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Stroke pacemaker

Min Ho Ju, Jin Hyung Huh, Chee-Hoon Lee, Ho Jin Kim, Hyung Gon Je, Joon Bum Kim, Sung-Ho Jung, Jae Won Lee
BACKGROUND: Data on robotic-assisted surgical atrial fibrillation (AF) ablation in patients undergoing mitral valve (MV) surgeries are lacking. This study aimed to evaluate early and late outcomes following robotic-assisted ablation of AF combined with MV surgery. METHODS: Between 2007 and 2017, this study enrolled 94 patients (53.9±12.7 years; 67 males) undergoing AF ablation using an argon-based flexible cryoablation system during robotic-assisted MV surgery...
October 11, 2018: Annals of Thoracic Surgery
Khaled Al-Shaibi, Waqar Ahmed, Walid Abukhudair, Yousef Nosir, Abdulaziz Al-Shaibi, Rayan Kateb, Mirvat Alasnag
BACKGROUND: Partner 2 and SURTAVI trials (mean STS score of 5.8 and 4.5) support extending TAVR into the intermediate risk group. We present our results of TAVR in a group with mean STS score of 2.9 and 2 year follow up. METHODS: This is a prospective cohort study of 46 consecutive patients undergoing TAVR between 2011 and 2016. All patients had severe symptomatic AS. Age, functional status, coronary disease, co-morbidity and imaging parameters were assessed. Patients were followed up for 12-60 months...
October 4, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Luca Nai Fovino, Mostafa R A Badawy, Chiara Fraccaro, Augusto D'Onofrio, Paola A M Purita, Anna C Frigo, Paola Tellaroli, Agnifili Mauro, Maurizio Tusa, Massimo Napodano, Gino Gerosa, Sabino Iliceto, Francesco Bedogni, Alaa E R AbdelRheim, Giuseppe Tarantini
BACKGROUND: New-generation transcatheter heart valves have been developed to reduce complications of transcatheter aortic valve implantation (TAVI). With this study we sought to compare procedural and 30-day outcomes of the new-generation repositionable Boston Scientific Lotus (Lotus) and the balloon-expandable Edwards Sapien 3 (ES3) transcatheter heart valves. METHODS: A total of 315 patients with severe symptomatic aortic stenosis undergoing transfemoral TAVI with Lotus or ES3 included in two large Italian registries were considered for this analysis...
November 2018: Journal of Cardiovascular Medicine
Kees van der Wulp, Michel W A Verkroost, Marleen H van Wely, Helmut R Gehlmann, Leen A F M Van Garsse, L Noyez, Marc A Brouwer, Peter C Kievit, Menko-Jan De Boer, Harry Suryapranata, Wim J Morshuis, Niels van Royen
BACKGROUND: The femoral artery is generally used as primary access for TAVI. However, peripheral artery disease often precludes femoral access. The purpose of this study was to describe clinical outcome of TAVI using the left axillary artery (LAA) as primary access site. METHODS: From December 2008 until June 2016, data on all consecutive patients treated with a Medtronic device via the LAA at our hospital were registered and outcome was prospectively collected according to the updated VARC-2 criteria...
October 4, 2018: Annals of Thoracic Surgery
Vinayak Nagaraja, William Suh, David L Fischman, Adrian Banning, Sara C Martinez, Jessica Potts, Chun Shing Kwok, Karim Ratib, Jim Nolan, Rodrigo Bagur, Mamas A Mamas
AIM: TAVR in patients with bicuspid aortic valves (BAV) is more challenging compared to individuals with trileaflet aortic valves (TAV). BAV have been excluded from the large randomized clinical trials assessing transcatheter aortic valve replacements (TAVR) and has been considered as a relative contraindication to TAVR. To report the outcomes of TAVR in BAV and compare them to TAV in the National Inpatient Sample (NIS). METHODS AND RESULTS: TAVR procedures were identified between 2011 and 2014 in the NIS dataset...
September 18, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Ibrahim Sultan, Valentino Bianco, Arman Kilic, Danny Chu, Forozan Navid, Thomas G Gleason
OBJECTIVE: To study mid-term survival in patients with infective endocarditis as a result of IV drug use undergoing aortic root replacement with cryopreserved aortic homograft. METHODS: Patients undergoing aortic root homograft replacement from 2011-2017 were studied retrospectively. Aortic root replacement was performed using a modified Bentall technique. Primary outcomes included both short-term and mid-term survival. Secondary outcomes included immediate postoperative complications...
June 4, 2018: Journal of Thoracic and Cardiovascular Surgery
James O'Neill, Lina Jegodzinski, Muzahir H Tayebjee
BACKGROUND: South Asians have a lower prevalence of atrial fibrillation (AF) compared with Caucasians despite higher rates of conventional risk factors and a higher incidence of stroke. It is not clear whether South Asians truly experience less AF or whether this is due to under-detection of the arrhythmia. Therefore, we aimed to determine whether South Asian patients with pacemakers have a lower incidence of device-detected subclinical episodes of AF compared with Caucasian controls...
