Predictors of adoption and impact of evidence-based programming on the incidence of implantable cardioverter-defibrillator therapies.

Introduction And Objectives: The ADVANCE III trial showed that a delayed-detection strategy reduces implantable cardioverter-defibrillator (ICD) therapies. Here, we describe the adherence to and predictors of ADVANCE adoption and compare ICD therapy rates between patients with and without ADVANCE programming.

Methods: This observational retrospective study analyzed patients implanted with Medtronic ICDs included from 2005 to 2016 in a Spanish national multicenter registry (UMBRELLA database; ClinicalTrials.

Ichnotaxonomic review of large ornithopod dinosaur tracks: temporal and geographic implications.

Background: Large ornithopod tracks are known from the Upper Jurassic to the uppermost Cretaceous rocks of all continents but Antarctica. They include the tracks historically called Iguanodon footprints, iguanodontid footprints, hadrosaur/hadrosaurid footprints, and other large ornithopod tracks that have been used to define ichnotaxa. More than 40 ichnospecies based on large ornithopod tracks have been defined, but the validity of many of them is questionable.

Tetradactyl footprints of an unknown affinity theropod dinosaur from the Upper Jurassic of Morocco.

Background: New tetradactyl theropod footprints from Upper Jurassic (Oxfordian-Kimmeridgian) have been found in the Iouaridène syncline (Morocco). The tracksites are at several layers in the intermediate lacustrine unit of Iouaridène Formation. The footprints were named informally in previous works "Eutynichnium atlasipodus".

[Comparison between theoretical an actual intracoronary stent dimensions in non-complex lesions].

The minimum in-stent lumen diameter is a predictor of restenosis. Stent dimensions provided by manufacturers are derived from in vitro tests. The aim of this study was to compare actual stent dimensions obtained by angiography and intracoronary ultrasound with dimensions that would be expected theoretically for a given inflation pressure in a cohort of 100 non-complex lesions suitable for direct stenting.

[Short- and medium-term outcomes of percutaneous coronary intervention for unprotected left main coronary artery disease in patients who are poor candidates for surgical revascularization].

Introduction And Objectives: Surgical revascularization is the procedure of choice for unprotected left main coronary artery stenosis, but it may be unsuitable in some patients. We report short- and medium-term outcomes of percutaneous coronary intervention for unprotected left main coronary artery stenosis in a series of patients who were poor candidates for surgery.

Patients And Method: Descriptive study of a historic cohort of consecutive patients with unprotected left main coronary artery stenosis who were not candidates for surgery, treated with percutaneous coronary intervention at a single center between April 1999 and December 2003.

[Intracoronary stents in small vessels: short- and long-term clinical results].

Objective: To assess the clinical outcome of coronary stenting in small vessels (< 3 mm), using high pressure balloon inflation and antithrombotic therapy.

Patients And Methods: Vessel size was evaluated as < or >= 3 mm at the time of procedure and measured at a level of maximum diameter. We studied 234 consecutive patients with placement of 300 stents in 279 lesions, comprising 84 stents implanted in 79 lesions located at small vessels (< 3 mm).

[The effectiveness of stents in restinotic lesions and coronary grafts].

Regarding restenotic lesions, the data suggest that stent implantation decrease the number of cardiac events including the restenosis rate. The higher number of acute cardiac events are related to stent thrombosis, and they are markedly reduced by the new techniques of antiagregation and implantation. The restenosis rate post-stent implantation does not bear relation to the number of previous dilations as it does with conventional angioplasty.

[Usefulness of transesophageal echocardiography in the diagnosis of coronary anomalies].

Background: Although rare, anomalous coronary arteries are associated with myocardial ischemia and sudden death. Identification is made by angiography but its true course is difficult to determine even with this invasive procedure.

Objectives: The purpose of this study is to determine the role of transesophageal echocardiography (TEE), Doppler and color flow Doppler, in identifying the origin and course of anomalous coronary arteries.

[Complications at the first month following various types of intracoronary stents, implanted with high pressure without intracoronary ultrasonography or anticoagulation].

