Perioperative Cardiac Considerations in the Surgical Patient.

The ability to identify and guide evaluation of the patient with cardiac disease represents a necessary skill for success in surgery of the foot and ankle. Common risk factors, such as diabetes and peripheral arterial disease, are encountered in podiatric practice. Recognition of patients at risk for cardiac disease and a predilection for sustaining a major adverse cardiac event perioperatively advocates for preoperative cardiology consultation.

Developing a panel of biomarkers and miRNA in patients with myocardial infarction for early intervention strategies of heart failure in West Virginian population.

Background: Myocardial infarction is the most common cause of heart failure. MI has been intricately linked to ventricular remodeling, subsequently leading to the reduction in the cardiac ejection fraction causing HF. The cumulative line of evidence suggests an important role of several biomarkers in modulating the cardiac vasculature, further contributing towards the progression of post-MI complications.

Antithrombotic Therapy in Nonvalvular Atrial Fibrillation: Consensus and Challenges.

Atrial fibrillation (AF) is associated with high risk of systemic thromboembolism leading to significant morbidity and mortality. Warfarin, previously the mainstay for stroke prevention in AF, requires close monitoring because of multiple food and drug interactions. In recent years, food and drug administration has approved several direct oral anticoagulants (DOACs) for use in patients with nonvalvular AF.

Battery longevity from cardiac resynchronization therapy defibrillators: differences between manufacturers and discrepancies with published product performance reports.

Aims: Cardiac resynchronization therapy (CRT) is an important treatment for heart failure that requires constant ventricular pacing, placing a high energy burden on CRT defibrillators (CRT-D). Longer battery life reduces the need for device changes and associated complications, thereby affecting patient outcomes and cost of care. We therefore investigated the time to battery depletion of CRT-D from different manufacturers and compared these results with manufacturers' published product performance reports (PPRs).

Mortality risk of long-term amiodarone therapy for atrial fibrillation patients without structural heart disease.

Background: Amiodarone is often prescribed in the management of atrial fibrillation (AF) but is known to cause significant end-organ toxicities. In this study, we examined the impact of amiodarone on all-cause mortality in AF patients with structurally normal hearts.

Methods: We performed a retrospective cohort analysis of all AF patients with structurally normal hearts who were prescribed antiarrhythmic drugs (AAD) for rhythm control of AF at our institution from 2006 to 2013 (n = 2,077).

Comparative effectiveness of antiarrhythmic drugs for rhythm control of atrial fibrillation.

Introduction: Although there are many different antiarrhythmic drugs (AADs) approved for rhythm management of atrial fibrillation (AF), little comparative effectiveness data exist to guide drug selection.

Methods: We followed 5952 consecutive AF patients who were prescribed amiodarone (N=2266), dronedarone (N=488), dofetilide (N=539), sotalol (N=1718), or class 1C agents (N=941) to the primary end point of AF recurrence.

Results: Median follow-up time was 18.

Risk of Stroke and Death in Atrial Fibrillation by Type of Anticoagulation: A Propensity-Matched Analysis.

Background: We examined the effect of novel oral anticoagulants (NOACs) compared to warfarin on the risk of death or stroke in atrial fibrillation (AF) patients in every day clinical practice.

Methods: We examined a cohort of 2,836 AF patients, of whom 2,253 were prescribed warfarin and 583 were prescribed an NOAC. Patients with glomerular filtration rate < 30 mg/mL or history of significant valvular heart disease were excluded.

Outcomes of Sprint Fidelis and Riata lead extraction: Data from 2 high-volume centers.

Background: The Sprint Fidelis (SF) and the Riata (RT) implantable cardioverter-defibrillator leads have been recalled for premature failure.

Objective: Data on SF and RT extractions are limited; therefore, we performed a pooled analysis to compare the safety and efficacy of lead extraction for the SF and RT lead families.

Methods: We retrospectively reviewed consecutive patients undergoing transvenous extraction of SF and RT leads at Emory University and the University of Pittsburgh Medical Center from January 2007 to October 2013.

Patient outcomes according to adherence to treatment guidelines for rhythm control of atrial fibrillation.

Background: Although guidelines for antiarrhythmic drug therapy in atrial fibrillation (AF) were published in 2006, it remains uncertain whether adherence to these guidelines affects patient outcomes.

