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Stroke pacemaker

Jun Hyung Kim, Sung Ho Lee, Seung-Jung Park, Kyoung Min Park, Young Keun On, June Soo Kim
BACKGROUND: Atrial fibrillation (AF) often progresses to more sustained forms and raises the risk of ischemic stroke or sinus node dysfunction (SND). However, there has been no data on the clinical outcomes of AF developed during head-up tilt testing (HUT). OBJECTIVE: The purpose of this study was to evaluate the clinical significance of AF detected during HUT performed for syncope evaluation. METHODS: We analyzed incidence, short-and long-term prognosis, and predictors for adverse outcomes of AF detected during HUTs which were performed in 6780 consecutive patients without AF history...
December 4, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Priyam Mithawala, Priyank Shah, Edward Koomson
Marijuana is the most commonly used illicit drug in the world. Over the last decade, the potency of marijuana has increased tremendously. Its use is associated with harmful health consequences including adverse cardiovascular effects, such as arrhythmias, myocardial infarction, cardiomyopathy and stroke. It has been reported to cause bradycardia. This report describes the case of a 51-year-old female with no significant past medical history who presented with complete heart block due to chronic marijuana use, requiring a permanent pacemaker...
October 30, 2018: American Journal of the Medical Sciences
David Del Val, Alfredo Nunes Ferreira-Neto, Lluis Asmarats, Frédéric Maes, Leonardo Guimaraes, Lucia Junquera, Jérome Wintzer, Quentin Fischer, Afonso Barroso de Freitas Ferraz, Rishi Puri, Josep Rodés-Cabau
Transcatheter aortic valve replacement (TAVR) is a well-established treatment for patients with severe aortic stenosis and intermediate-to-high surgical risk. The increasing clinical experience along with technical and design iterations of transcatheter valve systems have contributed to reducing adverse events and improving clinical outcomes. Areas covered: Overview of the latest generation transcatheter heart valves (THVs), focusing on early safety and efficacy outcomes. Expert commentary: Improvements in valve repositionability, reducing the size of valve delivery systems, and antiparavalvular leak iterations have contributed to improving the safety and clinical outcomes following TAVR...
December 10, 2018: Expert Review of Medical Devices
H Liu, Y Yang, Y T Lu, L M Zhu, D Zhu, Y Q Guo, W Wang, L Wei, C S Wang
Objective: To report on the two years outcome of Chinese multi-center study of the treatment of high risk non-calcified pure aortic regurgitation with transcatheter heart valve replacement (TAVR) using domestic made J-Valve™ system. Methods: The national multi-center clinical study of the treatment of high risk non-calcified pure aortic regurgitation with transcatheter heart valve replacement using domestic made J-Valve™ system was conducted during the period from April 2014 to July 2015. The follow-up time was up to 2 years...
December 1, 2018: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
Amilia Aminuddin, Isabella Tan, Mark Butlin, Alberto P Avolio, Hosen Kiat, Edward Barin, Nor Anita Megat Mohd Nordin, Kalaivani Chellappan
Finger photoplethysmography (PPG) is a noninvasive method that measures blood volume changes in the finger. The PPG fitness index (PPGF) has been proposed as an index of vascular risk and vascular aging. The objectives of the study were to determine the effects of heart rate (HR) on the PPGF and to determine whether PPGF is influenced by blood pressure (BP) changes. Twenty subjects (78±8 years, 3 female) with permanent cardiac pacemakers or cardioverter defibrillators were prospectively recruited. HR was changed by pacing, in a random order from 60 to 100 bpm and in 10 bpm increments...
2018: PloS One
Ganesh Manoharan, Nicolas M Van Mieghem, Stephan Windecker, Johan Bosmans, Sabine Bleiziffer, Thomas Modine, Axel Linke, Werner Scholtz, Bernard Chevalier, Robert Gooley, Cathy Zeng, Jae K Oh, Eberhard Grube
OBJECTIVES: This study sought to report the 1-year safety and efficacy outcomes in the FORWARD (CoreValve Evolut R FORWARD) study following transcatheter aortic valve replacement (TAVR) with the next-generation Evolut R device (Medtronic, Minneapolis, Minnesota) in routine clinical practice. BACKGROUND: The FORWARD study reported low incidences of mortality, disabling stroke, and significant paravalvular leak following TAVR in routine clinical practice at 30 days...
