{"title":"Strategies for Catheter Ablation of Premature Ventricular Contractions and Ventricular Tachycardia With Intramural Origins.","authors":"Yi-Wen Becky Liao,Pasquale Santangeli","doi":"10.14503/thij-24-8465","DOIUrl":"https://doi.org/10.14503/thij-24-8465","url":null,"abstract":"","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142223122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A 62-year-old woman who had undergone mitral valve replacement 24 years ago was admitted to the hospital with congestive heart failure. She needed heart transplantation for stage D heart failure. Preoperative cardiac computed tomographic scans showed a severely calcified left atrium and a large right atrium. Given that the left atrium's calcification was too severe to suture, the calcified left atrial wall was broadly resected, and the resected left atrial wall was reconstructed with a bovine pericardial patch for anastomosis with the donor's left atrial wall. The operation was completed without heavy bleeding, and the patient was discharged from the hospital with no complications.
一名 62 岁的妇女在 24 年前接受了二尖瓣置换术,因充血性心力衰竭入院。她因 D 期心力衰竭需要接受心脏移植手术。术前心脏计算机断层扫描显示左心房严重钙化,右心房较大。鉴于左心房钙化严重,无法缝合,因此对钙化的左心房壁进行了大范围切除,并用牛心包补片重建切除的左心房壁,以便与供体的左心房壁吻合。手术在无大出血的情况下完成,患者无并发症出院。
{"title":"Heart Transplantation in a Patient With Rheumatic Heart Disease and Severe Left Atrial Calcification.","authors":"Kyungsub Song, Seonhwa Lee, Yun Seok Kim","doi":"10.14503/THIJ-23-8286","DOIUrl":"10.14503/THIJ-23-8286","url":null,"abstract":"<p><p>A 62-year-old woman who had undergone mitral valve replacement 24 years ago was admitted to the hospital with congestive heart failure. She needed heart transplantation for stage D heart failure. Preoperative cardiac computed tomographic scans showed a severely calcified left atrium and a large right atrium. Given that the left atrium's calcification was too severe to suture, the calcified left atrial wall was broadly resected, and the resected left atrial wall was reconstructed with a bovine pericardial patch for anastomosis with the donor's left atrial wall. The operation was completed without heavy bleeding, and the patient was discharged from the hospital with no complications.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.8,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075517/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pengyang Li, Ao Shi, Xiaojia Lu, Chenlin Li, Peng Cai, Catherine Teng, Lingling Wu, Yuan Shu, Su Pan, Richard A F Dixon, Qi Liu, Bin Wang
Background: Takotsubo syndrome has been reported in patients with COVID-19, although minimal data are available. This investigation assessed the incidence and impact of takotsubo syndrome on patients hospitalized with COVID-19.
Methods: A retrospective cohort study was conducted using International Statistical Classification of Diseases, Tenth Revision, codes to identify patients with a primary diagnosis of COVID-19 with or without takotsubo syndrome in the National Inpatient Sample 2020 database. Outcomes between groups were compared after propensity score matching for patient and hospital demographics and comorbidities.
Results: A total of 211,448 patients with a primary diagnosis of COVID-19 were identified. Of these, 171 (0.08%) had a secondary diagnosis of takotsubo syndrome. Before matching, patients with COVID-19 and takotsubo syndrome, compared with patients without takotsubo syndrome, were older (68.95 vs 64.26 years; P < .001); more likely to be female (64.3% vs 47.2%; P < .001); and more likely to have anxiety (24.6% vs 12.8%; P < .001), depression (17.5% vs 11.4%; P = .02), and chronic obstructive pulmonary disease (24.6% vs 14.7%; P < .001). The takotsubo syndrome group had worse outcomes than the non-takotsubo syndrome group for death (30.4% vs 11.1%), cardiac arrest (7.6% vs 2.1%), cardiogenic shock (12.9% vs 0.4%), length of hospital stay (10.7 vs 7.5 days), and total charges ($152,685 vs $78,468) (all P < .001). After matching and compared with the non-takotsubo syndrome group (n = 508), the takotsubo syndrome group (n = 170) had a higher incidence of inpatient mortality (30% vs 14%; P < .001), cardiac arrest (7.6% vs 2.8%; P = .009), and cardiogenic shock (12.4% vs 0.4%; P < .001); a longer hospital stay (10.7 vs 7.6 days; P < .001); and higher total charges ($152,943 vs $79,523; P < .001).
