Cardiology Commons^™

Lead Extraction In The Contemporary Setting: The Lexicon Study. An Observational Retrospective Study Of Consecutive Laser Lead Extractions, Oussama Wazni, Md, Laurence M. Epstein, Md, Roger G. Carrillo, Md, Charles Love, Md, Stuart W. Adler, Md, David W. Riggio, Md, Shahzad S. Karim, Md, Jamil Bashir, Md, Arnold J. Greenspon, Md, John P. Dimarco, Md, Phd, Joshua M. Cooper, Md, John R. Onufer, Md, Kenneth A. Ellenbogen, Md, Stephen P. Kutalek, Md, Sherri Dentry-Mabry, Msn, Carolyn M. Ervin, Phd, Bruce L. Wilkoff, Md

Division of Cardiology Faculty Papers

Objectives: This study sought to examine the safety and efficacy of laser-assisted lead extraction and the indications, outcomes, and risk factors in a large series of consecutive patients.

Background: The need for lead extraction has been increasing in direct relationship to the increased numbers of cardiovascular implantable electronic devices.

Methods: Consecutive patients undergoing transvenous laser-assisted lead extraction at 13 centers were included.

Results: Between January 2004 and December 2007, 1,449 consecutive patients underwent laser-assisted lead extraction of 2,405 leads (20 to 270 procedures/site). Median implantation duration was 82.1 months (0.4 to 356.8 months). Leads were completely removed 96.5% of the …

Emergency Evaluation Of Acute Chest Pain., Aysha Almas, Om Parkash, Aamir Hameed, Muhammad Islam

Department of Medicine

Objective: To determine the sensitivity and specificity of initial clinical assessment about the diagnosis of acute coronary syndrome (ACS) in patients presenting with acute chest pain by a cardiology resident in the emergency room and assess the 30-day outcome of patients with ACS and non ACS.

Study Design: Cohort study.

Place and Duration of Study: The study was conducted in the emergency department and cardiac care units of the Aga Khan University in 2006-07.

Methodology: A total of 202 patients, who presented to the emergency room with chest pain, were given an initial ECG and troponin check. Patients were assigned …

Role Of Cardiac Magnetic Resonance Imaging In The Detection Of Cardiac Amyloidosis, Imran S. Syed Md, James F. Glockner Md, Dali Feng Md, Philip A. Araoz Md, Matthew W. Martinez, William D. Edwards Md, Morie A. Gertz Md, Angela Dispenzieri Md, Jae K. Oh Md, Diego Bellavia Md, Phd, A Jamil Tajik Md, Martha Grogan Md

Department of Medicine

No abstract provided.

Partial And Transitional Atrioventricular Septal Defect Outcomes., L Luann Minich, Andrew M. Atz, Steven D. Colan, Lynn A. Sleeper, Seema Mital, James Jaggers, Renee Margossian, Ashwin Prakash, Jennifer S. Li, Meryl S. Cohen, Ronald V. Lacro, Gloria L. Klein, John A. Hawkins, Pediatric Heart Network Investigators, Girish S. Shirali

Manuscripts, Articles, Book Chapters and Other Papers

BACKGROUND: Surgical and perioperative improvements permit earlier repair of partial and transitional atrioventricular septal defects (AVSD). We sought to describe contemporary outcomes in a multicenter cohort.

METHODS: We studied 87 patients undergoing primary biventricular repair of partial or transitional AVSD between June 2004 and February 2006 across seven North American centers. One-month and 6-month postoperative data included weight-for-age z-scores, left atrioventricular valve regurgitation (LAVVR) grade, residual shunts, and left ventricular ejection fraction. Paired methods were used to assess 6-month change.

