Simplified demonstration of cavotricuspid isthmus block after catheter ablation in patients after Mustard's operation.

Background: The Mustard operation is a complex atrial rerouting performed in patients with transposition of the great arteries (TGA). Cavotricuspid isthmus (CTI)-dependent atrial flutter (AFL) is an important problem in these patients. While catheter ablation (CA) is successful, three-dimensional (3D) mapping is necessary to prove block at the CTI.

Direct admission to cardiology for patients hospitalized for atrial fibrillation reduces length of stay and increases guideline adherence.

Objective: We hypothesized that a clinical pathway for inpatient management of atrial fibrillation on a cardiology service would result in improved resource utilization.

Methods: In July 2002, an evidence-based pathway was developed for treatment of patients hospitalized for atrial fibrillation. Guidelines directed patient care from admission from the emergency department to inpatient management on a cardiology service.

Disease management produces limited quality-of-life improvements in patients with congestive heart failure: evidence from a randomized trial in community-dwelling patients.

Background: Disease management programs are reported to improve clinical and quality-of-life outcomes while simultaneously lowering healthcare costs.

Objective: To examine the effectiveness of disease management in improving health-related quality of life (HRQL) among patients with heart failure beyond 12 months.

Methods: A total of 1069 community-dwelling patients 18 years and older in South Texas with echocardiographic evidence of congestive heart failure were randomly assigned to disease management, augmented disease management, and control groups.

Fluoroscopic localization of the femoral head as a landmark for common femoral artery cannulation.

We sought to determine the reliability of frequently used landmarks for femoral arterial access in patients undergoing cardiac catheterization. The common femoral artery (CFA) is the most frequently used arterial access in cardiac catheterization. Arterial sheath placement into the CFA has been shown to decrease vascular complications.

Sudden death in young adults: a 25-year review of autopsies in military recruits.

Background: Sudden death among military recruits is a rare but devastating occurrence. Because extensive medical data are available on this cross-sectional and diverse population, identification of the underlying causes of sudden death may promote health care policy to reduce the incidence of sudden death.

Objective: To determine the causes of nontraumatic sudden death among a cohort of military recruits.

Long-term healthcare and cost outcomes of disease management in a large, randomized, community-based population with heart failure.

Background: Because of the prevalence and expense of congestive heart failure (CHF), significant efforts have been made to develop disease management (DM) programs that will improve clinical and financial outcomes. The effectiveness of such programs in a large, heterogeneous population of CHF patients remains unknown.

Methods And Results: We randomized 1069 patients (aged 70.

Cardiopulmonary and mental health diagnoses surrounding the September 11 terrorist acts in a military population.

Background: In addition to psychological disorders, emotional stress can trigger a chain of neurohumoral imbalances that can manifest as cardiopulmonary complaints. No studies were identified that used objective clinical data on complaints after the terrorist attacks of September 11, 2001. The purpose of this descriptive study was to identify all cardiopulmonary and psychological diagnoses among active duty personnel seeking care at a military treatment facility and/or its ancillary facilities before and after September 11, 2001.

Addition of right-sided and posterior precordial leads during stress testing.

Background: Exercise treadmill testing has limited sensitivity for the detection of coronary artery disease, frequently requiring the addition of imaging modalities to enhance the predictive value of the test. Recently, there has been interest in using nonstandard electrocardiographic (ECG) leads during exercise testing.

Methods: We consecutively enrolled all patients undergoing exercise myocardial imaging with four additional leads recorded (V4R, V7, V8, and V9).

Percutaneous coronary intervention in the elderly: procedural success and 1-year outcomes.

Clinical trials have found increased morbidity in elderly persons presenting for percutaneous coronary intervention for chronic stable angina. Long-term follow-up is limited for the elderly following percutaneous coronary intervention. The authors reviewed all coronary interventions performed from January 1998 to August 2001.