Conclusion: Takotsubo syndrome is a rare but severe in-hospital complication in patients with COVID-19.
背景:据报道,COVID-19 患者中存在塔克次氏综合征,但相关数据极少。这项调查评估了COVID-19住院患者中塔可氏综合征的发病率和影响:这项回顾性队列研究使用《国际疾病统计分类第十版》代码,在 2020 年全国住院病人样本数据库中识别出主要诊断为 COVID-19 并伴有或不伴有 takotsubo 综合征的患者。在对患者和医院的人口统计学特征及合并症进行倾向得分匹配后,比较了各组间的结果:结果:共确定了211448名主要诊断为COVID-19的患者。其中,171 人(0.08%)继发了塔克次氏综合征。配对前,COVID-19和塔克次博综合征患者与无塔克次博综合征的患者相比,年龄更大(68.95岁 vs 64.26岁;P < .001);更可能是女性(64.3% vs 47.2%;P < .001);更可能患有焦虑症(24.6% vs 12.8%;P < .001)、抑郁症(17.5% vs 11.4%;P = .02)和慢性阻塞性肺病(24.6% vs 14.7%;P < .001)。在死亡(30.4% vs 11.1%)、心脏骤停(7.6% vs 2.1%)、心源性休克(12.9% vs 0.4%)、住院时间(10.7天 vs 7.5天)和总费用(152,685美元 vs 78,468美元)方面,塔可次波综合征组的预后比非塔可次波综合征组差(所有P < .001)。匹配后,与非塔可次波综合征组(n = 508)相比,塔可次波综合征组(n = 170)的住院患者死亡率(30% vs 14%; P < .001)、心脏骤停(7.6% vs 2.8%; P = .009)和心源性休克(12.4% vs 0.4%; P < .001);住院时间更长(10.7天 vs 7.6天;P < .001);总费用更高(152,943美元 vs 79,523美元;P < .001):结论:在 COVID-19 患者中,塔克次氏综合征是一种罕见但严重的院内并发症。
{"title":"Incidence and Impact of Takotsubo Syndrome in Hospitalized Patients With COVID-19.","authors":"Pengyang Li, Ao Shi, Xiaojia Lu, Chenlin Li, Peng Cai, Catherine Teng, Lingling Wu, Yuan Shu, Su Pan, Richard A F Dixon, Qi Liu, Bin Wang","doi":"10.14503/THIJ-23-8309","DOIUrl":"10.14503/THIJ-23-8309","url":null,"abstract":"<p><strong>Background: </strong>Takotsubo syndrome has been reported in patients with COVID-19, although minimal data are available. This investigation assessed the incidence and impact of takotsubo syndrome on patients hospitalized with COVID-19.</p><p><strong>Methods: </strong>A retrospective cohort study was conducted using International Statistical Classification of Diseases, Tenth Revision, codes to identify patients with a primary diagnosis of COVID-19 with or without takotsubo syndrome in the National Inpatient Sample 2020 database. Outcomes between groups were compared after propensity score matching for patient and hospital demographics and comorbidities.</p><p><strong>Results: </strong>A total of 211,448 patients with a primary diagnosis of COVID-19 were identified. Of these, 171 (0.08%) had a secondary diagnosis of takotsubo syndrome. Before matching, patients with COVID-19 and takotsubo syndrome, compared with patients without takotsubo syndrome, were older (68.95 vs 64.26 years; P < .001); more likely to be female (64.3% vs 47.2%; P < .001); and more likely to have anxiety (24.6% vs 12.8%; P < .001), depression (17.5% vs 11.4%; P = .02), and chronic obstructive pulmonary disease (24.6% vs 14.7%; P < .001). The takotsubo syndrome group had worse outcomes than the non-takotsubo syndrome group for death (30.4% vs 11.1%), cardiac arrest (7.6% vs 2.1%), cardiogenic shock (12.9% vs 0.4%), length of hospital stay (10.7 vs 7.5 days), and total charges ($152,685 vs $78,468) (all P < .001). After matching and compared with the non-takotsubo syndrome group (n = 508), the takotsubo syndrome group (n = 170) had a higher incidence of inpatient mortality (30% vs 14%; P < .001), cardiac arrest (7.6% vs 2.8%; P = .009), and cardiogenic shock (12.4% vs 0.4%; P < .001); a longer hospital stay (10.7 vs 7.6 days; P < .001); and higher total charges ($152,943 vs $79,523; P < .001).