Ticagrelor potentiates cardioprotection by remote ischemic preconditioning: the ticagrelor in remote ischemic preconditioning (TRIP) randomized clinical trial.

Objective: Remote ischemic preconditioning (RIPC) reduces periprocedural myocardial injury (PMI) after percutaneous coronary intervention (PCI) through various pathways, including an adenosine-triggered pathway. Ticagrelor inhibits adenosine uptake, thus may potentiate the effects of RIPC. This randomized trial tested the hypothesis that ticagrelor potentiates the effect of RIPC and reduces PMI, assessed by post-procedural troponin release.

Box Lesion Isolation of the Left Atrial Posterior Wall with Radiofrequency Ablation Restricted in Predetermined Lines for the Treatment of Persistent Atrial Fibrillation: The Prognostic Role of Acute Interventional Outcome and Trigger Identification.

The left atrial posterior wall (PW) is known to be a critical substrate for the initiation and perpetuation of atrial fibrillation (AF) and has been explored as a target for catheter ablation, particularly in persistent AF (PerAF). In this retrospective study, we investigate the clinical outcome of patients with PerAF who underwent PW isolation (PWI) restricted in predetermined lines in addition to pulmonary vein isolation (PVI). One hundred consecutive patients (64 ± 9.

Ping-pong guide catheter technique for facilitating antegrade crossing of a chronic total occlusion.

A 60-year-old man was referred for percutaneous coronary intervention of a proximal left circumflex (Cx) chronic total occlusion (CTO) with distal filling via epicardial collaterals from the left anterior descending (LAD) artery.

Spatial characterization of the tachycardia circuit of atrioventricular nodal re-entrant tachycardia.

Aims: The exact circuit of atrioventricular nodal re-entrant tachycardia (AVNRT) remains elusive. To assess the location and dimensions of the AVNRT circuit.

Methods And Results: Both typical and atypical AVNRT were induced at electrophysiology study of 14 patients.

The Electrophysiology of Atrial Fibrillation: From Basic Mechanisms to Catheter Ablation.

The electrophysiology of atrial fibrillation (AF) has always been a deep mystery in understanding this complex arrhythmia. The pathophysiological mechanisms of AF are complex and often remain unclear despite extensive research. Therefore, the implementation of basic science knowledge to clinical practice is challenging.

Incidence, electrophysiological characteristics, and long-term follow-up of perimitral atrial flutter in patients with previously confirmed mitral isthmus block.

Introduction: After mitral isthmus (ΜΙ) catheter ablation, perimitral atrial flutter (PMF) circuits can be maintained due to the preservation of residual myocardial connections, even if conventional pacing criteria for complete MI block are apparently met (MI pseudo-block). We aimed to study the incidence, the electrophysiological characteristics, and the long-term outcome of these patients.

Methods: Seventy-two consecutive patients (mean age 62.

Ventricular ectopy from the non-coronary cusp: Pathophysiological and anatomical considerations.

Non-coronary cusp (NCC) is a rare site for ventricular arrhythmias because it does not come into direct contact with the ventricular myocardium. Instead, the NCC comes in contact with the membranous septum near the His region. We describe a case of a young man with a ventricular ectopy who was successfully ablated in the NCC.

Prospective Assessment of Biomarkers of Hypercoagulability for the Identification of Patients With Severe Coronary Artery Disease. The ROADMAP-CAD Study.

In patients with stable coronary artery disease (CAD) blood hypercoagulability figures among factors leading to thrombosis. Tissue factor (TF) exposure at ruptured plaque initiates blood coagulation and hypercoagulability is responsible for thrombus formation. Early identification of patients eligible for angiography is a challenging issue for effective prevention of ACS.

Anatomic and Flow Characteristics of Left Anterior Descending Coronary Artery Angiographic Stenoses Predisposing to Myocardial Infarction.

The impact of the anatomic characteristics of coronary stenoses on the development of future coronary thrombosis has been controversial. This study aimed at identifying the anatomic and flow characteristics of left anterior descending (LAD) coronary artery stenoses that predispose to myocardial infarction, by examining angiograms obtained before the index event. We identified 90 patients with anterior ST-elevation myocardial infarction (STEMI) for whom coronary angiograms and their reconstruction in the three-dimensional space were available at 6 to 12 months before the STEMI, and at the revascularization procedure.

Hospital attendance and admission trends for cardiac diseases during the COVID-19 outbreak and lockdown in Greece.

Objectives: The coronavirus disease 2019 (COVID-19) outbreak, along with implementation of lockdown and strict public movement restrictions, in Greece has affected hospital visits and admissions. We aimed to investigate trends of cardiac disease admissions during the outbreak of the pandemic and possible associations with the applied restrictive measures.

