing percutaneous coronary intervention.

Objective: Acute kidney injury (AKI) is a frequent complication in patients with ST segment elevation myocardial infarction (STEMI) undergoing percutaneous coronary intervention (PCI). While AKI occurring post-PCI has been well studied, the incidence and clinical significance of early renal impairment evident on hospital admission prior to PCI and which resolves towards discharge has not been investigated.

Methods: We retrospectively studied 2339 STEMI patients treated with primary PCI.

Family history of coronary artery disease and adverse clinical outcomes in patients suffering from acute ST-segment elevation myocardial infarction.

Background: A positive family history (FHx+) of coronary artery disease (CAD) is a well-known risk factor for the development of coronary pathology in first-degree relatives. We sought to evaluate the association between FHx+ of CAD and clinical outcomes in patients presenting with a first ST-elevation myocardial infarction (STEMI).

Patients And Methods: A historical cohort study of all patients with a first STEMI, who were admitted to cardiac ICU between 2007 and 2016, was carried out.

Association between central venous pressure as assessed by echocardiography, left ventricular function and acute cardio-renal syndrome in patients with ST segment elevation myocardial infarction.

Background: Recent reports have demonstrated the adverse effects of venous congestion on renal function in patients with heart failure. None of these trials, however, has evaluated the effect of acute myocardial ischemia on the occurrence of acute kidney injury (AKI).

Methods: We conducted a retrospective study of 1336 ST segment elevation myocardial infarction (STEMI) patients undergoing primary percutaneous coronary intervention (PCI) between June 2012 and June 2016.

Association of pre-admission statin therapy and the inflammatory response in ST elevation myocardial infarction patients.

Purpose: To demonstrate the possible association of statin therapy with C reactive protein (CRP) serial measurements in ST elevation myocardial infarction (STEMI) patients.

Materials And Methods: STEMI patients between 2008 and 2016 with available CRP data from admission were divided into two groups according to pre-admission statin therapy. A second CRP measurement was noted following primary coronary intervention (within 24 h from admission).

Trends and predictors of prehospital delay in patients undergoing primary coronary intervention.

Objective: Delay in seeking medical care following symptom onset in patients with acute ST-elevation myocardial infarction (STEMI) is related to increased morbidity and mortality. Actual trends of prehospital delays in patients hospitalized with STEMI have not been well characterized. We evaluated trends in the length of time that had elapsed from symptom onset to hospital presentation among STEMI patients admitted to our hospital.