</p><p><strong>Conclusion: </strong>Takotsubo syndrome is a rare but severe in-hospital complication in patients with COVID-19.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075496/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140871168","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
HyeYon Yu, Jihun Ahn, Byoung Geol Choi, Soohyung Park, Dong Oh Kang, Cheol Ung Choi, Seung-Woon Rha, Myung Ho Jeong
Background:
This study compared the safety and effectiveness of paclitaxel/cilostazol–eluting Cilotax stents with those of everolimus-eluting stents in patients with acute myocardial infarction. Real-world data from the Korea Acute Myocardial Infarction Registry were examined.
Methods:
A total of 5,472 patients with acute myocardial infarction underwent percutaneous coronary intervention with Cilotax stents (n = 212) or everolimus-eluting stents (n = 5,260). The primary end point was the 3-year rate of target lesion failure. The other end points were major adverse cardiovascular events (a composite of cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization), target vessel revascularization, and stent thrombosis. A propensity score matching analysis was performed to adjust for potential confounders by using a logistic regression model; propensity score matching generated 2 well-balanced groups (Cilotax group, n = 180; everolimus-eluting stents group, n = 170; N = 350). After propensity score matching, baseline clinical characteristics were similar between the groups.
Results:
After percutaneous coronary intervention, compared with the everolimus-eluting stents group, the Cilotax group more often had major adverse cardiovascular events (24.1% vs 18.5%; P = .042), myocardial infarction (8.0% vs 3.2%; P < .001), target lesion revascularization (8.0% vs 2.6%; P < .001), target vessel revascularization (11.3% vs 4.5%; P < .001), and stent thrombosis (4.7% vs 0.5%; P < .001) before matching. Even after matching, the Cilotax group had more frequent target lesion revascularization (9.4% vs 2.9%; P = .22) and stent thrombosis (5.6% vs 1.2%; P = .34).
Conclusion:
In patients with acute myocardial infarction who underwent percutaneous coronary intervention, use of the Cilotax stent was associated with higher rates of target lesion revascularization, target vessel revascularization, and stent thrombosis than were everolimus-eluting stents. Use of the Cilotax dual drugeluting stent should be avoided in the treatment of myocardial infarction.