November 26, 2018: JACC. Cardiovascular Interventions
David H Birnie, Jeff S Healey, George A Wells, Felix Ayala-Paredes, Benoit Coutu, Glen L Sumner, Giuliano Becker, Atul Verma, François Philippon, Eli Kalfon, John Eikelboom, Roopinder K Sandhu, Pablo B Nery, Nicholas Lellouche, Stuart J Connolly, John Sapp, Vidal Essebag
Aims: Guidelines recommend warfarin continuation rather than heparin bridging for pacemaker and defibrillator surgery, after the BRUISE CONTROL trial demonstrated an 80% reduction in device pocket haematoma with this approach. However, direct oral anticoagulants (DOACs) are now used to treat the majority of patients with atrial fibrillation. We sought to understand the best strategy to manage the DOACs at the time of device surgery and specifically hypothesized that performing device surgery without DOAC interruption would result in a reduced haematoma rate...
November 21, 2018: European Heart Journal
Jan Steffel, Christian T Ruff, Eugene Braunwald, Rose A Hamershock, Sabina A Murphy, Markku Nieminen, Hans-Joachim Lanz, Michele F Mercuri, Nancy Peterson, Elliott M Antman, Robert P Giugliano
Aims: Pacemaker, implantable cardioverter-defibrillator, and cardiac resynchronization therapy device implantations and generator changes are frequently performed in patients receiving direct oral anticoagulants. In an exploratory analysis, we investigated the outcome of patients undergoing such device procedures in the ENGAGE AF-TIMI 48 trial. Methods and results: During the trial, 1217 device procedures were performed in 1145 patients, with intervention dates available for 1203 procedures...
November 19, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Xiao-Li Chen, Xue-Jun Ren, Zhuo Liang, Zhi-Hong Han, Tao Zhang, Zhi Luo
Objective: To retrospectively identify risk factors and the prognosis for new-onset atrial fibrillation (AF) after implantation of dual-chamber pacemakers in elderly patients. Methods: Consecutive patients aged ≥ 65 years who underwent their first implantation of a dual-chamber permanent pacemaker in Beijing Anzhen Hospital from October 2013 to May 2016 were enrolled. Their complete programming and follow-up data were recorded. Follow-up end points included new-onset AF and major adverse cardiovascular and cerebrovascular events...
October 2018: Journal of Geriatric Cardiology: JGC
Tomo Ando, Oluwole Adegbala, Pedro A Villablanca, Alexandros Briasoulis, Hisato Takagi, Cindy L Grines, Theodore Schreiber, Tamim Nazif, Susheel Kodali, Luis Afonso
OBJECTIVES: To assess the in-hospital outcomes of transcatheter aortic valve replacement (TAVR) vs. surgical aortic valve replacement (SAVR) in non-teaching hospitals. BACKGROUND: TAVR has become widely available in the United States. However, the comparative outcomes of TAVR vs. SAVR in non-teaching hospitals are largely under explored. METHODS: We queried the Nationwide Inpatient Sample database from 2011 to September 2015 to identify those who were 50 years or above and underwent either trans-arterial TAVR or SAVR at non-teaching hospital...
November 8, 2018: Catheterization and Cardiovascular Interventions
Paweł Balsam, Monika Gawałko, Michał Peller, Agata Tymińska, Krzysztof Ozierański, Martyna Zaleska, Katarzyna Żukowska, Katarzyna Szepietowska, Kacper Maciejewski, Marcin Grabowski, Mariusz Borkowski, Łukasz Kołtowski, Anna Praska-Oginska, Inna Zaboyska, Grzegorz Opolski, Janusz Bednarski
Congestive heart failure (CHF) and atrial fibrillation (AF) frequently coexist and are associated with increased risk of cardiovascular events.To compare baseline characteristics, comorbidities and pharmacotherapy in AF patients with concomitant CHF to those without CHF.The study included 3506 real-life AF patients with (37.1%) and without CHF - participants of the multicentre, retrospective MultiCenter expeRience in AFib patients Treated with OAC (CRAFT) trial (NCT02987062).All patients were treated with non-vitamin K antagonist oral anticoagulants (NOAC) or vitamin K antagonists (VKA)...
