Adverse obstetric outcomes in cases of meconium-stained amniotic fluid complicated with intrapartum fever.

Purpose: Meconium-stained amniotic fluid (MSAF) often signifies colonization of the amniotic sac by microorganisms. This study investigated additional adverse obstetric outcomes associated with MSAF in deliveries complicated by maternal intrapartum fever (IF).

Methods: This retrospective study included all singleton pregnancies from 2014 to 2020, with intrapartum maternal fever ≥ 38 °C during a trial of labor.

Induction of Labor in Twins-Double Trouble?

Objective: To determine and compare the safety and efficacy of different methods of induction of labor in twin gestations and their effect on maternal and neonatal outcomes.

Methods: A retrospective observational cohort study was conducted at a single university-affiliated medical center. Patients with a twin gestation undergoing induction of labor at >32 + 0 weeks comprised the study group.

Depression, Anxiety, and Acute Stress Disorder Among Patients Hospitalized With COVID-19: A Prospective Cohort Study.

Background: The epidemiology of psychiatric symptoms among patients with coronavirus disease 2019 is poorly characterized.

Objective: This article sought to identify the prevalence of anxiety, depression, and acute stress disorder among hospitalized patients with coronavirus disease 2019.

Methods: Adult patients recently admitted to nonintensive care unit medical ward settings with coronavirus disease 2019 were eligible for enrollment.

Combined therapy with vaginal progesterone, Arabin cervical pessary and cervical cerclage to prevent preterm delivery in high-risk women.

Purpose: Preterm birth is the leading cause of perinatal morbidity and mortality. Vaginal progesterone cervical cerclage and Arabin cervical pessary are considered as preventive treatments in women at risk for preterm birth. However, there is less evidence as to which of these interventions is the preferred management.

Arabin cervical pessary with vaginal progesterone versus vaginal progesterone for preventing preterm delivery.

To compare the rate of preterm delivery in pregnant women with a short cervical length managed with Arabin cervical pessary and vaginal progesterone versus vaginal progesterone alone. This was a retrospective cohort study of singletons pregnancies managed in two tertiary medical centers between September 2011 and May 2017. One center utilized the combined treatment of Arabin cervical pessary and vaginal progesterone (study group) and the second utilized vaginal progesterone approach (control group).

Clear cell adenocarcinoma of the colon: a case report and review of the literature.

Clear cell adenocarcinoma of the colon has been described scarcely in the literature. It affects elderly men more commonly than women and usually appears in the left side of the colon. A Hispanic 41-year-old female came to the emergency room with abdominal pain, vomiting, and distension.

Functional pace-mapping responses for identification of targets for catheter ablation of scar-mediated ventricular tachycardia.

Background: Myocardial scars harbor areas of slow conduction and display abnormal electrograms. Pace-mapping at these sites can generate a 12-lead ECG morphological match to a targeted ventricular tachycardia (VT), and in some instances, multiple exit morphologies can result. At times, this can also result in the initiation of VT, termed pace-mapped induction (PMI).

Idiopathic muscular hypertrophy of the duodenum.

There have not been any cases published of idiopathic muscular hypertrophy of the gastrointestinal tract in the past 20 years, mainly because it is a very rare condition of unknown aetiology. It is usually asymptomatic and presents mostly in the oesophagus of adult men. Our case involves a 69 year old female that presented with a 6 week history of abdominal discomfort and weight loss.

Relationship between mechanical and electrical remodelling in patients with cardiac resynchronization implanted defibrillators.

Aims: Cardiac resynchronization therapy (CRT) is associated with reverse left ventricular (LV) remodelling. However, the effects of CRT-induced mechanical remodelling on electrical remodelling, and the occurrence of ventricular arrhythmias have not been clearly established. We studied the relationship between mechanical remodelling, electrical remodelling, and the occurrence of appropriate implantable cardioverter-defibrillator (ICD) therapy 1 year after CRT.

Defibrillation threshold testing fails to show clinical benefit during long-term follow-up of patients undergoing cardiac resynchronization therapy defibrillator implantation.

Background: The utility of defibrillation threshold testing in patients undergoing implantable cardioverter-defibrillator (ICD) implantation is controversial. Higher defibrillation thresholds have been noted in patients undergoing implantation of cardiac resynchronization therapy defibrillators (CRT-D). Since the risks and potential benefits of testing may be higher in this population, we sought to assess the impact of defibrillation safety margin or vulnerability safety margin testing in CRT-D recipients.

Electrophysiological differences between the epicardium and the endocardium of the left atrium.

Background: Electrophysiological properties of the atrial endocardium compared to epicardium are not well understood. The purpose of this study was to compare the electrophysiological properties and vulnerability to arrhythmia induction from these regions.

Methods And Results: Transseptal endocardial and percutaneous epicardial mapping were performed in a porcine model (n = 7).

Distribution of late potentials within infarct scars assessed by ultra high-density mapping.

Background: Late potential (LP) electrograms represent areas of slow conduction and are often sites critical to reentrant tachycardia circuits. The distribution of LPs within infarct scar is not known.

Objective: The purpose of this study was to delineate infarct heterogeneity using ultra high-density mapping and to determine the location of LPs with respect to scar architecture.

Ultra high-density multipolar mapping with double ventricular access: a novel technique for ablation of ventricular tachycardia.

Unlabelled: Ultra High-Density Multipolar Mapping With Double Ventricular Access. 

Background: Analogous to the use of circular loop catheters to guide ablation around the pulmonary veins, it may be advantageous to use a multipolar catheter in the ventricle for rapid mapping and to guide ablation. We describe a technique using double access into the left ventricle for multipolar electroanatomic mapping and ablation of scar-mediated ventricular tachycardia (VT).

