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Research Article  |   Volume 1, Issue 2

Patients Treated with Catheter Ablation for Atrial Fibrillation have Long-Term Renal Function Similar to Patients without Atrial Fibrillation

David L. Johnson, John D. Day, Brian G. Crandall, J. Peter Weiss, Heidi T. May, Tami L. Bair, Jeffrey S. Osborn, Jeffrey L. Anderson, Joseph B. Muhlestein, Donald L. Lappe and T. Jared Bunch
Abstract

Background: Atrial fibrillation (AF) has been reported to worsen renal function over time. Renal dysfunction in the setting of AF decreases response to rhythm control approaches and increases risk of cardiovascular morbidity and mortality. Aggressive rhythm control approaches, such as catheter ablation, may interrupt this cycle and impact renal function favorably over time. Methods: Patients were enrolled from the large ongoing prospective Intermountain Cardiovascular Health Study.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410017

Research Article  |   Volume 1, Issue 2

Use of Statins in an Australian Elderly Population

Svetla Gadzhanova, Elizabeth Roughead and Jenni Ilomaki
Abstract

Background: Statins are the fist drug choice for lowering high cholesterol and are one of the most widely used classes of medicines in Australia. Although well tolerated, some adverse effects are dose and potency dependent to which older people are particularly susceptible. Objective: The aim of this study was to examine the use of statins in elderly Australians, and how usage had changed over time with respect to dose and potency of statin prescribed.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410016

Case Report  |   Volume 1, Issue 2

Necrotizing Pancreatitis Causing Acute Focal Pericarditis

William F McIntyre, Andres Enriquez, Kevin Michael and Adrian Baranchuk
Abstract

We describe the case of a 39-year old man with acute necrotizing pancreatitis. A twelve-lead electrocardiogram (A) showed signs of pericarditis and a computed tomography of the abdomen showed focal pericardial effusion, confirming the diagnosis.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410015

Case Report  |   Volume 1, Issue 2

A Case Report of Immediate Extubation Post Primary PCI in STEMI

Sharan Rufus Ponniah, Pradeepto Ghosh, Nagapradeep Nagajothi, Srinivasa Satti, Kavitha Nidamanuri and Baskar Rajala
Abstract

We report a case of immediate extubation following primary percutaneous intervention (PCI) for ST elevation myocardial infarction (STEMI). The optimal timing of extubation following revascularization in STEMI is unclear. Early extubation in this scenario, if feasible has a mortality benefit. Duration of mechanical ventilation following STEMI is a strong predictor of mortality. In this case, we report a scenario of immediate extubation following revascularization, which we believe contributed to the patient's mortality benefit. We present this case to emphasize the importance of early withdrawal of mechanical support following revascularization in STEMI.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410014

Research Article  |   Volume 1, Issue 2

Beverage Specific Effect of Alcohol on Ishaemic Heart Disease Mortality in Russia

Y. E. Razvodovsky
Abstract

Objective: It was repeatedly emphasized that alcohol provides the most plausible explanation for both the high rate and the dramatic fluctuation in Russian Ischemic Heart Disease (IHD) mortality rate during the last decades, while other traditional risk factors identified in epidemiologic studies had little predictive value. The link between IHD mortality and beverage-specific alcohol drinking has been analyzed in a number of aggregate-level studies with conflicting results. The aim of this study was to examine the relation between the consumption of different beverage types and IHD mortality rates in Russia. Method: Time-series analytical modeling techniques (ARIMA) were used to examine the relation between the sale of different alcoholic beverages and age-standardized male and female IHD mortality rates.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410013

Research Article  |   Volume 1, Issue 2

Carotid Sinus Syndrome as a Manifestation of Head and Neck Cancer Case Report and Literature Review

Nikhil Mehta, Medhat Abdelmessih, Lachlan Smith, Daniel Jacoby and Mark Marieb
Abstract

Head and neck cancers rarely manifest as Carotid Sinus Syndrome (CSS). CSS is a rare complex of symptoms found in 1% of all patients who experience syncope, the pathophysiology of which is yet to be fully understood. Common trigger mechanisms for CSS include neck movement, shaving, constricting neck wear, coughing, sneezing and straining to lift heavy objects. The left carotid sinus mainly causes AV block while the right carotid sinus mainly causes sinus bradycardia. The incidence of AV block in CSS is very low (4.9 to 16.7%) as reported in many case series. In case of head and neck cancers, treatment is by surgical removal of the cancer, chemotherapy or radiation.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410012

