Incidence and risk factors of ventricular fibrillation before primary angioplasty in patients with first ST-elevation myocardial infarction: a nationwide study in Denmark.

Background: We aimed to investigate the incidence and risk factors for ventricular fibrillation (VF) before primary percutaneous coronary intervention (PPCI) among patients with ST-segment elevation myocardial infarction (STEMI) in a prospective nationwide setting.

Methods And Results: In this case-control study, patients presenting within the first 12 hours of first STEMI who survived to undergo angiography and subsequent PPCI were enrolled. Over 2 years, 219 cases presenting with VF before PPCI and 441 controls without preceding VF were enrolled.

Time to treatment-door-to-balloon time is not everything.

International guidelines for the management of patients with ST-elevation myocardial infarction (STEMI) recommend various performance measures to monitor the quality of STEMI systems of care. Door-to-balloon (D2B) time (arrival at hospital to percutaneous coronary intervention, PCI) and overall health care system delay (first medical contact to reperfusion) are acknowledged as valuable performance measures when treating patients with primary percutaneous coronary intervention (PPCI). However, there is confusion regarding the exact definition of these performance measures, and moreover system delay and PCI-related delay (the extra delay acceptable to perform PPCI instead of fibrinolysis) are often used synonymously, which add confusion when considering reperfusion strategy.

Pre-hospital evaluation of electrocardiographic grade 3 ischemia predicts infarct progression and final infarct size in ST elevation myocardial infarction patients treated with primary percutaneous coronary intervention.

Background: In STEMI, grade-3 ischemia (G3) on admission ECG predicts larger infarct size (IS) than grade-2 (G2). We evaluated whether pre-hospital G3 and its temporal behavior are associated with IS and salvage after pPCI.

Methods: In 401 STEMI patients, pre-hospital and pre-PCI ECGs were classified as G3 or G2.

Predictors for not completing exercise-based rehabilitation following cardiac surgery.

Objectives: The beneficial effects of exercise-based cardiac rehabilitation (ECR) are well documented. A substantial proportion of patients fail to complete ECR. The purpose of this study was to identify factors associated with patients not completing ECR.

Hemodynamic function of the standard St. Jude bileaflet disc valve has no clinical impact 10 years after aortic valve replacement.

Objectives: Size mismatch and impaired left ventricular function have been shown to determine the hemodynamic function of the standard St. Jude bileaflet disc valve early after aortic valve replacement (AVR). We aimed to analyse St.

Regression of left ventricular hypertrophy during 10 years after valve replacement for aortic stenosis is related to the preoperative risk profile.

Background: Previous studies have suggested that regression of hypertrophy may be the underlying determinant of longevity and left ventricular function after valve replacement (AVR) for aortic stenosis (AS). The potential for hypertrophy regression could therefore be related to the preoperative risk profile.

Methods: Ninety-one consecutive patients with AS had a "project" Doppler-echo and radionuclide ventriculography in addition to the standard investigation programme prior to AVR with a disc valve (19-29mm, n=82), a caged ball valve (26-29mm, n=8), or a stented porcine valve (26mm, n=1); 49 (group A) were selected for a serial follow-up study while 42 served as controls (group B).

Changes in left ventricular function and mass during serial investigations after valve replacement for aortic stenosis.

Background And Aim Of The Study: The potential for left ventricular hypertrophy regression and associated functional improvements may well be the underlying mechanism of results in general after valve replacement for aortic stenosis. The study aim was to investigate preoperative predictors and the time course of such ventricular changes.

Methods: Forty-six patients (mean age 61 years; range: 24-82 years) with aortic stenosis were prospectively followed with serial investigations (Doppler echocardiography, radionuclide ventriculography) at eight days (n = 43), three months (n = 42) and 18 months (n = 39) after valve replacement with a mechanical valve (19-29 mm).

Performance profile of the Starr-Edwards aortic cloth covered valve, track valve, and silastic ball valve.

Objective: The Starr-Edwards aortic ball valve has passed 30 years of clinical follow-up. A detailed account of the long-term performance from a large series could thus give valuable guidance in managing patients who are still alive, depict the total remaining life-span after aortic valve replacement (AVR) for the average patient, and set a record yet to be matched by modern disc valves.

Methods: A detailed follow-up to a maximum of 31.