Safety and acute efficacy of catheter ablation for atrial fibrillation with pulsed field ablation vs thermal energy ablation: A meta-analysis of single proportions.

Background: Pulsed field ablation (PFA) has emerged as a novel energy source for the ablation of atrial fibrillation (AF) using ultrarapid electrical pulses to induce cell death via electroporation.

Objective: The purpose of this study was to compare the safety and acute efficacy of ablation for AF with PFA vs thermal energy sources.

Methods: We performed an extensive literature search and systematic review of studies that evaluated the safety and efficacy of ablation for AF with PFA and compared them to landmark clinical trials for ablation of AF with thermal energy sources.

Should urinary catheters be avoided in patients with total joint arthroplasty?

Patients undergoing total joint arthroplasty typically have indwelling urinary catheters placed preoperatively to decompress the bladder, assess urinary output, and prevent postoperative urinary retention. However, catheterization is associated with several complications and increased hospital length of stay, and research supports eliminating routine placement of urinary catheters in most patients undergoing elective joint arthroplasty and certain general surgeries lasting no more than 2 hours.

Safety and efficacy of catheter ablation of atrial fibrillation in the very elderly (≥80 years old): Insights from the UC San Diego AF Ablation Registry.

Background: Catheter ablation improves outcomes in symptomatic atrial fibrillation (AF) patients. However, its safety and efficacy in the very elderly (≥80 years old) is not well described.

Hypothesis: Ablation of AF in the very elderly is safe and effective.

Acute myeloid leukemia causing acute thrombosis of the coronary arteries: a case report.

Background: This case report demonstrates acute myeloid leukemia causing acute thrombosis of coronary arteries with anterolateral ST elevation myocardial infarction and ventricular tachycardia in an otherwise healthy woman. Few case reports have been documented on patients with concomitant conditions of acute myeloid leukemia and acute myocardial infarction, and it is important to note that prognosis for patients with both is worse than that of either condition. While both conditions together are rare, other non-atherosclerotic causes of acute coronary syndromes are likewise important considerations in the context of myocardial ischemia.

Comparison of Outcomes After Ablation of Atrial Fibrillation in Patients With Heart Failure With Preserved Versus Reduced Ejection Fraction.

Catheter ablation improves outcomes in atrial fibrillation (AF) patients with heart failure (HF) with reduced ejection fraction (HFrEF). We sought to evaluate the efficacy and safety of catheter ablation of AF in HF patients with a preserved ejection fraction (HFpEF). We performed a retrospective study of all patients who underwent de novo radiofrequency catheter ablation enrolled in the UC San Diego AF Ablation Registry.

Atrial fibrillation in patients with heart failure with preserved ejection fraction.

Purpose Of Review: To review the shared pathology of atrial fibrillation and heart failure with preserved ejection fraction (HFpEF) and the prognostic, diagnostic, and treatment challenges incurred by the co-occurrence of these increasingly prevalent diseases.

Recent Findings: Multiple risk factors and mechanisms have been proposed as potentially linking atrial fibrillation and HFpEF, with systemic inflammation more recently being invoked. Nonvitamin K oral anticoagulants, left atrial appendage occlusion devices, and catheter ablation have emerged as alternative treatment options.

Accuracy of left ventricular ejection fraction determined by automated analysis of handheld echocardiograms: A comparison of experienced and novice examiners.

Background: Handheld ultrasound devices have been developed that facilitate imaging in new clinical settings. However, quantitative assessment has been difficult. Software algorithms have recently been developed with the aim of providing rapid measurements of left ventricular ejection fraction (LVEF) with minimal operator input.

Meta-analysis of Effect of Modest (≥10%) Weight Loss in Management of Overweight and Obese Patients With Atrial Fibrillation.

Obesity and atrial fibrillation (AF) are growing epidemics with significant overlap in co-morbidities. Multiple smaller studies have evaluated the effects of weight loss and risk factor modification on recurrence of AF, reduction in AF burden and improvement in AF symptom severity. The objective of this study was to determine if a modest weight loss of ≥10% of initial body weight is enough to improve outcomes in overweight or obese patients with established AF.

Surgical vs. Conservative Interventions for Treating ACL Injuries.

Editor's note: This is a summary of a nursing care-related systematic review from the Cochrane Library.

Change in Overactive Bladder Symptoms After Surgery for Stress Urinary Incontinence in Women.

Objective: To assess change in overactive bladder (OAB) symptoms up to 5 years after surgery and to identify associated predictors of change from baseline.

Methods: This is a secondary analysis of data from three multicenter urinary incontinence (UI) surgical trials of women with stress-predominant mixed UI assigned to Burch colposuspension, autologous fascial sling, or retropubic or transobturator midurethral slings. The primary outcome was improvement of 70% or greater from baseline in symptoms measured by the Urinary Distress Inventory-Irritative subscale.

Posttraumatic stress syndrome associated with stays in the intensive care unit: importance of nurses' involvement.

More patients in the intensive care unit are surviving their critical illnesses because of advances in medical care. This change in survival has led to an increased awareness of the emotional consequences of being critically ill. Posttraumatic stress disorder has been identified in approximately 9% to 27% of critically ill patients compared with 7% of the general US population.

Preoperative education on postoperative delirium, anxiety, and knowledge in pulmonary thromboendarterectomy patients.

Background: Delirium is the most common postoperative psychiatric condition in intensive care settings and can lead to increased complications and costs.

Objectives: To evaluate the impact of multifaceted preoperative patient education on postoperative delirium, anxiety, and knowledge and to explore predictors of postoperative delirium, days of mechanical ventilation, and days in the intensive care unit (ICU) in patients undergoing pulmonary thromboendarterectomy.

Method: A prospective, randomized controlled trial was conducted on consented patients from October 2011 to April 2013.