RESULTS: Median age at surgery was 1.8 years; median weight z-score was -0.88. Median days for ventilation were 1, intensive …

Ganglionic Plexus Ablation During Pulmonary Vein Isolation--Predisposing To Ventricular Arrhythmias?, Faizel Osman, Suman Kundu, Jiun Tuan, Jeilan Mohamed, Peter J. Stafford, G. Andre' Ng

Internal Medicine, East Africa

Catheter ablation is increasingly used to treat patients with atrial fibrillation (AF). Ablation of ganglionic plexi is often performed to reduce vagal innervation and has been shown to confer a better long-term outcome in terms of AF recurrence. We report a case of a patient having AF ablation with a profound vagal response, suggesting ganglionic plexus ablation, who subsequently developed ventricular fibrillation after programmed ventricular stimulation. Reduced vagal modulation is known to predispose to ventricular arrhythmias and vagal denervation following AF ablation may predispose to ventricular arrhythmias and requires further study.

Implementing The 2005 American Heart Association Guidelines, Including Use Of The Impedance Threshold Device, Improves Hospital Discharge Rate After In-Hospital Cardiac Arrest, Ken Thigpen, Scott Davis, Roberta Basol, Peggy Lange, Sandeep Jain, John Olsen, Bernard Erickson, Timothy Schuchard, Tom P. Aufderheide

Articles

OBJECTIVE:

To determine the impact of the 2005 American Heart Association cardiopulmonary resuscitation (CPR) guidelines, including use of an impedance threshold device (ITD), on survival after in-hospital cardiac arrest.

METHODS:

Two community hospitals that tracked outcomes after in-hospital cardiac arrest pooled and compared their hospital discharge rate before and after implementing the 2005 American Heart Association CPR guidelines (including ITD) in standardized protocols. In CPR we used the proper ventilation rate, allowed full chest-wall recoil, conducted continuous CPR following intubation, and used an ITD. We compared historical control data from a 12-month period at St Cloud Hospital, St Cloud, Minnesota, …

Reducing Late Charges In Cardiovascular Services, Diane Rydzy Rn

Posters

• Late charges are charges that are “added” to a patient’s bill after the bill has been sent
• Late charges strain the system by making it necessary to “re-bill” the account
• In order to reduce late charges, it is necessary to understand how late charges occur

Research Note: Exploration Of Factors That Impede Door-To-Balloon Times, Erin Troby

Inquiry: The University of Arkansas Undergraduate Research Journal

When experiencing an acute myocardial infarction (AMI), more commonly known as a heart attack, patients need rapid treatment in order to open up and reestablish blood flow within the coronary artery. By far, the most common way to do this is an invasive procedure that allows a physician to inflate a tiny balloon into the plaque-filled area of the artery. The American College of Cardiology (ACC) and the American Heart Association (AHA) have established a 90-minute goal for this procedure, which means that, from the time a patient enters the door of the emergency department (ED), the medical team has …

Diverticular And Aneurysmal Structures Of The Left Ventricle In Adults: Report Of A Case Within The Context Of A Literature Review., Premraj Makkuni, Morris N Kotler, Vincent M. Figueredo

Department of Medical Genetics Faculty Papers

Left ventricular outpouchings are increasingly detected on cardiovascular imaging. Herein, we describe the case of a 45-year-old man who underwent noncardiac preoperative imaging and was found to have an asymptomatic left ventricular outpouching. The patient underwent successful surgical repair of the structure. When left ventricular outpouchings are detected, the main differential diagnoses are pseudoaneurysm, aneurysm, and diverticulum. The outcomes for these conditions differ substantially, and accurate diagnosis can be crucial in making clinical decisions. We review the relevant medical literature, outline the natural history of these left ventricular abnormalities, and discuss options in regard to their management.

Acute Subarachnoid Hemorrhage And Cardiac Abnormalities: Takotsubo Cardiomyopathy Or Neurogenic Stunned Myocardium? A Case Report, C Franco, B Khaled, L Afonso, M Raufi

Wayne State University Associated BioMed Central Scholarship

Abstract

Introduction

Cardiac abnormalities can be seen with subarachnoid hemorrhage. To date, there have been isolated case reports of transient left ventricular apical ballooning cardiomyopathy, also known as Takotsubo cardiomyopathy in patients suffering from subarachnoid hemorrhage.