Study Design: This is a retrospective observational study.

Distal Radial Access for Percutaneous Endovascular Repair of a Radial Artery Pseudoaneurysm.

Percutaneous pseudoaneurysm repair through the ipsilateral ulnar artery is an alternative to surgical repair; however, distal radial access, as described in this case, may offer increased safety.

The evolution of mapping and ablation techniques in the treatment of atrial tachycardias occurring after atrial fibrillation ablation.

Purpose: A possible consequence of atrial fibrillation (AF) ablation is the occurrence of organized atrial tachycardias (ATs). ATs after AF ablation (ATAAF) may be more symptomatic than AF itself, thus necessitating catheter ablation. We evaluated the prognostic significance of clinical and invasive characteristics for long-term sinus rhythm (SR) maintenance following ATAAF ablation and assessed the effect of technological developments on these results.

First Reported Case of Skin Necrosis Due to Prolonged Mechanical Compression After Transradial Catheterization.

We present a patient under triple-antithrombotic therapy who underwent prolonged mechanical compression after radial intervention; the subsequent necrosis at the access site required surgical repair.

Selective Activation Re-Mapping Reveals the Mechanism in Apparently Unstable Atrial Tachycardias.

Following atrial fibrillation (AF) ablation procedures, patients may present with atrial tachycardias (ATs) that show remarkable stability for short periods of time but degenerate in unstable forms right afterwards. In order to map these types of ATs, we applied the sequential mapping capabilities only for time segments where ATs exhibited constant cycle length (CL) and activation sequence, excluding the segments with unstable recordings. We herein describe two cases of ATs after AF ablation which were mapped with this technique that allowed for the successful identification and subsequent ablation of the tachycardia circuit.

Dissection Re-entry Technique: How is it Really Looking?

Dissection re-entry is a widely used technique in many chronic total occlusion centers. This account of a failed re-entry attempt provides in vivo photographic evidence of how the vessel looked after such an attempt. Operators are advised to keep dissection of subintimal space and hematoma limited and use dedicated materials and techniques for controlled re-entry.

Endpoints for Successful Slow Pathway Catheter Ablation in Typical and Atypical Atrioventricular Nodal Re-Entrant Tachycardia: A Contemporary, Multicenter Study.

Objectives: This study sought to investigate markers of success following slow pathway ablation for atrioventricular nodal re-entrant tachycardia (AVNRT).

Background: Published data are conflicting.

Methods: The authors studied 1,007 patients with typical AVNRT and 77 patients with atypical AVNRT.

Coronary artery ectasia in Crohn's disease.

Coronary artery ectasia (CAE) can be ascribed, in the majority of cases, to coronary atherosclerosis. Nevertheless, the presence of isolated ectatic lesions without obstructive coronary artery disease and the association of CAE with several autoimmune diseases characterised by systemic vascular involvement suggest that the pathogenesis of CAE may extend beyond coronary atherosclerosis. We herein report the case of a 56-year-old male patient with Crohn's disease and isolated CAE, who has been found positive for IgM and IgA antiendothelial cell antibodies, and discuss a potential pathogenic mechanism.

Compartment Syndrome: A Rare and Frightening Complication of Transradial Catheterization.

The compartment syndrome is a severe complication of transradial approach and can be prevented by prompt treatment of forearm hematoma; otherwise, fasciotomies are urgent.

Effects of omega-3 polyunsaturated fatty acids on fibrosis, endothelial function and myocardial performance, in ischemic heart failure patients.

Background & Aims: Polyunsaturated fatty acids (PUFAs) may affect the cardiovascular system with a multiplicity of mechanisms. We assessed the effects of omega-3 PUFAs supplements on inflammation, fibrosis, left ventricle performance and endothelial function of ischemic heart failure (HF) patients.

Methods: In this double-blind, placebo controlled, cross-over trial we enrolled 31 patients with ischemic HF, followed by a 6-week wash-out period.

Rotational Atherectomy and Simultaneous Temporary Transvenous Pacing Through a Forearm Approach.

This is the first reported rotational atherectomy procedure with transvenous pacing utilizing a complete forearm approach. An imaging series illustrates the feasibility of this procedure and its advantages for the patient.

Left Septal Slow Pathway Ablation for Atrioventricular Nodal Reentrant Tachycardia.

Background: Immunohistochemistry studies suggest that the anatomic substrate of the slow pathway in atrioventricular nodal reentrant tachycardia (AVNRT) is the left inferior nodal extension. We hypothesized that slow pathway ablation from the left septum is an effective alternative to right-sided ablation.

Methods And Results: We analyzed our databases of AVNRT in search of cases that had used slow pathway ablation from the left septum because of failure of right septal ablation, and then prospectively subjected consenting patients to a left septal-only procedure.