Research Article  |   Volume 1, Issue 2

Cardiac Troponin Assessment Following Atrial Fibrillation Ablation: Implications for Chest Pain Evaluation

Jason C. Rubenstein, Jason Jacobson, Jeffrey J. Goldberger, Rod Passman, Alan Kadish and Michael H. Kim
Abstract

Background: The range of elevation of troponin I (tI) that is within expected limits from left atrial radiofrequency ablation for atrial fibrillation (AF) is not well described, though such information may be of clinical value. Objectives: Identify the expected range of tI values post-atrial fibrillation (AF) ablation. Methods: 31 patients undergoing AF ablation had a single tI level drawn the day following the procedure. Clinical variables were also collected, such as ablation type and radiofrequency (RF) time. Results: Paroxysmal AF was present in 23 patients, and 8 had chronic AF. The average RF time was 2627.8 ± 737.5 seconds. The mean RF power was 61.7 ± 4.3W (range 55-70W).

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410011

Research Article  |   Volume 1, Issue 2

Discriminant Analysis of Heart Rate Variability after Electrical Cardioversion Predicts Atrial Fibrillation Recurrence

Donatella B, Angela V, Emilia I, Kristian E, Claudia C, Rita SA, Francesco F and Riccardo F
Abstract

Aims: Cardiac Autonomic Modulation (CAM) may be pivotal for Atrial Fibrillation (AF) occurrence and affect early recurrence (ER) after Electrical Cardioversion (EC). Previous studies investigating linear (L) Heart Rate Variability (HRV) after EC have given conflicting results about which CAM pattern favours ER. This study aimed at evaluating if non-linear (NL) HRV analysis (HRVa) could provide better accuracy in predicting ER. Methods: 36 patients, 16 under Antiarrhythmic Drugs (AAD), were enrolled after EC for persistent AF. Stable sinus rhythm (SR) was obtained in 34. HRVa was performed, with L and NL methods, from five-minutes time-segments selected within the fist hour after EC and the subsequent 24 (daily activity and sleep). Discriminant Analysis (DA) was used to evaluate which parameters were efficient in predicting ER of AF.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410010

Case Report  |   Volume 1, Issue 2

Surgical Treatment of Severe Tricuspid Valve Regurgitation Due to Permanent Pacemaker

Wenjian Jiang, Haiyang Li, Dong Guo, Yongqiang Lai and Hongjia Zhang
Abstract

A 64-year-old woman, received implantation of a Permanent Pace Maker (PPM) 7 years ago, was referred for severe tricuspid valve regurgitation with a lead impingement of the tricuspid valve leaflets. We fied the lead to the posterior septal commissure, used 28 # Edwards MC3 ring to annulus form the tricuspid valve ring and then sutured the posterior septal commissure by edge to edge. This patient recovered uneventfully, with only mild tricuspid valve regurgitation by echocardiography after one year of follow-up.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410009

Research Article  |   Volume 1, Issue 2

Parameters of Mitral Deformability in Patients with Functional Mitral Regurgitation

Kammoun I, Marrakchi S, Zouari F, Fersi I, Ibn Elhaj Z, Mokrani S, Added F and Kachboura S
Abstract

Background: Functional mitral regurgitation (FMR) is one of the common and severe complications in patients with dilated cardiomyopathy. Then determinants of degree of FMR must be more defined. Purpose: We sought to determine a cut off value of the tenting area and the coaptation depth which correlate with the severity of the FMR. Methods and results: We enrolled prospectively 96 patients (71 males; age 57 ± 13 years) with left ventricular (LV) dilation and systolic dysfunction (LV ejection fraction ≤40%) in sinus rhythm.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410008

Letter to Editor  |   Volume 1, Issue 2

Rheumatic Mitral Restenosis with Concomitant Coronary artery Disease

Anupam Dey, Ramesh Aggarwal and Shridhar Dwivedi
Abstract

Rheumatic heart disease (RHD) has practically vanished from developed countries; however one often sees complicated rheumatic valvular disease in elderly individuals, in developing countries. It is not very common to see operated cases of mitral stenosis (MS) coexisting with coronary artery disease (CAD). Studies have reported prevalence of CAD coexisting with rheumatic MS ranging from 1.7% to 28%. We recently had a case of rheumatic MS, who was operated twice, had again developed restenosis, and presented with acute coronary syndrome (ACS) attributed to angiographically documented double vessel disease.

PDF   |    Full Text | DOI: 10.23937/2378-2951/1410007


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