Polymorphic Ventricular Tachycardia Detected by a Smartwatch in a Patient With Recurrent Syncope.

The diagnosis of vasospastic angina remains challenging. It may present with syncope and life-threatening arrhythmia. Patients with syncope usually require automatic modes of recording.

Bridging Care Transition After Hospitalization for Atrial Fibrillation and Coronary Interventions.

Treatment fragmentation between hospitals and the community can result in catastrophic outcomes; uninterrupted treatment with anticoagulant and platelet aggregation inhibitors is particularly important. We assessed the proportion and characteristics of patients who did not visit their primary community-based physician within 1 week of discharge from our department of cardiovascular medicine and the proportion that failed to procure essential drugs at the community pharmacy. We prospectively studied 423 patients who were discharged from our department.

Causes of mortality in a department of cardiology over a 15-year period.

Aims: Over the last four decades, in-hospital mortality from acute coronary syndromes (ACS) has declined. We characterized the patients who died in our cardiovascular intensive care unit (CICU) over a 15-year period. Based on these data, we described the changing patient population in the CICU.

Anemia and the Risk of Life-threatening Ventricular Tachyarrhythmias from the Israeli Implantable Cardioverter Defibrillator Registry.

Anemia was shown to be associated with increased risk for adverse events in patients with heart failure (HF). However, there are limited data on the association between anemia and the risk for ventricular arrhythmias (VAs) in patients with an implantable cardioverter defibrillator (ICD). The present study population comprised 2,352 patients who were enrolled and prospectively followed up in the Israeli ICD Registry.

A novel system for continuous, real-time monitoring of heart motion signals.

Background: Understanding cardiac mechanics is important for developing cardiac therapies. Current modalities for assessing cardiac mechanics sample patient's heart at specific heart rate, contractility, preload, and afterload. The objective of this study was to test the feasibility of a novel system composed of intra-cardiac leads equipped with an inertial module chip (3D accelerometers and 3D gyroscopes) in monitoring continuous heart motion.

Programmed electrical stimulation for risk stratification of patients with ischemic cardiomyopathy.

Background: Patients with ischemic cardiomyopathy (ICM) are at an increased risk for sudden death. Although earlier trials used programmed electrical stimulation (PES) for risk stratification, more recent data demonstrate the benefit of implantable cardiac defibrillators (ICDs) in selected patients with reduced left ventricular ejection fraction (LVEF) without performing PES. However, little is known about the outcome of non-inducible patients.

Contemporary evaluation of the causes of cardiac tamponade: Acute and long-term outcomes.

Background: Cardiac tamponade is a life-threatening state that complicates various medical conditions. The contemporary interventional era may have led to changes in clinical characteristics, causes and outcomes of cardiac tamponade.

Methods: We investigated all patients diagnosed with cardiac tamponade, based on clinical and echocardiographic findings, at a single medical center between the years 2000 and 2013.

Role of defibrillation threshold testing during implantable cardioverter-defibrillator placement: data from the Israeli ICD Registry.

Background: Defibrillation threshold (DFT) testing during placement of an implantable cardioverter-defibrillator (ICD) has been considered mandatory. Accumulating data suggest a more limited role for DFT.

Objective: The purpose of this study was to compare the outcome of ICD recipients who underwent DFT testing compared with those who did not.

Relation of reduced expression of MiR-150 in platelets to atrial fibrillation in patients with chronic systolic heart failure.

Atrial fibrillation (AF) is associated with poor prognosis in patients with heart failure (HF). Although platelets play an important role in rendering a prothrombotic state in AF, the exact mechanism by which the effect is mediated is still debated. MicroRNAs (miRNAs), which have been shown to be involved in a variety of cardiovascular conditions, are abundant in platelets and in a cell-free form in the circulation.

Clinical characteristics and outcomes of elderly patients treated with an implantable cardioverter-defibrillator or cardiac resynchronization therapy in a real-world setting: data from the Israeli ICD Registry.

Background: Elderly patients are underrepresented in clinical trials of device therapy.

Objective: To provide real-world data regarding outcomes associated with device-based therapy in a large cohort of elderly patients enrolled in the Israeli ICD Registry.

Methods: Between July 2010 and June 2012, a total of 2807 consecutive patients undergoing implanted cardioverter-defibrillator/cardiac resynchronization therapy-defibrillator (ICD/CRT-D) implantation were prospectively enrolled in the Israeli ICD Registry.

Ejection fraction in patients with heart failure and preserved ejection fraction is greater than that in controls - a mechanism facilitating left ventricular filling and maximizing cardiac output.

The absolute value of ejection fraction (EF) in patients with heart failure and preserved ejection fraction (HFpEF) is often observed to be greater than that in healthy, age- or risk-factor matched controls. Assuming this observation is true, we sought for a physiological explanation. It is hypothesized that an increased EF in HFpEF patients has a role in augmenting cardiac output (CO) especially during exercise.

Acute pericardial tamponade due to screw-in atrial lead heart perforation.

A case of peri-procedural perforation of right atrium following the implantation of atrial screw-in lead in a 74-year-old man is reported. The perforation caused acute pericardial tamponade and worsening of the patient's clinical and haemodynamic conditions. Urgent surgical intervention with lead extraction was performed.

Autonomic remodeling in the left atrium and pulmonary veins in heart failure: creation of a dynamic substrate for atrial fibrillation.

Background: Atrial fibrillation (AF) is commonly associated with congestive heart failure (CHF). The autonomic nervous system is involved in the pathogenesis of both AF and CHF. We examined the role of autonomic remodeling in contributing to AF substrate in CHF.

Use of a custom-designed adapter to manage ICD lead fracture.

We report the case of a 72-year-old patient with ischemic cardiomyopathy who was found to have a lead fracture in the RV coil DF-1 connector of an integrated bipolar implantable cardioverter-defibrillator (ICD) lead system at the time of upgrade to a biventricular ICD. Due to the redundant connection of the RV coil to the DF-1 connector and the ring on the IS-1 connector, a custom-designed adapter was used to exclude the site of fracture. This novel solution spared the patient the potential risks of lead extraction or abandoning the fractured ICD lead.

Usefulness and predictive value of circulating NT-proBNP levels to stratify patients for referral and priority treatment in a specialized outpatient heart failure center.

Background: Serum natriuretic peptide levels are useful diagnostic and prognostic markers in patients with acute decompensated heart failure, but have been little used to stratify urgency of treatment in the outpatient situation.

Objectives: To examine the use of natriuretic peptide to guide priority of patient referral to a heart failure center.

Methods: We analyzed data from 70 consecutive patients with chronic heart failure (NYHA class 2-4) referred for first evaluation in a specialized outpatient heart failure center.