Surgical and transcatheter left atrial appendage closure in patients with atrial fibrillation and hypertrophic cardiomyopathy.

Background: Patients with hypertrophic cardiomyopathy (HCM) and atrial fibrillation (AF) are at increased stroke risk in comparison to those with non-valvular AF not affected by HCM.

Objectives: To investigate the role of left atrial appendage closure (LAAC) in patients with HCM and AF.

Methods And Results: We identified patients with HCM and AF using the National Readmission Dataset.

Door-to-balloon Time for ST-elevation MI in the Coronavirus Disease 2019 Era.

In patients presenting with ST-elevation MI, prompt primary coronary intervention is the preferred treatment modality. Several studies have described improved outcomes in patients with door-to-balloon (D2B) and symptom onset-to-balloon (OTB) times of less than 2 hours, but the specific implications of the coronavirus disease 2019 (COVID-19) pandemic on D2B and OTB times are not well-known. This review aims to evaluate the impact of COVID-19 on D2B time and elucidate both the factors that delay D2B time and strategies to improve D2B time in the contemporary era.

Impact of catheter ablation in patients with atrial flutter and concurrent heart failure.

Background: No studies assessed impact of atrial flutter (AFL) ablation on outcomes in patients with AFL and concurrent heart failure (HF).

Objectives: To assess the effect of AFL ablation on mortality and HF readmissions in patients with AFL and HF.

Methods: This retrospective cohort study identified 15,952 patients with AFL and HF from the 2016-17 Nationwide Readmissions Database.

Calcified myocardial scar seen via cardiac imaging correlating with ventricular tachycardia focus.

A 74-year-old man presented with presyncope and non-sustained monomorphic ventricular tachycardia in the setting of acute coronary syndrome. On coronary angiogram, a calcified myocardial scar was revealed, which was later identified as the ventricular tachycardia focus via electrophysiological study.

Invasive Approaches in the Management of Cocaine-Associated Non-ST-Segment Elevation Myocardial Infarction.

Objectives: The aim of this study was to determine the impact of invasive approaches and revascularization in patients with cocaine-associated non-ST-segment elevation myocardial infarction (NSTEMI).

Background: The role of invasive approaches in cocaine-associated NSTEMI is uncertain.

Methods: This retrospective cohort study identified 3,735 patients with NSTEMI and history of cocaine use from the Nationwide Readmissions Database from 2016 to 2017.

Transcatheter aortic valve replacement in aortic regurgitation: The U.S. experience.

Background: Transcatheter aortic valve replacement (TAVR) can be an effective option for high-risk Aortic Regurgitation (AR) patients. Although international experiences of TAVR for AR are published, U.S.

Catheter Ablation for Atrial Fibrillation in Patients With Concurrent Heart Failure.

Due to limited real-world data, the aim of this study was to explore the impact of catheter ablation (CA) for atrial fibrillation (AF) in heart failure (HF). This retrospective cohort study identified 119,694 patients with AF and HF from the Nationwide Readmissions Database (NRD) from 2016 to 2017. Propensity-matching was generated using demographics, comorbidities, hospital and other characteristics through multivariate logistic regression.

Evaluation and Treatment of Severe Rhabdomyolysis in a Patient with Legionnaires' Disease.

A 53-year-old man with alcoholism and a three-day history of diarrhea and abdominal pain was hospitalized with mild acute kidney injury (AKI) and rhabdomyolysis after a fall where he was down for a short duration. Subsequent testing revealed patchy right lower lobe infiltrates on chest X-ray and a positive urinary Legionella antigen test. Creatinine phosphokinase (CPK) peaked at 85,780 U/L (normal 0-250) on hospital day two and remained markedly elevated for five days despite aggressive intravenous (IV) hydration and appropriate antibiotic treatment.

High Thoracic Disc Herniation Causing Horner Syndrome with the Intraoperative Finding of Conjoined Nerve Root Compression: A Case Report.

Case: A 29-year-old man presented with right medial arm pain with paresthesia, as well as right-sided ptosis, miosis, and anhidrosis. Magnetic resonance imaging revealed a right paracentral disc herniation at the T1-T2 level. The patient underwent a hemilaminectomy with a medial facetectomy through a posterolateral approach to the T1-T2 disc space, followed by a discectomy.

Na+ inhibits the epithelial Na+ channel by binding to a site in an extracellular acidic cleft.

The epithelial Na(+) channel (ENaC) has a key role in the regulation of extracellular fluid volume and blood pressure. ENaC belongs to a family of ion channels that sense the external environment. These channels have large extracellular regions that are thought to interact with environmental cues, such as Na(+), Cl(-), protons, proteases, and shear stress, which modulate gating behavior.

Inhibitory tract traps the epithelial Na+ channel in a low activity conformation.

Proteolysis plays an important role in the maturation and activation of epithelial Na(+) channels (ENaCs). Non-cleaved channels are inactive at high extracellular Na(+) concentrations and fully cleaved channels are constitutively active. Cleavage of the α and γ subunits at multiple sites activates the channel through the release of imbedded inhibitory tracts.

Constraint-based, homology model of the extracellular domain of the epithelial Na+ channel α subunit reveals a mechanism of channel activation by proteases.

The epithelial Na(+) channel (ENaC) mediates Na(+) transport across high resistance epithelia. This channel is assembled from three homologous subunits with the majority of the protein's mass found in the extracellular domains. Acid-sensing ion channel 1 (ASIC1) is homologous to ENaC, but a key functional domain is highly divergent.