Case presentation

An adult female was brought to the emergency department with somnolence. A 3 × 3 mm ruptured basilar aneurysm was found and successfully embolized. Two days after the patient developed acute heart failure. Troponin-I was elevated to 4.2 (normal <0.4). On ECG, new symmetric T wave inversion in V3, V4, V5 with prolonged QT were evident. Transthoracic echocardiogram showed severe systolic dysfunction with an ejection fraction of 20% and akinetic apex along with the distal left ventricular segments, consistent with Takotsubo cardiomyopathy. Myocardial contrast echocardiography showed a decrease in capillary blood flow and volume in the akinetic areas with delayed contrast replenishment, sparing the basal segments. A repeat study 2 weeks later showed near normalization of the perfusion parameters. The patient improved with medical management. A repeat echocardiogram, a month later revealed an ejection fraction of 45% with no identifiable wall motion abnormality.

Conclusion

Our case, as well as others reported previously, supports the diagnosis of Takotsubo cardiomyopathy in patients with Subarachnoid Hemorrhage who fulfill the …

Hydatid Cyst Disease Of The Thorax, Saulat H. Fatimi, Naima Waqar Butt, Taimur Saleem, Mohammad Asim Beg

Section of Cardiothoracic Surgery

Hydatid disease is a frequently encountered entity in endemic areas and constitutes a serious health problem. The lung is the second most commonly affected organ after the liver. In three of four cases of pulmonary hydatid cyst, the cyst is solitary. The early phase after primary infection is always asymptomatic. Primary symptoms in patients with pulmonary cystic echinococcosis include cough, fever, and chest pain. The clinical and radiological manifestations for the hydatid cyst in the lung depend on the integrity of the cyst. Bronchial fistulization is an important event in the evolution of the cyst. In cases of dubious orientation …

Left Atrial Enlargement Is Associated With Postoperative Respiratory Failure And Mortality, Bertrand N. Mukete Md, Christina Dunbar Do, Mph, Matthew M. Miller Do, Sherrine Eid Mph, Bruce Feldman Do

Department of Medicine

No abstract provided.

Outcome Of Traumatic Aortic Rupture: A 14-Year Experience, Matthew Wilson, James K. Wu, Sanjay M. Mehta Md, Theodore G. Phillips Md, Raymond L. Singer Md, Michael F. Szwerc Md, Gary W. Szydlowski Md

Department of Medicine

No abstract provided.

Cardiopulmonary Resuscitation Prescription Program: A Prospective Randomized Pilot Study, Marna R. Greenberg Do, Mph, Facep, Gavin Barr Md, Valerie Rupp Rn, Bsn, Nainesh C. Patel Md, Kevin R. Weaver Do, Kimberly Hamilton Ba, James F. Reed Iii Phd

Department of Emergency Medicine

No abstract provided.

Clinico-Morphological Correlations In The Categorization Of Holes Between The Ventricles., Brad A. Friedman, Anthony Hlavacek, Karen Chessa, Girish S. Shirali, Eowyn Corcrain, Diane Spicer, Robert H. Anderson, Sinai Zyblewski

Manuscripts, Articles, Book Chapters and Other Papers

Controversy still exists in the categorization of holes between the ventricles, although they are the most common congenital cardiac malformation. Advanced imaging techniques such as three-dimensional echocardiography and computed tomographic angiography offer superb anatomical details of these defects. In this review, we have sought to collate the features highlighted in different categorizations and identify their similarities, but also emphasize their differences. We hope that an analysis of this type, now achievable during life, using advanced imaging, might lead to the appearance of a unified system for diagnosis and description of holes between the ventricles.