Vagal response during radiofrequency catheter ablation initiated from right superior pulmonary vein: Incidence, risk factors, and clinical outcomes.

Background: The vagal response (VR) is unavoidable during pulmonary vein isolation (PVI) for atrial fibrillation (AF). In this study, we aimed to investigate the incidence, risk factors, and clinical outcomes of VR during PVI initiated from the right superior pulmonary vein (RSPV).

Methods: Patients with AF were consecutively enrolled.

Bradyarrhythmias in patients with embolic stroke of undetermined source: a tight relationship with atrial cardiomyopathy.

Background: Implantable loop recorders (ILRs) have been shown to significantly improve the detection of atrial fibrillation (AF) in patients with embolic stroke of undetermined source (ESUS). The incidence and characterization of bradyarrhythmias in this subset of patients is still unknown.

Methods: All consecutive patients who received ILRs, after an ESUS, between March 2015 and December 2022 in our Center were retrospectively enrolled and analyzed.

Impact of dietary supplementation of beef cows with rumen-protected methionine during the periconceptional period on prenatal growth and performance to weaning.

Changes in maternal nutrition during the periconceptional period can influence postnatal growth in cattle. This study aimed to identify the impact of supplementing beef cows with rumen-protected methionine (RP-Met) during the periconceptional period on their female progeny. In exp 1, plasma methionine (Met) levels were analyzed in samples from 10 Angus crossbred, non-lactating beef cows.

Cardiac Implantable Electronic Devices in Cardiac Transplant Patients: A Comprehensive Review.

A fraction of patients (approximately 10%) undergoing heart transplantation require permanent pacemaker (PPM) implantation due to sinus node dysfunction or atrioventricular block, occurring either shortly after surgery or later. The incidence of PPM implantation has declined to less than 5% with the introduction of bicaval anastomosis transplantation surgery. Pacing dependency during follow-up varies among recipients.

Surgical explantation of an infected Lotus Edge valve: a case report.

Background: With the rapid expansion of transcatheter aortic valve replacement (TAVR), TAVR valve explantation is also increasing. Nevertheless, previous reports on Lotus Edge valve explantation are limited to only two reports, none of which include intraoperative videos. Therefore, we report the case of an older adult who underwent a 2-year-old Lotus Edge valve explantation, after developing prosthetic valve endocarditis (PVE) and aortic annular abscess, with a strong indication for a TAVR explantation and surgical aortic valve replacement (AVR).

Assessing Interpectoral Nerve Block for Postoperative Pain Management in Reduction Mammaplasty Surgery: A Case-control Study.

Background: Reduction mammaplasty surgery is a commonly performed procedure in plastic surgery, offering significant improvements in quality of life. However, the postoperative period may be accompanied by considerable pain. In this study, we assess the impact of interpectoral block on reducing postoperative pain.

Atypical Wenckebach AV Block in the Infra-Hisian Region: Clinical Implications and Management.

BACKGROUND Second-degree atrioventricular (AV) block is a frequently encountered conduction abnormality on surface electrocardiogram (ECG). However, it does not always imply a block at the AV nodal level. In rare cases, this block can occur below the bundle of His, within the infra-Hisian region of the His-Purkinje system.

The sedation efficacy of different doses of remimazolam in elderly patients with regional nerve block anaesthesia.

Background: Remimazolam is a benzodiazepine sedative that is indicated for induction and maintenance during general anaesthesia. Remimazolam is also used for sedation in outpatient surgery; however, most reports have focused on nonelderly patients, whereas only a few studies have reported the use of remimazolam for elderly patients when receiving regional nerve block anaesthesia.

Aim: The aim of this study was to evaluate the effects of different doses of remimazolam in elderly patients when specifically related to regional nerve block anaesthesia.

Single-point ultrasound-guided iliohypogastric-ilioinguinal-genitofemoral nerve block for inguinal hernia surgery in older adult patients: a randomized controlled trial.

Background: Ultrasound-guided nerve block can be used for perioperative analgesia and can potentially improve the course of recovery. Although iliohypogastric-ilioinguinal nerve block has been successfully used for inguinal hernia surgery, the poor blocking effect of intraoperative traction reflex remains a major drawback of this technique. The main objective of this study was to investigate the feasibility of single-point ultrasound-guided iliohypogastric-ilioinguinal-genitofemoral nerve (GFN) blockage for open anterior inguinal hernia repair in older adults.

An improved multi-scale feature extraction network for medical image segmentation.

Background: The use of U-Net and its variations has led to significant advancements in medical image segmentation. However, the encoder-decoder structures of these models often lose spatial information during downsampling. Skip connections can help address this issue; however, they may also introduce excessive irrelevant background information.

Myocardial perfusion imaging in a case of cardiac strangulation: A novel approach to detect pacemaker-induced ischemia.

Cardiac strangulation is a rare phenomenon in children following epicardial pacemaker implantation, caused by compression of the heart and great vessels by the epicardial pacemaker wires. We report a rare case of cardiac strangulation presenting after 8 years of epicardial pacemaker implantation. On routine follow-up, computed tomography angiography showed significant extrinsic compression of the mid-left anterior descending (LAD) artery by the epicardial pacing wire.

Delayed coronary air embolism post re-do mitral valve replacement: A case report.