November 2018: Medicine (Baltimore)
Nishant Saran, Kevin L Greason, Hartzell V Schaff, Sertac M Cicek, Richard C Daly, Simon Maltais, John M Stulak, Alberto Pochettino, Katherine S King, Joseph A Dearani, Sameh M Said
BACKGROUND: Mitral annular calcification(MAC) is associated with worse outcomes after mitral valve replacement(MVR). With limited data available on long-term outcomes, we reviewed our experience of MVR in presence of MAC. METHODS: A retrospective review of 1710 consecutive patients who underwent MVR between 1/2000 and 12/2015 was done. Patients with isolated primary MVR(n=496) were included while concomitant cardiac surgery(n=1068), previous MVR(n=110) and mitral valve(MV) endocarditis(n=36) were excluded...
November 1, 2018: Annals of Thoracic Surgery
Min Soo Cho, Ran Heo, Xin Jin, Jung-Bok Lee, Sahmin Lee, Dae-Hee Kim, Joon Bum Kim, Jun Kim, Sung-Ho Jung, Suk Jung Choo, Jong-Min Song, Gi-Byoung Nam, Kee-Joon Choi, Duk-Hyun Kang, Cheol Hyun Chung, Jae Won Lee, You-Ho Kim, Jae-Kwan Song
Background To characterize the development of sick sinus syndrome ( SSS ) after the additive maze procedure ( MP ) during mitral valve surgery. Methods and Results Follow-up data (median, 3.6 years) of 750 patients with a prevalence of rheumatic cause of 57.6% were analyzed. SSS occurred in 35 patients with a time-dependent increase: the incidence rates at 1, 2, and 4 years after surgery were 2.9%, 3.7%, and 4.3%, respectively. The additive MP showed higher risks of SSS development (hazard ratio, 7.44; 95% confidence interval, 3...
October 2, 2018: Journal of the American Heart Association
Gerhard Schymik, Valentin Herzberger, Jens Bergmann, Peter Bramlage, Lars O Conzelmann, Alexander Würth, Armin Luik, Holger Schröfel, Panagiotis Tzamalis
OBJECTIVES: Use of transcatheter aortic valve implantation (TAVI) to treat severe aortic stenosis (AS) has gained popularity, accompanied by an evolution of patient and clinical factors. We aimed to characterise changes and evaluate their impact on outcomes. SETTING: In this single-centre, German TAVIK registry patients undergoing TAVI between 2008 and 2015 were documented prospectively. PARTICIPANTS/INTERVENTIONS: 2000 consecutive patients with AS undergoing TAVI were divided in four cohorts...
October 25, 2018: BMJ Open
Deepak Padmanabhan, Krishna Kancharla, Majd A El-Harasis, Ameesh Isath, Nayani Makkar, Peter A Noseworthy, Paul A Friedman, Yong-Mei Cha, Suraj Kapa
BACKGROUND: Implantable loop recorders (ILRs) are effective in achieving symptom-rhythm correlation, However, diagnostic yield in routine clinical practice is not as well established. METHODS: Patients undergoing ILR implantation between April 2010 and May 2015 were included. All devices were enrolled in remote monitoring with automatic arrhythmia detection and P sense algorithms switched 'ON'. Symptom-rhythm correlation was assessed and changes in management were recorded...
October 25, 2018: Pacing and Clinical Electrophysiology: PACE
Anson Cheung, John Webb, Ulrich Schaefer, Robert Moss, Florian G Deuschl, Lenard Conradi, Paolo Denti, Azeem Latib, Bob Kiaii, Rodrigo Bagur, Enrico Ferrari, Marco Moccetti, Luigi Biasco, Philippe Blanke, Yanai Ben-Gal, Shmuel Banai
BACKGROUND: Transcatheter mitral valve replacement (TMVR) may mature to become a therapeutic option for high-risk patients with severe mitral regurgitation (MR), particularly in patients at high or prohibitive surgical risk. MR patients with preexisting aortic valve prosthesis have been excluded from most TMVR trials because of the potential risks of left ventricular outflow tract obstruction or interaction between the TMVR anchoring mechanism and the aortic prosthesis. We describe the procedural and short-term outcomes of transapical TMVR with the Tiara valve in patients experiencing severe symptomatic MR with previous aortic valve replacement (AVR)...
October 2018: Circulation. Cardiovascular Interventions
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
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