Characterization of the arrhythmogenic substrate in ischemic and nonischemic cardiomyopathy implications for catheter ablation of hemodynamically unstable ventricular tachycardia.

Objectives: The purpose of this study was to compare the characteristics and prevalence of late potentials (LP) in patients with nonischemic cardiomyopathy (NICM) and ischemic cardiomyopathy (ICM) etiologies and evaluate their value as targets for catheter ablation.

Background: LP are frequently found in post-myocardial infarction scars and are useful ablation targets. The relative prevalence and characteristics of LP in patients with NICM is not well understood.

The altruistic unbalanced paired kidney exchange: proof of concept and survey of potential donor and recipient attitudes.

Background: Altruistic unbalanced paired kidney exchanges (AUPKE) use compatible live donor/recipient pairs to facilitate transplants for individuals with incompatible live donors. We report a three donor/recipient pair complex AUPKE. Little is known of the circumstances under which individuals are likely to trade away a compatible live donor or the overall impact that AUPKE could have on the organ supply.

Supraventricular tachycardia after orthotopic cardiac transplantation.

Objectives: The purpose of this study was to define the incidence, mechanisms, and management, including catheter ablation, of supraventricular tachycardia (SVT) in a large series of patients after orthotopic heart transplantation (OHT).

Background: Supraventricular arrhythmias are frequently encountered after OHT, but their characteristics in this population have not been well established.

Methods: We analyzed the incidence, clinical course, and management of SVTs in a cohort of 729 adult patients who underwent OHT.

Cardiac resynchronization therapy response is associated with shorter duration of atrial fibrillation.

Background: Atrial fibrillation (AF) is commonly associated with heart failure. The benefit of cardiac resynchronization therapy (CRT) on atrial remodeling has been demonstrated. However, biventricular pacing did not reduce the global incidence of AF.

Left ventricular apical wall motion abnormality is associated with lack of response to cardiac resynchronization therapy in patients with ischemic cardiomyopathy.

Background: Many patients with appropriate indications fail to respond to cardiac resynchronization therapy (CRT).

Objective: The purpose of our study was to determine the relationship between CRT response and preimplantation apical wall motion abnormality.

Methods: We analyzed data from 83 patients with ischemic cardiomyopathy who underwent CRT.

Changes and predictive value of dispersion of repolarization parameters for appropriate therapy in patients with biventricular implantable cardioverter-defibrillators.

Background: The impact of cardiac resynchronization therapy (CRT) on dispersion of repolarization is controversial. The benefit of CRT on sudden cardiac death has been demonstrated only after 3 years follow-up.

Objective: The purpose of this study was to explore the immediate effect of CRT on dispersion of repolarization and to define the value of dispersion of repolarization parameters as predictors of appropriate implantable cardioverter-defibrillator (ICD) therapy.

Functional characterization of atrial electrograms in sinus rhythm delineates sites of parasympathetic innervation in patients with paroxysmal atrial fibrillation.

Objectives: This study sought to characterize left atrial (LA) sinus rhythm electrogram (EGM) patterns and their relationship to parasympathetic responses during atrial fibrillation (AF) ablation.

Background: The mechanistic basis of fractionated LA EGMs in patients with paroxysmal AF is not well understood.

Methods: We analyzed 1,662 LA ablation sites from 30 patients who underwent catheter ablation for paroxysmal AF.

Inductionless or limited shock testing is possible in most patients with implantable cardioverter- defibrillators/cardiac resynchronization therapy defibrillators: results of the multicenter ASSURE Study (Arrhythmia Single Shock Defibrillation Threshold Testing Versus Upper Limit of Vulnerability: Risk Reduction Evaluation With Implantable Cardioverter-Defibrillator Implantations).

Background: Implantable cardioverter-defibrillators and cardiac resynchronization therapy defibrillators have relied on multiple ventricular fibrillation (VF) induction/defibrillation tests at implantation to ensure that the device can reliably sense, detect, and convert VF. The ASSURE Study (Arrhythmia Single Shock Defibrillation Threshold Testing Versus Upper Limit of Vulnerability: Risk Reduction Evaluation With Implantable Cardioverter-Defibrillator Implantations) is the first large, multicenter, prospective trial comparing vulnerability safety margin testing versus defibrillation safety margin testing with a single VF induction/defibrillation.

Methods And Results: A total of 426 patients receiving an implantable cardioverter-defibrillator or cardiac resynchronization therapy defibrillator underwent vulnerability safety margin or defibrillation safety margin screening at 14 J in a randomized order.

Usefulness of preimplantation B-type natriuretic peptide level for predicting response to cardiac resynchronization therapy.

Nearly 1/3 of patients with heart failure (HF) fail to respond to cardiac resynchronization therapy (CRT). The purpose of this study was to evaluate the value of preimplantation brain natriuretic peptide (BNP) in predicting the clinical response to CRT. We retrospectively analyzed 164 patients who underwent CRT.

Catheter ablation of right ventricular outflow tract tachycardia: value of defining coronary anatomy.

Introduction: Thermal damage to coronary arteries during catheter ablation has been previously reported. Coronary artery damage during LV outflow tract ventricular tachycardia is well recognized. However, the relationship of the coronary arteries to the RV outflow tract during catheter ablation has not been delineated.

Value of high-density endocardial and epicardial mapping for catheter ablation of hemodynamically unstable ventricular tachycardia.

Background: Percutaneous epicardial mapping has been used for ablation of recurrent ventricular tachycardia (VT).

Objectives: The purpose of this study was to use a combined epicardial and endocardial mapping strategy to delineate the myocardial substrate for recurrent VT in both ischemic (n = 12) and nonischemic cardiomyopathy (n = 8), and to define the role of epicardial ablation.

Methods: Electroanatomic mapping was performed in 20 patients.