Background: Coronary air embolism (CAE) is a complication that can lead to catastrophic outcomes, including myocardial infarction, stroke, and death. It is reported to occur during cardiac catheterization, within a few hours after cardiac surgery, or as a result of chest trauma. This is a case report of delayed coronary air embolism following cardiac surgery.

A case report of pre-implantation feasibility test for combining leadless pacemaker and subcutaneous implantable cardioverter-defibrillator in adult congenital heart disease.

Unlabelled: New cardiac implantable electronic devices (CIEDs), such as leadless pacemakers and subcutaneous implantable cardioverter defibrillators (S-ICDs), are being used in patients with adult congenital heart disease. The selection of CIEDs often requires careful consideration due to technical challenges posed by a unique heart structure. A 27-year-old man following a surgical tetralogy of Fallot (TOF) repair developed non-sustained ventricular tachycardia, sick sinus syndrome, and complete atrioventricular block.

Nitazene opioids and the heart: Identification of a cardiac ion channel target for illicit nitazene opioids.

The growing use of nitazene synthetic opioids heralds a new phase of the opioid crisis. However, limited information exists on the toxic effects of these drugs, aside from a propensity for respiratory depression. With restricted research availability of nitazenes, we used machine-learning-based tools to evaluate five nitazene compounds' interaction potential with the hERG potassium channel, a key drug antitarget in the heart.

Constrictive pericarditis following epicardial pacemaker implant: a diagnostic dilemma.

Constrictive pericarditis is a rare complication after cardiac surgery. It is mostly seen in adults. We report a case of constrictive pericarditis in a 3-year-old child with right ventricular dysfunction after permanent pacemaker implantation during infancy for congenital complete heart block.

Prospective Validation of a Pre-Specified Algorithm for the Management of Conduction Disturbances Following Transcatheter Aortic Valve Replacement. The PROMOTE Study.

Background: There is a large variability regarding the management of conduction disturbances (CDs) after TAVR.

Objectives: To validate a pre-specified algorithm for managing CDs in patients undergoing TAVR.

Methods: Prospective multicenter study including consecutive patients without prior pacemaker undergoing TAVR.

A Novel Focal Lattice Tip Catheter Toggling Between Pulsed Field Energy and Radiofrequency for Atrial Arrhythmia Ablation: Results from a Real-World, Multicenter Registry.

Introduction: A novel focal lattice tip catheter allowing the delivery of either pulsed field (PF) or radiofrequency (RF) energy has recently received regulatory approval. The technology features a proprietary 3D electroanatomical mapping system.

Objective: to describe the first real-world and multicentre experience.

The Role of P-Wave Variables in Enhancing Prediction of New-Onset Atrial Fibrillation in Patients With Acute Myocardial Infarction.

Background: After acute myocardial infarction (AMI), it is common to observe new-onset atrial fibrillation (NOAF), which is often related to a negative prognosis. Some P-wave variables (P-wave duration [PWD], P-wave amplitude, and interatrial block [IAB]), reflecting the process of electrical and structural remodeling, could predict the risk of atrial fibrillation (AF). This study aimed to assess the predictive value of P-wave variables for post-AMI NOAF.

Dual Chamber Aveir Retrievable Leadless Pacemaker Implant via the Right Internal Jugular Vein in a 13-year-old With Congenital Complete Heart Block.

Introduction: Congenital complete heart block is a condition where there is a risk of Stokes Adam's attacks and sudden death may occur. Once the escape rate is too low, or other high-risk factors occur, these patients ultimately need pacemakers placed. Epicardial or transvenous pacemakers have typically been in employed dependent on size of the patient and other circumstances.

3 Leadless Pacemaker Implantations in an 81-Year-Old Woman With a History of Transvenous Pacemaker Infection.

Leadless pacemakers (LPMs) offer an alternative for patients with challenging venous access or device infection history. Management of LPM battery depletion in frail patients presents unique challenges. We present the case of an 81-year-old frail woman with obstructive hypertrophic cardiomyopathy and complete heart block, previously treated with percutaneous transseptal myocardial ablation and a transvenous pacemaker, who received an LPM after device extraction for infection.

End-stage heart failure and heart transplant in cardiac sarcoidosis: a case series.

Background: Diagnosing cardiac sarcoidosis (CS) is challenging. Immunosuppressive therapies are less effective in end-stage disease, and often heart transplant (HT) is the only available option. We present a series of advanced CS cases, requiring HT, along with a review of the literature evidence in this field.

Is conduction system pacing more effective than right ventricular pacing in reducing atrial high-rate episodes in patients with heart failure and preserved ejection fraction?

Background: The relationship between conduction system pacing (CSP) and the incidence of atrial fibrillation (AF) in patients with heart failure and preserved ejection fraction (HFpEF) remains uncertain. This study aims to investigate the occurrence of atrial high-rate episodes (AHREs) following CSP in patients with HFpEF, in comparison to right ventricular pacing (RVP).

Methods: Patients with HFpEF who received dual-chamber pacemakers for atrioventricular block were retrospectively enrolled from January 2018 to January 2023.

Prognostic Value of Ultra-Short Heart Rate Variability Measures Obtained from Electrocardiogram Recordings of Hospitalized Patients Diagnosed with Non-ST-Elevation Myocardial Infarction.

Myocardial infarction (MI) is a common emergency with high rates of morbidity and mortality. Current risk stratification scores for non-ST-elevation MI (NSTEMI) use subjective or delayed information. Heart rate variability was shown to correlate with prognosis following MI.