Short term outcome after left atrial appendage occlusion with the AMPLATZER Amulet and WATCHMAN device: results from the ORIGINAL registry (saxOnian RegIstry analyzinG and followINg left atrial Appendage cLosure).

Background: Various randomized multicenter studies have shown that percutaneous left atrial appendage closure (LAAC) is not inferior in stroke prevention compared to vitamin K antagonists (VKA) and can be performed safely and effectively.

Aims: The prospective multicenter ORIGINAL registry in the Free State of Saxony (saxOnian RegIstry analyzinG and followINg left atrial Appendage cLosure) investigated the efficiency and safety of LAAC with Watchman or Amulet device in a real word setting. A special focus was put on the influence of LAAC frequency on periprocedural efficiency and safety.

Circumferential pulmonary vein ablation for treatment of atrial fibrillation using an irrigated-tip catheter.

In this study, a series of 52 consecutive patients with atrial fibrillation from 1 institution underwent circumferential pulmonary vein ablation using an irrigated-tip catheter. The technique was safe, and 81% of the patients maintained sinus rhythm at 6 months. However, 1/3 of them required additional antiarrhythmic drug therapy.

Angioplasty of the internal thoracic artery bypass-graft an alternative to reoperation.

Background: This review presents an overview of interventional revascularization procedures of the internal thoracic artery after prior implantation as a coronary-artery bypass graft.

Methods: Our search was concentrated on the MEDLINE-database to identify all articles on internal thoracic artery-graft-angioplasties and reoperation after internal thoracic artery bypass grafting published between 1968 and 2000.

Results: Surgical revascularization and reoperation were reported in five papers including a total of 785 patients.

[Interventional therapy after failed fibrinolysis in acute myocardial infarct. Acute and long-term outcome of referral for rescue balloon angioplasty].

Background: The results from studies of coronary angioplasty after failed thrombolysis (rescue-PTCA) in acute myocardial infarction are contradictory. Long-term results were not presented till now. Therefore we analyzed the data from our registry of those patients whose acute and long-term results were available.

Detection of myocardial viability using stress echocardiography.

Asynergic myocardial regions in patients with coronary artery disease can be viable. They may have the ability to improve their function after restoring coronary blood flow. Asynergic but viable myocardial regions have a positive inotropic reserve which can be stimulated by catecholamines.

Stress echocardiography: personnel and technical equipment.

In recent years, stress echocardiography has gained broad acceptance as a non-invasive method for the diagnosis of coronary artery disease. Facing different protocols, dosages and instrumentation, official guidelines for the performance, standardization and quality control of stress echocardiograms are needed; however, so far they are not available. This paper recommends the type of personnel and technical equipment needed for stress echocardiography laboratories, based on experience gained during more than 2000 stress echocardiographic procedures.

Arbutamine stress echocardiography.

Arbutamine, a new potent non-selective beta-adrenoceptor agonist with mild alpha 1-sympathomimetic activity, has been developed specifically for pharmacological stress testing. The drug acts like physical exercise, increasing both heart rate and myocardial contractility. Sensitivity, specificity and accuracy in detecting significant stenotic coronary artery disease are 76%, 96%, and 82%, respectively, again similar to those of exercise echocardiography.

Dobutamine stress echocardiography.

Dobutamine is a synthetic catecholamine with predominant beta-stimulation. Its half-life is approximately 2 min. The positive chronotropic and inotropic effects of dobutamine induce myocardial ischaemia if significant coronary artery obstruction is present.

[-Value of activated blood coagulation time in monitoring anticoagulation during coronary angioplasty-].

Accurate heparin anticoagulation assessment is important to prevent complications (hemorrhage, thrombotic coronary occlusion) during and after coronary angioplasty (PTCA). Paired ACT-, aPTT- and prothrombin time (PT) measurements have not been studied after PTCA using a high dose heparin management. For that reason we analyzed in 150 consecutive patients (115 m.

[Anti-arrhythmia effects of calcium antagonists].

Calcium antagonists such as verapamil/diltiazem predominantly delay av-nodal conduction. Thus, the most important clinical indications for their application are the av-nodal-reentrant-tachycardia as well as the slowing of rapid ventricular response in intraatrial tachyarrhythmias. To reestablish sinus rhythm in atrial fibrillation, verapamil should be combined with chinidin.

[Results of thrombolytic therapy in acute myocardial infarct].

Acute thrombosis of highly stenosed coronary arteries often results in acute myocardial infarction. The rationale for thrombolytic therapy is to restore blood flow before irreversible myocardial cell damage develops. In this review the results of more than 60 interventional studies in which reperfusion or "patency" rates, left ventricular function, infarct size, as well as intrahospital and long-term mortality following thrombolytic therapy were assessed, are reported and analyzed with respect to the patterns of applying thrombolytic therapy (different thrombotic agents and percutaneous transluminal coronary angioplasty).