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Stroke pacemaker

Chalak Berzingi, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Zakeih Chaker, Mohamad Alkhouli
Background: Early experience with transcatheter mitral valve replacement (TMVR) highlighted several investigational challenges related to this novel therapy. Conclusive randomised clinical trials in the field may, therefore, be years ahead. In the interim, contemporary outcomes of isolated surgical bioprosthetic mitral valve replacement (MVR) can be used as a benchmark for the emerging TMVR therapies. Methods: We used the nationwide inpatient sample to examine recent trends and outcomes of surgical bioprosthetic MVR for mitral regurgitation (isolated and combined)...
2018: Open Heart
Tommaso Sanna
An increasing number of detection tools are available and several detection strategies have been described to pursue the diagnosis of atrial fibrillation to prevent ischemic stroke. Monitoring tools include standard electrocardiography, snapshot single-lead recordings with professional or personal devices (e.g. smartphone-based), Holter monitor, external devices with long-term recording capabilities, and cardiac implantable electronic devices, including pacemakers, implantable cardioverter defibrillators and insertable cardiac monitors...
August 9, 2018: International Journal of Stroke: Official Journal of the International Stroke Society
Corey J Warf, Martin R Huecker, Daniel J O'Brien, Don A Bertolotti
A 56-year-old female presented to the emergency department with evolving cardiac tamponade after receiving alteplase for acute ischemic stroke. This is the first case report of cardiac tamponade from thrombolytics in the setting of recent pacemaker placement. Point-of-care ultrasound was used to make the diagnosis quickly and expedite the patient to the operating room where a pericardial window was performed.
August 2018: Clinical practice and cases in emergency medicine
Nikhil Nalluri, Varunsiri Atti, Nileshkumar J Patel, Varun Kumar, Shilpkumar Arora, Sreeram Nalluri, Bhargava Krishna Nelluri, Gregory A Maniatis, Ruben Kandov, Chad Kliger
BACKGROUND: The incidence of patients with previous history of coronary artery bypass grafting (CABG) presenting for aortic valvular replacement has been consistently on the rise. Repeat sternotomy for surgical aortic valve replacement (SAVR) carries an inherent risk of morbidity and mortality when compared to Transcatheter aortic valve replacement (TAVR). METHODS: The Nationwide inpatient sample (NIS) from 2012 to 2014 was queried using the International Classification of Diseases-Ninth edition, Clinical Modification (ICD-9-CM) codes to identify all patients ≥ 18 years with prior CABG who underwent TAVR (35...
August 5, 2018: Catheterization and Cardiovascular Interventions
Mingwui Tung, Xu Wang, Fei Li, Hao Wang, Yingqiang Guo, Chunsheng Wang, Lai Wei, Xinjin Luo, Xin Wang, Wei Wang
BACKGROUND: The novel J-Valve (JC Medical Inc, Burlingame, CA, USA) was developed to cope with aortic valvular disease by facilitating accurate positioning. We present the first one-year results regarding the safety and efficacy of the J-Valve system implantation in patients with severe aortic stenosis (AS) or aortic regurgitation (AR) undergoing transapical-transcatheter aortic valve implantation. METHODS: This prospective multicenter study enrolled 107 high-risk patients (mean age 74...
July 28, 2018: Journal of Cardiology
Ying Yang, Fen Xu, Jinshan Tong, Leyan Cai, Wenbing Jiang, Xia Sheng, Yiwen Pan, Jiangfen Jiang, Jiefang Zhang, Dongmei Jiang, Linlin Zhao, Guosheng Fu
PURPOSE: Subclinical atrial fibrillation (AF) was found in a large number of pacemaker patients. It is not certain whether there is a similar risk/benefit ratio for oral anticoagulation in patients with subclinical AF compared to patients with similar risk profiles and clinically diagnosed AF. Given the weakness of clinical evidence for oral anticoagulation in patients with device-detected subclinical AF, specific recommendations in most guidelines for this population are scarce and rarely similar...