Methods And Results: We retrospectively evaluated the records of 5976 consecutive AF patients who were prescribed at least 1 antiarrhythmic drug between 2006 and 2013. Patients with 1 or more prescribed antiarrhythmic drugs that did not comply with guideline recommendations comprised the non-guideline-directed group (=2920); the remainder constituted the guideline-directed group (=3056).

Influence of QRS duration on outcome of death or appropriate defibrillator therapy by strategy of left ventricular lead placement in cardiac resynchronization therapy recipients.

Purpose: Echocardiography-guided (EG) lead placement at the site of latest left ventricular (LV) mechanical activation improves outcome in patients receiving a cardiac resynchronization therapy (CRT) defibrillator (D). The purpose of this study is to examine whether a strategy of EG LV lead placement equally improves outcome in CRT recipients with wide (≥150 ms) versus intermediate (120-149 ms) QRS duration.

Methods: Patients treated with a CRT-D in the Speckle Tracking Assisted Resynchronization Therapy for Electrode Region (STARTER) prospective, randomized trial (108 EG strategy and 75 routine strategy) were followed to the endpoint of death or first appropriate CRT-D therapy.

Effect of echocardiography-guided left ventricular lead placement for cardiac resynchronization therapy on mortality and risk of defibrillator therapy for ventricular arrhythmias in heart failure patients (from the Speckle Tracking Assisted Resynchronization Therapy for Electrode Region [STARTER] trial).

Echocardiography-guided left ventricular (LV) lead placement at the site of latest mechanical activation improves heart failure outcomes in patients receiving a cardiac resynchronization therapy defibrillator (CRT-D). In this study, we test the hypothesis that a strategy of echocardiography-guided LV lead placement improves patient survival rate free from appropriate CRT-D therapy for ventricular arrhythmias. Patients enrolled in the prospective, randomized Speckle Tracking Assisted Resynchronization Therapy for Electrode Region trial and treated with a CRT-D device (108 with the echo-guided strategy and 75 with the routine strategy) were followed to the end point of death or first appropriate CRT-D therapy.

Echocardiography-guided left ventricular lead placement for cardiac resynchronization therapy in ischemic vs nonischemic cardiomyopathy patients.

Background: Echocardiography-guided (EG) left ventricular (LV) lead placement at the site of latest mechanical activation improves outcome in heart failure (HF) patients receiving a cardiac resynchronization therapy (CRT)-defibrillator (CRT-D).

Objective: The purpose of this study was to examine the effect of a strategy of EG LV lead placement in each of ischemic (ICM) vs nonischemic (NICM) cardiomyopathy patients.

Methods: Patients enrolled in the Speckle Tracking Assisted Resynchronization Therapy for Electrode Region (STARTER) prospective, randomized trial who were treated with a CRT-D device (108 EG strategy and 75 routine strategy) were followed to the end-points of death, appropriate CRT-D therapy, or HF hospitalization.

Battery longevity in cardiac resynchronization therapy implantable cardioverter defibrillators.

Aims: Cardiac resynchronization therapy (CRT) implantable cardioverter defibrillators (ICDs) deliver high burden ventricular pacing to heart failure patients, which has a significant effect on battery longevity. The aim of this study was to investigate whether battery longevity is comparable for CRT-ICDs from different manufacturers in a contemporary cohort of patients.

Methods And Results: All the CRT-ICDs implanted at our institution from 1 January 2008 to 31 December 2010 were included in this analysis.

A fatal case of nafcillin-induced hepatotoxicity: a case report and the literature review.

Background. Drug-induced hepatotoxicity (DIH) is quite common, and there are several recommendations for its treatment based upon its etiology. DIH may range from mild and subclinical to fulminant liver failure and death.

Frequency and characteristics of skin cancers diagnosed at Ayub Medical College, Abbottabad Pakistan from 1995-2003.

Background: Our histopathology laboratory serves mountainous area of Hazara Division in Northern Pakistan. This study is an analysis of the records of skin cancers reported over a nine years period to develop local statistics about frequency and characteristics of skin cancers.

Methods: Data from 1995-2003 record of cancers reported by Department of Pathology, Ayub Medical College, Abbottabad were analysed to calculate cumulative and year wise frequency of skin cancers and their major types.