Background: Coronary stents have proved their efficacy in bail-out situations and restenosis. Nevertheless, the high incidence of subacute thrombosis and vascular and bleeding complications limits its use.

Objectives: To evaluate the clinical complications during the first month of three different types of stents, implanted with high pressure, without ultrasound guidance or anticoagulation.

[The anomalous origin of the left common coronary trunk in the right sinus of Valsalva with an interarterial path. Apropos a case].

We present the case of an old patient with coronary artery disease and two previous myocardial infarctions, admitted to the hospital by syncopal episodes, in which the coronariographic study showed the ectopic origin of the left main coronary artery in the right sinus of Valsalva with anomalous course between the aortic and pulmonary arteries. In this case the initial coronariographic diagnosis and the therapeutical attitude (initially aggressive only in cases of interarterial course) was confirmed by mean of transesophageal echocardiography, showing a better topographical definition of the ectopic vessel aberrant course, although due to the high degree of left ventricular disfunction and the diffuse disease of distal vessels in this patient, CABG surgery was avoided. The angiographic feature is described and the transesophageal approach is remarked as a complementary diagnostic tool in the correct definition of the anomalous course.

[The spectral analysis of the P wave in patients with paroxysmal atrial fibrillation].

Introduction And Objective: The aim of this study is to establish if patients with paroxysmal atrial fibrillation have an abnormal spectrum of the P wave.

Patients And Methods: Thirty-five patients with previous documented atrial fibrillation were compared with a control group of 29 patients. A signal-averaged ECG was performed using an ART-1200-EPX system, and a segment covering the last 75 ms of the P wave and the next 25 mg was analyzed in each of three orthogonal leads (X, Y, Z) and in a combined one (C).

[Mitral valve insufficiency in acute myocardial infarction. Assessment with pulsed and coded Doppler color].

We studied 108 patients who sustained an acute myocardial infarction (AMI) by means of echocardiography, pulsed doppler (PD) and Doppler color flow imaging (CD). We evaluate the presence of mitral regurgitation (MR) and it relationship to the site of the AMI and also to the ventricular function. The incidence of MR was 50.

[Study of the influence of arterial pressure response to exertion on cardiac hypertrophy in patients with mild or moderate hypertension].

In order to study the relationship between tensional response of an hypertensive patient to exercise and its cardiac repercussions, we have studied 42 essential hypertensive patients using echocardiography type M and 2D and exercise test. Patients were divided into two groups according to whether they had (GI) or not (GII) left ventricular hypertrophy. LVH was defined calculating left ventricular mass (LVM) or mean wall thickness (MWT).

[Study of blood pressure response to exertion in essential hypertension. Its modification with anti-hypertensive treatment].

We have studied the effect of atenolol, xipamide, and verapamil in the control of effort tensional response in 54 patients suffering essential hypertension. A first effort test without treatment and a second after a one month treatment randomly assigned were performed in all patients, evaluating the tensional response at 30, 60 and 80 Watts of charge, maximum peak, and after five minutes in recovery. Atenolol significantly reduced (p less than 0.

[Heart hydatidosis diagnoses with bidimensional echocardiography].

A case of calcificated intramyocardiac hydatid cyst is presented. The initial diagnosis was coronary artery disease and the onset was chest pain and typical abnormalities of the electrocardiogram. The diagnosis of hydatid disease was suspected from chest roentgenogram and confirmed by two-dimensional echocardiography and left ventriculography.

[Doppler echocardiography in cor triatriatum: apropos of 2 cases].

In this communication we present a Doppler-echocardiographic investigation on two cases of cor triatriatum. The echocardiographic features and the pulsed Doppler findings, which have not been published previously, are also discussed. When the Doppler sample volume is positioned in the distal camera of the left atrium from apical projections, a positive systolic flow is obtained.

[Dynamic intracavitary echoes from non-slow flow in a patient with a mitral prosthesis].

The infrequent finding of visualization of circulating blood by two-dimensional echocardiography in the left ventricle in a patient with a mitral prosthetic valve is reported. In contrast to most of the reports on dynamic intracavitary echoes, no correlation with blood stasis or diminished flow velocity is found, being normal in this pulsed Doppler study.