July 19, 2018: Cardiovascular Drugs and Therapy
Eleonora Solari, Cristiana Marcozzi, Daniela Negrini, Andrea Moriondo
Lymph formation and propulsion rely on an extrinsic mechanism based on the forces that surrounding tissues exert upon the vessel wall and lumen and an intrinsic mechanism based on spontaneous, rhythmic contractions of the lymphatic muscle layer of collecting vessels. The two spontaneous pacemakers described in literature involve chloride-dependent depolarizations (STDs) and If -like currents, both giving rise to a variable contraction frequency (fc ) of lymphatic vessels functional units (lymphangions). Several stimuli have been shown to modulate fc , such as temperature, shear stress, and several tissue chemical modulators (prostaglandins, norepinephrine, acetylcholine, substance P, and others)...
2018: Frontiers in Physiology
Won-Keun Kim, Christian Hengstenberg, Michael Hilker, Sebastian Kerber, Ulrich Schäfer, Tanja Rudolph, Axel Linke, Norbert Franz, Thomas Kuntze, Holger Nef, Utz Kappert, Michael O Zembala, Stefan Toggweiler, Thomas Walther, Helge Möllmann
OBJECTIVES: The SAVI-TF (Symetis ACURATE neo Valve Implantation Using Transfemoral Access) registry was initiated to study the ACURATE neo transcatheter heart valve in a large patient population treated under real-world conditions. BACKGROUND: The self-expanding, supra-annular ACURATE neo prosthesis is a transcatheter heart valve that gained the Conformité Européene mark in 2014, but only limited clinical data are available so far. METHODS: This prospective, multicenter registry enrolled 1,000 patients at 25 European centers who were followed for 1 year post-procedure...
July 23, 2018: JACC. Cardiovascular Interventions
Alex J Thompson, Joseph A Dearani, Jonathan N Johnson, Hartzell V Schaff, Eric C Towe, Jared Palfreeman, Philip L Wackel, Frank Cetta
BACKGROUND: The transapical approach has been utilized in adult HCM patients with either midventricular obstruction or a small LV cavity; however, there are little data on its use in children. METHODS: We retrospectively reviewed all patients (age <21 years) with HCM who underwent a transapical myectomy from January 2002 to December 2016. Indication for surgery was midventricular obstruction in 19/23 (83%) and small LV cavity in 4 (17%). Preoperative symptoms included: dyspnea (96%), chest pain (65%), presyncope (61%), and syncope (35%)...
July 17, 2018: Congenital Heart Disease
Stefan Toggweiler, Alfredo G Cerillo, Won K Kim, Patric Biaggi, Clinton Lloyd, Michael Hilker, Yaron Almagor, Florim Cuculi, Miriam Brinkert, Richard Kobza, Olivier Muller, Andreas Rück, Roberto Corti
OBJECTIVES: We report an international experience of transfemoral transcatheter aortic valve replacement (TAVR) using the self-expanding Acurate neo valve (Boston Scientific) in aortic regurgitation. METHODS: This series comprises 20 patients with pure aortic regurgitation undergoing transfemoral TAVR with the Acurate neo prosthesis at nine centers in Europe and Israel. RESULTS: Mean age was 79 ± 8 years and mean STS score was 8.3 ± 9.3%...
July 15, 2018: Journal of Invasive Cardiology
Jonathan S Steinberg, Heather O'Connell, Shelby Li, Paul D Ziegler
BACKGROUND: The Heart Rhythm Society consensus statement arbitrarily defines atrial fibrillation (AF) ablation failure as any episode ≥30 seconds. However, if brief AF events are not correlated to longer events, the rationale for this end point is questionable. We determined the impact of AF episode duration threshold on AF incidence and burden. METHODS: Patients with a pacemaker in a prospective registry with device-detected AF and follow-up >30 days were analyzed...