September 29, 2018: Pacing and Clinical Electrophysiology: PACE
Lars Søndergaard, Josep Rodés-Cabau, Axel Hans-Peter Linke, Stephan Fichtlscherer, Ulrich Schäfer, Karl-Heinz Kuck, Joerg Kempfert, Dabit Arzamendi, Francesco Bedogni, Federico M Asch, Stephen Worthley, Francesco Maisano
BACKGROUND: The new self-expanding, repositionable transcatheter heart valve (THV) system was designed for treatment of severe, symptomatic aortic stenosis in patients with high surgical risk. OBJECTIVES: To report 1-year outcomes of transcatheter aortic valve replacement (TAVR) with new THV system. METHODS: This ongoing, international, multicenter study evaluated patients with severe, symptomatic aortic stenosis implanted with the THV via transfemoral access and follow-up at 30 days, 1 year and annually through 5 years...
September 17, 2018: Journal of the American College of Cardiology
Thomas G Gleason, Michael J Reardon, Jeffrey J Popma, G Michael Deeb, Steven J Yakubov, Joon S Lee, Neal S Kleiman, Stan Chetcuti, James B Hermiller, John Heiser, William Merhi, George L Zorn, Peter Tadros, Newell Robinson, George Petrossian, G Chad Hughes, J Kevin Harrison, John V Conte, Mubashir Mumtaz, Jae K Oh, Jian Huang, David H Adams
BACKGROUND: The CoreValve US Pivotal High Risk Trial was the first randomized trial to show superior 1-year mortality of transcatheter aortic valve replacement (TAVR) compared with surgical aortic valve replacement (SAVR) among high operative mortality-risk patients. OBJECTIVES: The authors sought to compare TAVR to SAVR for mid-term 5-year outcomes of safety, performance, and durability. METHODS: Surgical high-risk patients were randomized (1:1) to TAVR with the self-expanding bioprosthesis or SAVR...
September 18, 2018: Journal of the American College of Cardiology
Emma Sandgren, Cecilia Rorsman, Nils Edvardsson, Johan Engdahl
BACKGROUND: Silent atrial fibrillation (AF) episodes are common but the role of anticoagulation treatment is under debate. METHODS: Consecutive patients with dual-chamber pacemakers for sinus node disease or AV block/bundle branch block were retrospectively enrolled and the development of silent AF, any anticoagulation and the incidence of ischaemic stroke and dementia were recorded. RESULTS: In total 411 patients without and 267 with known AF at implant were included...
2018: PloS One
Ron Waksman, Toby Rogers, Rebecca Torguson, Paul Gordon, Afshin Ehsan, Sean R Wilson, John Goncalves, Robert Levitt, Chiwon Hahn, Puja Parikh, Thomas Bilfinger, David Butzel, Scott Buchanan, Nicholas Hanna, Robert Garrett, Federico Asch, Gaby Weissman, Itsik Ben-Dor, Christian Shults, Roshni Bastian, Paige E Craig, Hector M Garcia-Garcia, Paul Kolm, Quan Zou, Lowell F Satler, Paul J Corso
BACKGROUND: Transcatheter aortic valve replacement (TAVR) is now standard of care for patients with symptomatic severe aortic stenosis who are extreme, high or intermediate risk for surgical aortic valve replacement (SAVR). OBJECTIVES: To evaluate TAVR in a prospective multicenter trial involving low-risk patients. METHODS: The Low Risk TAVR trial was the first FDA-approved Investigational Device Exemption trial to enroll in the US. This investigator-led trial was a prospective, multicenter, unblinded, comparison to historical controls from the Society of Thoracic Surgeons (STS) database...
August 9, 2018: Journal of the American College of Cardiology
Markus Bettin, Dirk Dechering, Simon Kochhäuser, Niklas Bode, Lars Eckardt, Gerrit Frommeyer, Florian Reinke
BACKGROUND: Implantable loop recorders (ILR) may be used to detect occult atrial fibrillation (AF) in patients with cryptogenic stroke. At present, there has been no description on the incidental findings of stored episodes in these patients. Furthermore, no standard practice has been established with respect to the duration of continued ECG monitoring in these patients. MATERIALS AND METHODS: In the prospective monocentric study (TRACK-AF), a total of 173 patients with cryptogenic stroke received an ILR for detection of AF between November 2010 and December 2014...
