Acute sedation-associated complications in GI endoscopy (ProSed 2 Study): results from the prospective multicentre electronic registry of sedation-associated complications.

Objectives: Sedation has been established for GI endoscopic procedures in most countries, but it is also associated with an added risk of complications. Reported complication rates are variable due to different study methodologies and often limited sample size.

Designs: Acute sedation-associated complications were prospectively recorded in an electronic endoscopy documentation in 39 study centres between December 2011 and August 2014 (median inclusion period 24 months).

Recanalisation of coronary chronic total occlusions with new techniques including the retrograde approach via collaterals.

Objective: Percutaneous treatment of coronary chronic total occlusions (CTO) remains one of the major challenges in interventional cardiology. The strategies of recanalisation in CTO have changed drastically due the development of new techniques such as the retrograde approach via collaterals. In this single-centre experience we sought to analyse the success rates with the use of different CTO techniques, the complication rates, and we evaluated predictors of failed CTO recanalisation attempts.

Six sequence variants on chromosome 9p21.3 are associated with a positive family history of myocardial infarction: a multicenter registry.

Background: Recent genome-wide association studies have identified several genetic loci linked to coronary artery disease (CAD) and myocardial infarction (MI). The 9p21.3 locus was verified by numerous replication studies to be the first common locus for CAD and MI.

Gender-based differences in long-term outcome after ST-elevation myocardial infarction in patients treated with percutaneous coronary intervention.

Background: In the era of fibrinolysis, women suffered from higher early and late mortality rates than men after acute ST-elevation myocardial infarction (STEMI). Primary percutaneous coronary intervention (PCI) has been determined to be the most effective therapy strategy in STEMI. It is not clear if female gender is an independent predictor of a worse long-term prognosis among patients who were systematically treated with PCI.

Comparison of usefulness of heart-type fatty acid binding protein versus cardiac troponin T for diagnosis of acute myocardial infarction.

We aimed to assess the additive diagnostic value of measuring the serum levels of soluble human heart-type fatty acid binding protein (H-FABP) in the early diagnosis of acute myocardial infarction (AMI) in unselected patients with chest pain. A total of 97 consecutive patients with acute ischemic-type chest pain were prospectively enrolled and classified according to the American Heart Association/American College of Cardiology guidelines. The test characteristics of H-FABP and cardiac troponin T serum levels at admission revealed a greater sensitivity of H-FABP in the first 4 hours of symptoms (86% vs 42%, p <0.

Variation in the human soluble epoxide hydrolase gene and risk of restenosis after percutaneous coronary intervention.

Background: Restenosis represents the major limiting factor for the long-term efficacy of percutaneous coronary intervention (PCI). Several genetic factors involved in the regulation of the vascular system have been described to play a role in the pathogenesis of restenosis. We investigated whether the EPHX2 K55R polymorphism, previously linked to significantly higher risk for coronary heart disease (CHD), was associated with the occurrence of restenosis after PCI.

Increased TNF-alpha and decreased TGF-beta expression in peripheral blood leukocytes after acute myocardial infarction.

Inflammation contributes to the development of atherosclerosis and cardiovascular events. Counteracting pro- and anti-inflammatory responses of serum cytokines have been reported, but the relevance of TNF-alpha, TGF-beta and IL-6 gene expression in peripheral blood leukocytes and their contribution to systemic inflammation in atherosclerosis, especially after acute myocardial infarction (AMI), has not been investigated yet. Using quantitative RT-PCR, we determined temporal cytokine mRNA expression alterations in blood cells from patients with AMI (n = 51).

[Therapy options for Prinzmetal angina induced ventricular vulnerability].

We report about a 46 year old male, who survived sudden cardiac death caused by recurrent ventricular tachycardia as the clinical manifestation of a vasospastic right coronary artery. After implantation of an implantable cardioverter defibrillator, the patient did not respond to conservative treatment despite of different drug therapies. Therefore, the vasospastic right coronary artery was treated by a percutaneous transluminal coronary angioplasty and stenting, which could not reduce the occurrence of further tachycardias.

Use of a pigtail catheter to engage a difficult internal mammary artery.

Increasing use of bilateral internal mammary arteries for coronary surgery will increase the number of interventions in these grafts. Such interventions may be technically challenging because of often tortuous and angulated vessels. We describe a technique to intubate an acutely angulated right internal mammary artery that was inaccessible with conventional catheters.

Echocardiographic quantification of regional left ventricular wall motion with color kinesis.

Echocardiographic assessment of regional systolic left ventricular function is usually performed qualitatively and depends on investigator experience. In this study, we investigated a new method for quantifying regional systolic wall motion based on color kinesis. In this study, regional systolic wall motion velocity (Vsys) was determined by dividing end-systolic color width by systolic time.

Polarity reversal improves defibrillation efficacy in patients undergoing transvenous cardioverter defibrillator implantation with biphasic shocks.

The purpose of this study was to determine the influence of polarity reversal on DFT in patients undergoing implantation of nonthoracotomy defibrillators with biphasic shocks. Previous studies have shown higher defibrillation efficacy with using the distal electrode as anode implantation of nonthoracotomy defibrillators and monophasic shocks. However, it is as yet unclear whether biphasic shock defibrillation will also be influenced by polarity reversal.

[Chronic frequency-adaptive pacemaker therapy in patients with heart failure].

Twenty patients (complete AV block n = 13, sick sinus syndrome n = 4 (replacement of a VVI system), bradyarrhythmia n = 3) with rate-adaptive pacemakers (respiration volume guided n = 10, QT-driven n = 1, dual sensor (QT/activity) system n = 9) were randomly assessed by ergospirometry after 4 weeks of VVI- (70 bpm), VVIR1-(70-110 bpm, low upper rate) and VVIR2-pacing (70-130 bpm, high upper rate). Oxygen uptake (VO2), work load (W), and heart rate were determined at peak exercise (max) and at the anaerobic threshold (AT). In the whole population, rate adaptation led to a significantly higher VO2-max than VVI-pacing for both VVIR1- (15.

[High-frequency current ablation of a Mahaim fiber at the tricuspid annulus].

The Mahaim syndrome is a rare variant of accessory pathways. Typically, a normal surface ECG and paroxysmal tachycardias with left bundle branch block morphology are found. The anatomic correlate is an atrioventricular or atriofascicular fiber with decremental conduction properties.

Potential of intracardiac ultrasonography as an adjunct for mapping and ablation.

Radio frequency catheter ablation of cardiac tissues has evolved rapidly as the standard therapy for various arrhythmias. Current mapping techniques include fluoroscopy and endocardial ECG recordings. These techniques are time-consuming and give only limited information with regard to cardiac anatomy and pathology.