July 2018: Circulation. Arrhythmia and Electrophysiology
Jonathan W Waks, Rod S Passman, Jason Matos, Matthew Reynolds, Amit Thosani, Theofanie Mela, David Pederson, Taya V Glotzer, Peter Zimetbaum
BACKGROUND: Chronic anticoagulation is recommended for atrial fibrillation (AF) patients with thromboembolic risk factors regardless of AF duration/frequency. Continuous rhythm assessment with pacemakers (PMs)/implantable cardioverter-defibrillators (ICDs) and use of direct-acting oral anticoagulants (DOACs) may allow anticoagulation only around AF episodes, reducing bleeding without increasing thromboembolic risk. OBJECTIVE: The purpose of this study was to evaluate the feasibility/safety of intermittent DOAC use guided by continuous remote AF monitoring via dual-chamber PMs or ICDs...
July 6, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Rishi Puri, John G Webb, Faisal Al Qoofi, Robert C Welsh, Craig Brown, Jean-Bernard Masson, Madhu K Natarajan, Charles Peniston, Asim N Cheema, Samuel Radhakrishnan, Philippe Généreux, Martin Thoenes, Mélanie Côté, Josep Rodés-Cabau
Transcatheter aortic valve implantation (TAVI) has evolved globally, yet its evolution and performance across the Canadian landscape have yet to be formally assessed. Patients captured within the early Canadian TAVI experience with a balloon-expanding valve (n = 339; 2005 to 2009) and those enrolled in the Canadian SOURCE XT registry (n = 415; 2012 to 2015) were systematically compared with respect to baseline clinical, echocardiographic, and procedural characteristics. Valve-related and clinical outcomes were compared across the 2 time periods according to standardized definitions...
May 4, 2018: American Journal of Cardiology
Kinjal Banerjee, Krishna Kandregula, Kesavan Sankaramangalam, Anil Anumandla, Arnav Kumar, Parth Parikh, Jimmy Kerrigan, Shameer Khubber, Amar Krishnaswamy, Stephanie Mick, Jonathon White, Lars Svensson, Samir Kapadia
Balloon predilation (BPD) has been an integral part of transcatheter aortic valve implantation (TAVI) since inception. We sought to investigate the effect of avoiding BPD on outcomes of TAVI across different valve types. Articles were included if outcomes of TAVI without BPD were reported. Pooled meta-analysis used a random effects model and reported odds ratios (ORs). Twenty-one studies with 10,752 patients were pooled for analysis. Age and gender were well matched between NoBPD and BPD groups. There was no difference in mortality, stroke, bleeding, and acute kidney injury...
May 1, 2018: American Journal of Cardiology
Oscar Millan-Iturbe, Ole De Backer, Gintautas Bieliauskas, Tasalak Thonghong, Manik Chopra, Nikolaj Ihlemann, Lars Søndergaard
AIMS: Transcatheter aortic valve implantation (TAVI) is an established therapy for patients with severe aortic stenosis (AS). The aim of this study was to evaluate the newer generation PorticoTM TAVI system (Abbott, MN, USA) in an all-comers population. METHODS AND RESULTS: This single-centre study included 216 patients with severe AS (Society of Thoracic Surgeons (STS) score 4.3±3.0%). The PorticoTM valve was implanted using transfemoral (91.2%), transsubclavian (5...