August 22, 2018: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
Yuji Murakawa, Teiichi Yamane, Masahiko Goya, Koichi Inoue, Shigeto Naito, Koichiro Kumagai, Yasushi Miyauchi, Norishige Morita, Akihiko Nogami, Morio Shoda, Ken Okumura, Kenzo Hirao
Background and purpose: In expectation of better outcome of catheter ablation of atrial fibrillation (AF), several strategies of extra-PV (pulmonary vein) substrate modification have been utilized. We assessed whether substrate modification or ablation of extra-PV source is a predictor of complications. Methods: Japanese Heart Rhythm Society requested electrophysiology centers to register the data of patients who underwent AF ablation. Results: The data of 10 795 AF ablation cases (age; 63...
August 2018: Journal of Arrhythmia
Giuseppe Boriani, Elena Biagini, Matteo Ziacchi, Vincenzo Livio Malavasi, Marco Vitolo, Marisa Talarico, Erminio Mauro, Giulia Gorlato, Giovanna Lattanzi
Lamin A/C gene mutations can be associated with cardiac diseases, usually referred to as "cardiolaminopathies" characterized by arrhythmic disorders and/or left ventricular or biventricular dysfunction up to an overt picture of heart failure. The phenotypic cardiac manifestations of laminopathies are frequently mixed in complex clinical patterns and specifically may include bradyarrhythmias (sinus node disease or atrioventricular blocks), atrial arrhythmias (atrial fibrillation, atrial flutter, atrial standstill), ventricular tachyarrhythmias and heart failure of variable degrees of severity...
August 21, 2018: Nucleus
Rebecca T Hahn, Philippe Pibarot, Jonathon Leipsic, Philipp Blanke, Pamela S Douglas, Neil J Weissman, Samir Kapadia, Vinod H Thourani, Howard C Herrmann, Tamim Nazif, Thomas McAndrew, John G Webb, Martin B Leon, Susheel Kodali
OBJECTIVES: The purpose of this study was to understand the effects of balloon post-dilatation on outcomes following transcatheter aortic valve replacement with the SAPIEN 3 valve. BACKGROUND: Hemodynamics and outcomes with balloon post-dilatation for the SAPIEN 3 valve have not been previously reported. METHODS: The effects of balloon post-dilatation (BPD) in 1,661 intermediate (S3i cohort) and high surgical risk (S3HR cohort) patients with aortic stenosis enrolled in the PARTNER (Placement of Aortic Transcatheter Valves) 2, SAPIEN 3 observational study on outcomes, as well as procedural complications, were assessed...
September 10, 2018: JACC. Cardiovascular Interventions
S Chiu Wong, Ilhwan Yeo, Geoffrey Bergman, Dmitriy N Feldman, Harsimran Singh, Robert Minutello, Luke K Kim
BACKGROUND: With the expected growth in the elderly segment of the U.S. population particularly in women, the prevalence of valvular heart disease is bound to increase in the coming years. We sought to delineate the impact of gender on in-hospital clinical outcomes in Medicare-age patients undergoing isolated left-side heart valve surgery. METHODS: Using the National Inpatient Sample files from 2003 to 2014, we compared the in-hospital major adverse cardiac and cerebral events (MACCE: all-cause mortality, stroke, or myocardial infarction) and composite complications (MACCE, permanent pacemaker implantation, bleeding requiring transfusion, iatrogenic vascular complications, acute respiratory failure, acute kidney injury requiring hemodialysis, sepsis and prolonged hospital stay) following isolated mitral or aortic surgery between genders with 1:1 propensity score analysis...
August 10, 2018: Cardiovascular Revascularization Medicine: Including Molecular Interventions
Francesco Maisano, Stephen Worthley, Josep Rodés-Cabau, Axel Hans-Peter Linke, Stephan Fichtlscherer, Ulrich Schäfer, Raj R Makkar, Gregory Fontana, Federico M Asch, Lars Søndergaard
AIMS: The aim of this study was to investigate the procedural and short-term outcomes of transcatheter aortic valve implantation (TAVI) with the Portico™ self-expanding, resheathable TAVI system from an ongoing long-term multicentre study. METHODS AND RESULTS: A total of 941 patients (82.4±5.9 years, 65.7% female, STS score 5.8±4.9%) with severe symptomatic aortic stenosis underwent TAVI using the Portico bioprosthesis. Patients were clinically and echocardiographically assessed at implantation, discharge and 30 days post TAVI...
August 17, 2018: EuroIntervention
Thorsten Lewalter, Helmut Pürerfellner, Andrea Ungar, Guido Rieger, Lorenza Mangoni, Firat Duru
BACKGROUND: First-degree AV block has in the past generally been considered a benign condition. A few recent studies have shown that 1st-degree AV block is associated with an increased risk for heart failure, pacemaker (IPG) implantation, and death. We investigated the outcomes of patients who received an insertable cardiac monitor (ICM) (Medtronic Reveal XT®) within the scope of the INSIGHT XT study and had 1st-degree AV block at baseline. METHODS: The observational, international, multi-center INSIGHT (R)XT study prospectively enrolled 1003 patients implanted with an ICM for arrhythmia diagnosis, irrespective of the clinical indication...
August 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
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
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