Proning the extracorporeal membrane oxygenation plus Impella: a case report.

Background: The prone position is recommended as supportive therapy in patients with moderate-to-severe acute respiratory distress syndrome (ARDS). However, little is known about prone position ventilation in patients with cardiogenic shock supported by extracorporeal membrane oxygenation (ECMO) plus Impella (ECPELLA) developing ARDS.

Case Summary: A 66-year-old man with severe left ventricular dysfunction was admitted to a non-academic ECMO centre for a high-risk coronary artery bypass grafting.

The Predictive Power of the 14-51 Ng/L High Sensitive Troponin T (hsTnT) Values for Predicting Cardiac Revascularization in a Clinical Setting.

Background: high sensitive Troponin T (hsTnT) values between 14−50 ng/L represent a challenge in diagnosing acute coronary syndrome (ACS) at the Emergency Department (ED). The European Society for Cardiology (ESC) recommends a second hsTnT measurement 3 h later to distinguish between ACS and other causes depending on the Δ hsTnT. Our study aims to evaluate the predictive power this approach in a clinical setting by following patients presenting at the ED with hsTnT values 14−51 ng/L.

Appropriate device selection for transcatheter atrial septal defect closure using three-dimensional transesophageal echocardiography.

Detail morphological evaluation for ASD is essential to achieve successful transcatheter closure. Three-dimensional transesophageal echocardiography (3D-TEE) is emerging, but few studies have comprehensively verified the usefulness of 3D-TEE. We divided 329 patients who underwent transcatheter ASD closure at our university hospital into 157 in the Conventional group evaluated with 2-dimensional transesophageal echocardiography and balloon sizing (BS), and 172 in the 3D-TEE group evaluated with 3D-TEE additionally.

Serial electrocardiography to detect newly emerging or aggravating cardiac pathology: a deep-learning approach.

Background: Serial electrocardiography aims to contribute to electrocardiogram (ECG) diagnosis by comparing the ECG under consideration with a previously made ECG in the same individual. Here, we present a novel algorithm to construct dedicated deep-learning neural networks (NNs) that are specialized in detecting newly emerging or aggravating existing cardiac pathology in serial ECGs.

Methods: We developed a novel deep-learning method for serial ECG analysis and tested its performance in detection of heart failure in post-infarction patients, and in the detection of ischemia in patients who underwent elective percutaneous coronary intervention.

Position of ST-deviation measurements relative to the J-point: Impact for ischemia detection.

Background: There is no consensus about the time instant relative to the J point where ST deviation has to be measured for detection of acute ischemia in the ECG.

Methods: We analyzed 53 ECGs, recorded preceding emergency catheterization of acute coronary syndrome patients with a completely occluded culprit artery (cases), and 88 control ECGs recorded in the cardiology outpatient clinic. ECG-amplitude measurements were made every 10 ms, between 20 ms before till 80 ms after the J point.

Intra-individual ECG changes over 25 years: How long can elective ECGs be used as reference for acute ischemia detection?

Background: The guidelines advocate, in patients with chest pain, comparison of the acute ECG with a previously made, non-ischemic ECG that serves as a reference, to corroborate the working diagnosis of acute coronary syndrome (ACS). Our approach of this serial comparison is to compute the differences between the ST vectors at the J point and 60 ms thereafter (∆ST(J+0), ∆ST(J+60)) and between the ventricular gradient (VG) vectors (∆VG). In the current study, we investigate if reference ECGs remain valid in time.

Performance of ST and ventricular gradient difference vectors in electrocardiographic detection of acute myocardial ischemia.

Introduction: Serial analysis could improve ECG diagnosis of myocardial ischemia caused by acute coronary occlusion.

Methods: We analyzed ECG pairs of 84 cases and 398 controls. In case-patients, who underwent elective percutaneous coronary intervention, ischemic ECGs during balloon occlusion were compared with preceding non-ischemic ECGs.