The authors present four cases of rheumatic heart disease with severe dilatation of the left atrium which reached the right profile in the radiologic study. An initial negative deflexion of the P-wave (qP) in the right precordial leads was recorder in these cases. The presence of qP was interpreted in view of the atrial activation and the solid angle of the right precordial leads as a variation of potential of the right atrial ceiling and/or of the high interatrial septum, a consequence of the dislocation of the right atrium produced by severe dilatation of the left atrium, demonstrated radiologically in the cases studied. Thee presence of qP is another undoubtably valuable sign for inferring a severe displacement of the left atrium toward the right profile.
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Ann Thorac Cardiovasc Surg
January 2025
Department of Cardiovascular Surgery, Kobe University, Kobe, Hyogo, Japan.
Purpose: In totally endoscopic off-pump left atrial appendage (LAA) closure and surgical ablation, securing the operative field is sometimes difficult in some patients because of a narrow working space caused by an elevated diaphragm or ventricles. In this study, we aimed to investigate the effectiveness of a method that facilitates securing the operative field using an artificial pneumothorax.
Methods: We analyzed 71 consecutive patients who underwent totally endoscopic off-pump LAA closure and bilateral pulmonary vein isolation.
JACC Clin Electrophysiol
January 2025
Cardioangiologisches Centrum Bethanien, Agaplesion Markus-Krankenhaus, Frankfurt am Main, Germany.
Background: The net benefit of oral anticoagulation in patients with end-stage renal disease on hemodialysis (HD) is uncertain. In recent years, left atrial appendage closure (LAAC) has emerged as an alternative to oral anticoagulation; however, there is scant evidence of LAAC in patients on HD.
Objectives: This study aimed to assess the feasibility and safety of LAAC in patients on HD.
JACC Clin Electrophysiol
January 2025
Cardiac Electrophysiology Section, Division of Cardiology, Department of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Duke Clinical Research Institute, Durham, North Carolina, USA. Electronic address:
Background: In patients with structurally normal hearts, algorithms using surface electrocardiographic P-wave morphology are helpful to predict focal atrial tachycardia (FAT) location. However, these algorithms have not been formally assessed in patients with adult congenital heart disease (ACHD).
Objectives: This study sought to assess the efficacy of FAT-location prediction algorithms in an adult population of patients with ACHD.
BMJ Case Rep
January 2025
ARHC/Stroke Service, Naas General Hospital, Naas, Kildare, Ireland.
A woman in her early 60s presented with multiple transient neurological symptoms over the course of 20 months, including transient loss of power to her right lower limb. Initial workup with CT brain scan, carotid dopplers and ECG revealed no abnormality; however, MRI of the brain suggested recent ischaemic events in separate cortical territories. Subsequent transoesophageal echocardiogram revealed a large mobile mass histologically confirmed to be an atrial myxoma.
View Article and Find Full Text PDFAm J Med
January 2025
Professor of Medicine, Department of Cardiology, Tufts Medical Center, (Tufts University School of Medicine), Boston, MA 02111, USA. Electronic address:
Cardiologists and gastroenterologists often encounter the coexistence of symptoms and functional abnormalities, but determining causation is more difficult. In 1962 Smith and Papp first coined the term "linked angina". Their statement was preceded by the experiment whereby increase in bile duct pressure elicited the typical chest pain in patients with ischemic heart disease.
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