背景:这项研究比较了紫杉醇/西洛他唑洗脱Cilotax支架与依维莫司洗脱支架在急性心肌梗死患者中的安全性和有效性。方法:共有5472名急性心肌梗死患者接受了Cilotax支架(212人)或依维莫司洗脱支架(5260人)经皮冠状动脉介入治疗。主要终点是3年靶病变失败率。其他终点为主要不良心血管事件(心源性死亡、靶血管心肌梗死和缺血驱动的靶病变血运重建的综合)、靶血管血运重建和支架血栓形成。进行倾向得分匹配分析是为了利用逻辑回归模型调整潜在的混杂因素;倾向得分匹配产生了两个平衡良好的组别(Cilotax 组,n = 180;依维莫司洗脱支架组,n = 170;N = 350)。结果:经皮冠状动脉介入治疗后,与依维莫司洗脱支架组相比,Cilotax 组发生主要不良心血管事件的比例更高(24.1% vs 18.5%; P = .042)、心肌梗死(8.0% vs 3.2%; P <.001)、靶病变血运重建(8.0% vs 2.6%; P <.001)、靶血管血运重建(11.3% vs 4.5%; P <.001)和支架血栓(4.7% vs 0.5%; P <.001)。结论:在接受经皮冠状动脉介入治疗的急性心肌梗死患者中,与依维莫司洗脱支架相比,Cilotax支架与更高的靶病变血运重建率、靶血管血运重建率和支架血栓形成率相关。在治疗心肌梗死时应避免使用 Cilotax 双药物洗脱支架。
{"title":"Three-Year Clinical Outcomes With the Cilotax Dual Drug-Eluting Stent vs Everolimus-Eluting Stents in Patients With Acute Myocardial Infarction","authors":"HyeYon Yu, Jihun Ahn, Byoung Geol Choi, Soohyung Park, Dong Oh Kang, Cheol Ung Choi, Seung-Woon Rha, Myung Ho Jeong","doi":"10.14503/thij-23-8271","DOIUrl":"https://doi.org/10.14503/thij-23-8271","url":null,"abstract":"<div>Background:</div><p>This study compared the safety and effectiveness of paclitaxel/cilostazol–eluting Cilotax stents with those of everolimus-eluting stents in patients with acute myocardial infarction. Real-world data from the Korea Acute Myocardial Infarction Registry were examined.</p><div>Methods:</div><p>A total of 5,472 patients with acute myocardial infarction underwent percutaneous coronary intervention with Cilotax stents (n = 212) or everolimus-eluting stents (n = 5,260). The primary end point was the 3-year rate of target lesion failure. The other end points were major adverse cardiovascular events (a composite of cardiac death, target vessel myocardial infarction, and ischemia-driven target lesion revascularization), target vessel revascularization, and stent thrombosis. A propensity score matching analysis was performed to adjust for potential confounders by using a logistic regression model; propensity score matching generated 2 well-balanced groups (Cilotax group, n = 180; everolimus-eluting stents group, n = 170; N = 350). After propensity score matching, baseline clinical characteristics were similar between the groups.</p><div>Results:</div><p>After percutaneous coronary intervention, compared with the everolimus-eluting stents group, the Cilotax group more often had major adverse cardiovascular events (24.1% vs 18.5%; <em>P</em> = .042), myocardial infarction (8.0% vs 3.2%; <em>P</em> < .001), target lesion revascularization (8.0% vs 2.6%; <em>P</em> < .001), target vessel revascularization (11.3% vs 4.5%; <em>P</em> < .001), and stent thrombosis (4.7% vs 0.5%; <em>P</em> < .001) before matching. Even after matching, the Cilotax group had more frequent target lesion revascularization (9.4% vs 2.9%; <em>P</em> = .22) and stent thrombosis (5.6% vs 1.2%; <em>P</em> = .34).</p><div>Conclusion:</div><p>In patients with acute myocardial infarction who underwent percutaneous coronary intervention, use of the Cilotax stent was associated with higher rates of target lesion revascularization, target vessel revascularization, and stent thrombosis than were everolimus-eluting stents. Use of the Cilotax dual drugeluting stent should be avoided in the treatment of myocardial infarction.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Previous studies have established a positive correlation between serum uric acid to creatinine (SUA/Cr) ratio and cardiovascular disease, but the relationship between SUA/Cr ratio and the prognosis of heart failure (HF) remains unknown. This study investigated the potential of SUA/Cr ratio as a prognostic predictor for patients with HF.
Methods:
This single-center prospective cohort study enrolled 2,122 patients with HF between March 2013 and June 2017. All patients were divided into 3 groups according to SUA/Cr ratio tertiles and were followed up with until December 31, 2022. The association between SUA/Cr ratio and the prognosis of HF was assessed using the Cox proportional hazards model.