July 3, 2018: EuroIntervention
Gilbert H L Tang, Syed Zaid, Isaac George, Omar K Khalique, Yigal Abramowitz, Yoshio Maeno, Raj R Makkar, Hasan Jilaihawi, Norihiko Kamioka, Vinod H Thourani, Vasilis Babaliaros, John G Webb, Nay M Htun, Adrian Attinger-Toller, Hasan Ahmad, Ryan Kaple, Kapil Sharma, Joseph A Kozina, Tsuyoshi Kaneko, Pinak Shah, Sameer A Hirji, Nimesh D Desai, Saif Anwaruddin, Dinesh Jagasia, Howard C Herrmann, Sukhdeep S Basra, Molly A Szerlip, Michael J Mack, Moses Mathur, Christina W Tan, Creighton W Don, Rahul Sharma, Sameer Gafoor, Ming Zhang, Samir R Kapadia, Stephanie L Mick, Amar Krishnaswamy, Nicholas Amoroso, Arash Salemi, S Chiu Wong, Annapoorna S Kini, Josep Rodés-Cabau, Martin B Leon, Susheel K Kodali
OBJECTIVES: The aim of this study was to determine factors affecting paravalvular leak (PVL) in transcatheter aortic valve replacement (TAVR) with the Edwards SAPIEN 3 (S3) valve in extremely large annuli. BACKGROUND: The largest recommended annular area for the 29-mm S3 is 683 mm2 . However, experience with S3 TAVR in annuli >683 mm2 has not been widely reported. METHODS: From December 2013 to July 2017, 74 patients across 16 centers with mean area 721 ± 38 mm2 (range: 684 to 852 mm2 ) underwent S3 TAVR...
July 23, 2018: JACC. Cardiovascular Interventions
F van Kesteren, M S van Mourik, E M A Wiegerinck, J Vendrik, J J Piek, J G Tijssen, K T Koch, J P S Henriques, J J Wykrzykowska, R J de Winter, A H G Driessen, A Kaya, R N Planken, M M Vis, J Baan
AIM: In the evolving field of transcatheter aortic valve implantations (TAVI) we aimed to gain insight into trends in patient and procedural characteristics as well as clinical outcome over an 8‑year period in a real-world TAVI population. METHODS: We performed a single-centre retrospective analysis of 1,011 consecutive patients in a prospectively acquired database. We divided the cohort into tertiles of 337 patients; first interval: January 2009-March 2013, second interval: March 2013-March 2015, third interval: March 2015-October 2016...
June 25, 2018: Netherlands Heart Journal
Syed Saleem Mujtaba, Stephen C Clark
Objective: The mitral valve may be accessed directly through the left atrium but visualisation can sometimes be challenging. A trans-septal interatrial approach provides better exposure and easy access for concomitant tricuspid procedures especially in difficult cases. This retrospective study evaluates the safety and effectiveness of the extended vertical trans-septal approach (EVTSA) for routine mitral valve exposure. Method: 1017 consecutive patients undergoing an isolated primary mitral valve procedure (repair/replacement) through a median sternotomy were retrospectively studied between 2000 and 2015...
2018: Heart Asia
Dhaval Kolte, Sahil Khera, Sreekanth Vemulapalli, Dadi Dai, Stephan Heo, Andrew M Goldsweig, Herbert D Aronow, Sammy Elmariah, Ignacio Inglessis, Igor F Palacios, Vinod H Thourani, Barry L Sharaf, Paul C Gordon, J Dawn Abbott
OBJECTIVES: The authors sought to examine outcomes and identify independent predictors of mortality among patients undergoing urgent/emergent transcatheter aortic valve replacement (TAVR). BACKGROUND: Data on urgent/emergent TAVR as a rescue therapy for decompensated severe aortic stenosis (AS) are limited. METHODS: The Society of Thoracic Surgeons and the American College of Cardiology Transcatheter Valve Therapy (STS/ACC TVT) Registry linked with Centers for Medicare & Medicaid Services claims was used to identify patients who underwent urgent/emergent versus elective TAVR between November 2011 and June 2016...
June 25, 2018: JACC. Cardiovascular Interventions
Juan A Siordia, Jackquelin M Loera, Matt Scanlon, Jessie Evans, Peter A Knight
Transcatheter aortic valve implantation is a suitable therapeutic intervention for patients deemed inoperable or high risk for surgical aortic valve replacement. Current investigations question whether it is a suitable alternative to surgery for intermediate- and low-risk patients. The following meta-analysis presents a comparison between transcatheter versus surgical aortic valve replacement in patients that are intermediate and low risk for surgery. Articles were collected via an electronic search using Google Scholar and PubMed...
May 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
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