Sex-based differences in cardiovascular outcomes among patients with atrial fibrillation undergoing left atrial appendage occlusion device placement.

Background: There is a growing body of data to support the presence of sex disparities in outcomes of cardiovascular related hospitalizations. Despite this, there remains a paucity of data on relationships between sex and in-hospital outcomes in patients receiving a left atrial appendage occlusion device (LAAOD).

Methods: We examined the 2016-2020 Nationwide Readmission Database to identify patients with Atrial Fibrillation receiving a LAAOD.

Work Environment, Burnout, and Intent to Leave Current Job Among Cardiologists and Cardiology Health Care Workers: Results From the National Coping With COVID Survey.

Background: Little is known about factors contributing to burnout and intent to leave in cardiologists and other cardiology health care workers.

Methods And Results: The Coping With COVID survey assessed work conditions, burnout, and intent to leave among physicians, nurses, advanced practice providers, and other clinical staff (OCS) from April 2020 to December 2020. Single-item measures assessed work conditions, burnout (emotional exhaustion), and intent to leave.

Artificial Intelligence Driven Prehospital ECG Interpretation for the Reduction of False Positive Emergent Cardiac Catheterization Lab Activations: A Retrospective Cohort Study.

Objectives: Data suggest patients suffering acute coronary occlusion myocardial infarction (OMI) benefit from prompt primary percutaneous intervention (PPCI). Many emergency medical services (EMS) activate catheterization labs to reduce time to PPCI, but suffer a high burden of inappropriate activations. Artificial intelligence (AI) algorithms show promise to improve electrocardiogram (ECG) interpretation.

Primary localized cutaneous lichen myxedematosus with light chain-restricted plasma cells: A distinct variant of the localized form of lichen myxedematosus.

Lichen myxedematosus (LM) is a chronic cutaneous mucinosis that can present as a localized skin lesion or as a generalized systemic disease termed scleromyxedema. The differential diagnosis is determined by a combination of clinical presentation, serological studies, and histopathological examination. Currently, well-established and accepted histopathological features to distinguish localized LM from scleromyxedema have not been elucidated.

Temporary-permanent pacemakers are associated with better clinical and safety outcomes compared to balloon-tipped temporary pacemakers.

Background: Balloon Tipped Temporary Pacemakers (BTTP) are the most used temporary pacemakers; however, they are associated with a risk of dislodgement and thromboembolism. Recently, Temporary Permanent Pacemakers (TPPM) have been increasingly used. Evidence of outcomes with TPPM compared to BTTP remains scarce.

Electrocardiographic Diagnosis of Acute Coronary Occlusion Myocardial Infarction in Ventricular Paced Rhythm Using the Modified Sgarbossa Criteria.

Study Objective: Ventricular paced rhythm is thought to obscure the electrocardiographic diagnosis of acute coronary occlusion myocardial infarction. Our primary aim was to compare the sensitivity of the modified Sgarbossa criteria (MSC) to that of the original Sgarbossa criteria for the diagnosis of occlusion myocardial infarction in patients with ventricular paced rhythm.

Methods: In this retrospective case-control investigation, we studied adult patients with ventricular paced rhythm and symptoms of acute coronary syndrome who presented in an emergency manner to 16 international cardiac referral centers between January 2008 and January 2018.

Atropine-Induced Ventricular Asystole During a Dobutamine Stress Test.

Dobutamine stress echocardiography is a safe diagnostic test with low incidence of serious complications. Atropine has been shown to reduce test duration without increasing the rate of complications. We present a case of a 52-year-old man with end stage renal disease who experienced syncope due to ventricular asystole after atropine administration during a dobutamine stress test.

Determinants of empiric transfusion in gastrointestinal bleeding in the emergency department.

Introduction: Current guidelines for the management of GI bleeding (GIB) recommend restrictive transfusion triggers unless patients have shock or specific comorbidities. However, these studies may not be applicable to Emergency Department (ED) patients. Factors determining transfusion decisions in the ED are poorly understood.

Methadone and the QTc Interval: Paucity of Clinically Significant Factors in a Retrospective Cohort.

Objective: Methadone is associated with prolongation of the electrocardiographic QTc interval. QTc prolongation may be linked to cardiac dysrhythmia and sudden cardiac death. The rate of these events is unknown in methadone-maintained patients.

What's in a Name? Utilization of the Innominate Vein for Pacemaker Lead Placement in the Setting of Persistent Left Superior Vena Cava.

Persistent left superior vena cava (PLSVC) represents the most common thoracic venous anomaly and is an important clinical entity for cardiologists and electrophysiologists, among others. In approximately 30% of cases, a bridging innominate vein connects the left superior vena cava to the right. The present report highlights the value of defining the venous anatomy with a case of dual-chamber pacemaker implantation in the PLSVC with the right ventricular lead placed via the innominate vein.

Cardiac pauses in competitive athletes: a systematic review examining the basis of current practice recommendations.

Aims: It is generally recommended that individuals aspiring to competitive sports should undergo pre-participation cardiovascular assessment, particularly including arrhythmia risk evaluation. In regard to bradyarrhythmias, the 36th Bethesda Conference suggested that asymptomatic cardiac pauses ≤3 s are 'probably of no significance', whereas longer 'symptomatic' pauses may be abnormal. This study focused on assessing the evidence for the '3 s' threshold.

Risk of new-onset atrial fibrillation and stroke after radiofrequency ablation of isolated, typical atrial flutter.

Background: Radiofrequency ablation (RFA) is considered a curative procedure for typical atrial flutter (AFL); however, patients remain at risk for developing new atrial fibrillation (AF).

Objective: The purpose of this study was to determine the incidence and predictors of new-onset AF and stroke after RFA of isolated AFL in a multicenter cohort.

Methods: The study included 315 consecutive patients who underwent successful RFA of isolated, typical AFL from 2006 to 2013 at 4 community and teaching hospitals.

Right ventricular pacing for right ventricular outflow tract obstruction in a man with biventricular hypertrophic cardiomyopathy.

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Adjuvant Role of CT in the Diagnosis of Post-Infarction Left Ventricular Free-Wall Rupture.

Left ventricular free wall rupture is usually a catastrophic mechanical complication of myocardial infarction. Risk factors include advanced age, female gender and absence of prior infarction. The vast majority of patients succumb rapidly due to cardiac tamponade and electromechanical dissociation.

Transvenous phrenic nerve stimulation for the treatment of central sleep apnoea in heart failure.

Aims: Periodic breathing with central sleep apnoea (CSA) is common in heart failure patients and is associated with poor quality of life and increased risk of morbidity and mortality. We conducted a prospective, non-randomized, acute study to determine the feasibility of using unilateral transvenous phrenic nerve stimulation for the treatment of CSA in heart failure patients.

Methods And Results: Thirty-one patients from six centres underwent attempted transvenous lead placement.

Physiological assessment of renal artery stenosis: comparisons of resting with hyperemic renal pressure measurements.

Objectives: We compared resting and hyperemic pressure gradients induced by intrarenal papaverine for the assessment of renal artery stenosis (RAS). We also investigated the incidence of the QT interval prolongation and ventricular arrhythmias.

Background: In the coronary circulation, maximal hyperemia is essential in determining the significance of a stenosis.

Recipient atrial flutter masquerading as donor flutter in a heart transplant recipient.

Atrial flutter is common after orthotopic heart transplantation. We present the case of a patient who presented with atrial flutter on 12-lead electrocardiogram. On invasive electrophysiologic study, the donor heart was found to be in sinus rhythm and the recipient atrium was in flutter, which was dissociated from the donor.