Results:
The mean (SD) age and mean (SD) SUA/Cr ratio of the study cohort (66% male) were 59.3 (14.7) years and 4.71 (2.09), respectively. During a median follow-up period of 15 months (range, 11-26 months), 390 end-point events were observed. Prognosis analysis revealed that a high SUA/Cr ratio was associated with an increased mortality risk of HF (hazard ratio, 1.62 [95% CI, 1.26-2.09]; P < .001) compared with the SUA/Cr ratio in the lowest tertile. After adjusting for covariates, the hazard ratio for mortality risk of HF was 1.71 (95% CI, 1.23-2.37; P = .001). Subgroup analysis showed that mortality risk increased in direct proportion with the SUA/Cr ratio in female patients, patients with a history of hypertension and β-blocker use, and patients with UA levels below 428 μmol/L and creatinine levels less than 97 mg/dL. Stratification by age; by history of diabetes, hyperlipidemia, and smoking; and by level of fasting plasma glucose, however, had no obvious effect on the association between SUA/Cr ratio and HF prognosis. Patients with higher SUA/Cr ratios had reduced left ventricular ejection fraction and increased left ventricular end-diastolic diameter.
Conclusion:
A high SUA/Cr ratio was an independent risk factor for the mortality risk of HF.
{"title":"Does Serum Uric Acid to Creatinine Ratio Predict Mortality Risk in Patients With Heart Failure?","authors":"Xiaoqing Xi, Jinfeng Cai, Chen Zhang, Xuefei Wang","doi":"10.14503/thij-23-8210","DOIUrl":"https://doi.org/10.14503/thij-23-8210","url":null,"abstract":"<div>Background:</div><p>Previous studies have established a positive correlation between serum uric acid to creatinine (SUA/Cr) ratio and cardiovascular disease, but the relationship between SUA/Cr ratio and the prognosis of heart failure (HF) remains unknown. This study investigated the potential of SUA/Cr ratio as a prognostic predictor for patients with HF.</p><div>Methods:</div><p>This single-center prospective cohort study enrolled 2,122 patients with HF between March 2013 and June 2017. All patients were divided into 3 groups according to SUA/Cr ratio tertiles and were followed up with until December 31, 2022. The association between SUA/Cr ratio and the prognosis of HF was assessed using the Cox proportional hazards model.</p><div>Results:</div><p>The mean (SD) age and mean (SD) SUA/Cr ratio of the study cohort (66% male) were 59.3 (14.7) years and 4.71 (2.09), respectively. During a median follow-up period of 15 months (range, 11-26 months), 390 end-point events were observed. Prognosis analysis revealed that a high SUA/Cr ratio was associated with an increased mortality risk of HF (hazard ratio, 1.62 [95% CI, 1.26-2.09]; <em>P</em> < .001) compared with the SUA/Cr ratio in the lowest tertile. After adjusting for covariates, the hazard ratio for mortality risk of HF was 1.71 (95% CI, 1.23-2.37; <em>P</em> = .001). Subgroup analysis showed that mortality risk increased in direct proportion with the SUA/Cr ratio in female patients, patients with a history of hypertension and β-blocker use, and patients with UA levels below 428 μmol/L and creatinine levels less than 97 mg/dL. Stratification by age; by history of diabetes, hyperlipidemia, and smoking; and by level of fasting plasma glucose, however, had no obvious effect on the association between SUA/Cr ratio and HF prognosis. Patients with higher SUA/Cr ratios had reduced left ventricular ejection fraction and increased left ventricular end-diastolic diameter.</p><div>Conclusion:</div><p>A high SUA/Cr ratio was an independent risk factor for the mortality risk of HF.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mohammad Alomari, Magdy M. El-Sayed Ahmed, Mostafa Ali, Ishaq J. Wadiwala, Si M. Pham, Basar Sareyyupoglu
Quadricuspid aortic valve is a rare congenital cardiac anomaly with an incidence of 0.008% to 0.043%. Its clinical course varies depending on cusp anatomy, function, and associated cardiac malformations. It frequently progresses to aortic valve regurgitation that may require surgical valve replacement. Detection has shifted from incidental discovery during autopsies or cardiac surgeries in the early 20th century to various cardiac imaging methods in recent decades. In addition to contributing to the literature, this report supports the use of transesophageal echocardiography more liberally to detect aortic valve abnormalities. The case presents a 48-year-old female patient with an incidentally discovered quadricuspid aortic valve.
{"title":"Quadricuspid Aortic Valve: Imaging, Diagnosis, and Prognosis","authors":"Mohammad Alomari, Magdy M. El-Sayed Ahmed, Mostafa Ali, Ishaq J. Wadiwala, Si M. Pham, Basar Sareyyupoglu","doi":"10.14503/thij-23-8256","DOIUrl":"https://doi.org/10.14503/thij-23-8256","url":null,"abstract":"<p>Quadricuspid aortic valve is a rare congenital cardiac anomaly with an incidence of 0.008% to 0.043%. Its clinical course varies depending on cusp anatomy, function, and associated cardiac malformations. It frequently progresses to aortic valve regurgitation that may require surgical valve replacement. Detection has shifted from incidental discovery during autopsies or cardiac surgeries in the early 20th century to various cardiac imaging methods in recent decades. In addition to contributing to the literature, this report supports the use of transesophageal echocardiography more liberally to detect aortic valve abnormalities. The case presents a 48-year-old female patient with an incidentally discovered quadricuspid aortic valve.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839810","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mahdi S. Agha, Peter R. Ermis, Wayne J. Franklin, Dhaval R. Parekh, Angeline D. Opina, Jeffrey J. Kim, Christina Y. Miyake, Santiago O. Valdes, Wilson W. Lam
Background:
Atrial tachyarrhythmias are common and difficult to treat in adults with congenital heart disease. Dronedarone has proven effective in patients without congenital heart disease, but data are limited about its use in adults with congenital heart disease of moderate to great complexity.
Methods:
A single-center, retrospective chart review of 21 adults with congenital heart disease of moderate to great complexity who were treated with dronedarone for atrial tachyarrhythmias was performed.
Results:
The median (IQR) age at dronedarone initiation was 35 (27.5-39) years. Eleven patients (52%) were male. Ten patients (48%) had New York Heart Association class I disease, 10 (48%) had class II disease, and 1 (5%) had class III disease. Ejection fraction at initiation was greater than 55% in 11 patients (52%), 35% to 55% in 9 patients (43%), and less than 35% in 1 patient (5%). Prior treatments included β-blockers (71%), sotalol (38%), amiodarone (24%), digoxin (24%), and catheter ablation (38%). Rhythm control was complete in 5 patients (24%), partial in 6 (29%), and inadequate in 10 (48%). Two patients (10%) experienced adverse events, including nausea in 1 (5%) and cardiac arrest in 1 (5%), which occurred 48 months after initiation of treatment. There were no deaths during the follow-up period. The median (IQR) follow-up time for patients with complete or partial rhythm control was 20 (1-54) months.
Conclusion:
Dronedarone can be effective for adult patients with congenital heart disease and atrial arrhythmias for whom more established therapies have failed, and with close monitoring it can be safely tolerated.
{"title":"Dronedarone for the Treatment of Atrial Arrhythmias in Adults With Congenital Heart Disease","authors":"Mahdi S. Agha, Peter R. Ermis, Wayne J. Franklin, Dhaval R. Parekh, Angeline D. Opina, Jeffrey J. Kim, Christina Y. Miyake, Santiago O. Valdes, Wilson W. Lam","doi":"10.14503/thij-22-7993","DOIUrl":"https://doi.org/10.14503/thij-22-7993","url":null,"abstract":"<div>Background:</div><p>Atrial tachyarrhythmias are common and difficult to treat in adults with congenital heart disease. Dronedarone has proven effective in patients without congenital heart disease, but data are limited about its use in adults with congenital heart disease of moderate to great complexity.</p><div>Methods:</div><p>A single-center, retrospective chart review of 21 adults with congenital heart disease of moderate to great complexity who were treated with dronedarone for atrial tachyarrhythmias was performed.</p><div>Results:</div><p>The median (IQR) age at dronedarone initiation was 35 (27.5-39) years. Eleven patients (52%) were male. Ten patients (48%) had New York Heart Association class I disease, 10 (48%) had class II disease, and 1 (5%) had class III disease. Ejection fraction at initiation was greater than 55% in 11 patients (52%), 35% to 55% in 9 patients (43%), and less than 35% in 1 patient (5%). Prior treatments included β-blockers (71%), sotalol (38%), amiodarone (24%), digoxin (24%), and catheter ablation (38%). Rhythm control was complete in 5 patients (24%), partial in 6 (29%), and inadequate in 10 (48%). Two patients (10%) experienced adverse events, including nausea in 1 (5%) and cardiac arrest in 1 (5%), which occurred 48 months after initiation of treatment. There were no deaths during the follow-up period. The median (IQR) follow-up time for patients with complete or partial rhythm control was 20 (1-54) months.</p><div>Conclusion:</div><p>Dronedarone can be effective for adult patients with congenital heart disease and atrial arrhythmias for whom more established therapies have failed, and with close monitoring it can be safely tolerated.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Byeng-Ju Son, Ung Kim, Jong-Ho Nam, Kang-Un Choi, Jong-Il Park, Jang-Won Son
Transcatheter aortic valve replacement is quickly becoming the standard of care for patients with severe aortic stenosis thanks to its minimally invasive nature and favorable outcomes. Recently, left ventricular pacing has been proposed as a safer alternative to traditional right heart pacing, which could simplify the transcatheter aortic valve replacement procedure overall, although procedural complications may still occur. This report describes a rare case of left ventricular pacing wire–induced acute severe mitral valve regurgitation during transcatheter aortic valve replacement.
{"title":"Acute Mitral Valve Regurgitation Caused by Left Ventricular Pacing Wire During Transcatheter Aortic Valve Replacement","authors":"Byeng-Ju Son, Ung Kim, Jong-Ho Nam, Kang-Un Choi, Jong-Il Park, Jang-Won Son","doi":"10.14503/thij-23-8215","DOIUrl":"https://doi.org/10.14503/thij-23-8215","url":null,"abstract":"<p>Transcatheter aortic valve replacement is quickly becoming the standard of care for patients with severe aortic stenosis thanks to its minimally invasive nature and favorable outcomes. Recently, left ventricular pacing has been proposed as a safer alternative to traditional right heart pacing, which could simplify the transcatheter aortic valve replacement procedure overall, although procedural complications may still occur. This report describes a rare case of left ventricular pacing wire–induced acute severe mitral valve regurgitation during transcatheter aortic valve replacement.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140839924","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This report discusses a case of transient 2:1 atrioventricular block with conduction system pacing 4 hours after leadless right ventricular pacemaker implantation in a 19-year-old patient with a history of cardioinhibitory syncope and asystole cardiac arrest but without preexisting atrioventricular block. The atrioventricular block was resolved spontaneously. Pacing morphology was suggestive of right bundle branch pacing. Neither 2:1 atrioventricular block nor conduction system pacing has previously been a reported outcome of right ventricular leadless pacemaker implantation. The report demonstrates that conduction system pacing with leadless devices is achievable. Further study of techniques, limitations, and complications related to intentional right ventricular leadless conduction system pacing is warranted.
{"title":"Transient 2:1 Atrioventricular Block with Peri-Conduction System Pacing After Leadless Pacemaker Implantation","authors":"Salim N. Najjar, Michael A. Bruno, Wilson W. Lam","doi":"10.14503/thij-23-8268","DOIUrl":"https://doi.org/10.14503/thij-23-8268","url":null,"abstract":"<p>This report discusses a case of transient 2:1 atrioventricular block with conduction system pacing 4 hours after leadless right ventricular pacemaker implantation in a 19-year-old patient with a history of cardioinhibitory syncope and asystole cardiac arrest but without preexisting atrioventricular block. The atrioventricular block was resolved spontaneously. Pacing morphology was suggestive of right bundle branch pacing. Neither 2:1 atrioventricular block nor conduction system pacing has previously been a reported outcome of right ventricular leadless pacemaker implantation. The report demonstrates that conduction system pacing with leadless devices is achievable. Further study of techniques, limitations, and complications related to intentional right ventricular leadless conduction system pacing is warranted.</p>","PeriodicalId":22352,"journal":{"name":"Texas Heart Institute journal","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140587623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}