Cardiology Medical Research Articles

Abstract 4114714: Impact of Cardiology Interest Groups on the Professional Development of Medical Students

Background: Launched in 2023, the American College of Cardiology Medical Student Member Community (ACC MSMC) began recognizing Cardiology Interest Groups (CIGs) at medical schools worldwide. This initiative fosters a robust network among ACC medical student members and celebrates their contributions within their institutions and broader communities. We surveyed medical students from 50 recognized CIGs to evaluate the influence of this network on their members' career trajectories. Methods: An anonymous web-based survey was sent to 50 student leaders of CIGs recognized by the ACC from 20 countries and was distributed to their members. The objective was to evaluate the impact of their involvement in these groups on their clinical knowledge, research activities and publications, professional advancement, and the promotion of diversity and equity. Results: Of 215 respondents (71% ACC members), 49.3% identified as female, with significant representation from Asia (35.7%), and the USA (17.6%). The majority joined CIGs to explore cardiology as a career path (61%), build professional networks (60%), and participate in specialized workshops (59.5%). Most rated their access to CIG resources as excellent (73.8%), supporting ACC's mission to enhance diversity and inclusion. Regarding educational outcomes, 48.6% rated their knowledge acquisition in cardiology as excellent, and 41% noted excellent preparation for a cardiology career. Additionally, 26.4% of students published research papers post-CIG involvement, with 39% attending ACC or AHA conferences. Survey feedback also highlighted strong networking (38.6% excellent) and mentoring opportunities (36.2% excellent) provided by CIGs. Conclusions: CIGs significantly enrich medical students' professional development by offering extensive networking, education, research, and mentorship opportunities. They play a crucial role in nurturing a global interest in cardiology, thereby enhancing diversity within the field. This model serves as a valuable blueprint for other scientific societies considering the establishment of student interest groups.

Palliative care for older adults with cardiovascular disease.

Heart disease is the number one cause of death in the United States. Advanced cardiac conditions, such as heart failure, are characterized by severe symptoms, recurrent hospitalizations, limited/uncertain prognosis, decreased quality of life, and high levels of caregiver burden. The burden of heart failure is highest in older adults, for whom cardiovascular symptoms are layered on existing age-related problems such as geriatric syndromes, polypharmacy, depression, frailty, inadequate social support, decreased representation in clinical trials, and aging caregivers. Deliberate integration of outpatient and interdisciplinary geriatrics, palliative care, and cardiovascular care are essential for this special population. Life-prolonging and quality of life-focused approaches to managing cardiovascular disease are not mutually exclusive; many cardiology medications and treatments prolong life while also improving symptom burden. Symptom management, a cornerstone of palliative care, is therefore not only complementary to life-prolonging cardiology treatments, but also integral to optimized daily cardiovascular care. In this review, we aim to summarize relevant literature and provide practical tools that can be used by primary care clinicians, geriatricians, cardiologists and palliative care clinicians to optimize holistic outpatient care for adults who are aging with heart disease. While palliative care is appropriate for any age or stage of illness, we will focus on older adults with heart disease, and the nuances of managing their symptoms, goals of care, and quality of life.

Clinical characteristics and associated factors of mild cognitive impairment in patients with common cardiovascular diseases

Objective: To analyze the clinical characteristics of patients with common cardiovascular diseases (CVD, including hypertension, coronary heart disease, atrial fibrillation, and heart failure) combined with mild cognitive impairment (MCI) and explore the potential risk factors of MCI in patients with CVD. Methods: A total of 2 294 patients with common cardiovascular diseases who met the criteria at Cardiology Medical Center in Beijing Anzhen Hospital, Capital Medical University, from June 1, 2021, to January 5, 2022, were retrospectively included. The patients were divided into the normal cognitive function group (1 107 cases) and the MCI group (1 187 cases). Demographic information and CVD status were collected. The information of cognitive function were collected using the Montreal Cognitive Assessment (MoCA) and the Mini-Mental State Examination (MMSE) scales. The difference between normal cognitive function and MCI were compared and analyzed. The logistic regression analysis was used to explored risk factors of MCI in CVD patients. Results: A total of 2 294 patients aged (60.6±10.4) years were included, among whom there were 29.99% (688 cases) females. Compared with patients in the normal cognitive function group, patients in the MCI group were older [ (57.9±11.4) vs (63.1±8.9) years old, P<0.001], with a higher proportion of women [26.47% (293 cases) vs 33.28% (395 cases), P<0.001]; there was a higher proportion of patients suffering from hypertension in the MCI group [59.62% (660 cases) vs 64.62% (767 cases), P=0.014］, and more components of CVD [(1.68±0.62) vs (1.74±0.65) components, P=0.017]. The risk factors of MCI in patients with common CVD were increased age, increased depression score, combined with hypertension, and ≥3 common components of CVD, with OR (95%CI) of 1.043 (1.032-1.054), 1.021 (1.004-1.037), 1.151 (1.142-3.439), and 1.137 (1.023-1.797), respectively (all P values <0.05). Increasing education level was observed to be associated with reduced risk of MCI with OR (95%CI) of 0.319 (0.271-0.378) (P<0.05). Conclusions: The incidence of MCI was high in CVD patients. The risk factors of MCI in CVD patients included hypertension and≥3 common components of CVD.

Can the Use of Cardiology Medical Record to Deliver Educational Intervention Improve Care? On Behalf of TAPP Program: Thinking Approach Towards Physician Support in Patient Management

Background: Despite clear and concise practice guidelines, strategies for lowering LDL-C are often poorly adopted in clinical practice, and many patients fail to reach guideline-recommended levels despite physician education and quality improvement programs. We studied whether physician focussed, guideline-based practice level educational intervention can improve lipid lowering management. Methods: Cardiologists or internal medicine specialists from the province of Ontario, Canada who were using a cardiology specific EMR (CEREBRUM, WELL Health Technologies Corporation) were invited to participate. Practice level data of patients with history of acute coronary syndromes (ACS) and lipid profile were studied. Physicians were alerted when patients in their practice were not treated according to recommendations. The primary endpoint was proportion of patients achieving the recommended LDL-C level of below 1.8 mmol/L. Results: Of the invited 378 specialists, 178 agreed to participate and shared their practice involving 7,683 ACS patients who were 70.4 ± 10.3 years of age and 27.2% were women. Overall, 57.7% of patients had LDL-C &lt; 1.8 mmol/L at the start of the program (1.84 ± 0.87 mmol/L) and 63.0% (1.75 ± 0.79 mmol/L) at the end of the program (p&lt;0.0001). With respect to the lipid lowering therapy, statin therapy was used in 52.9% of patients at the start of the program and increased to 72.1% at the end (p&lt;0.0001). The use of ezetimibe increased from 12.6% to 19.0% (p&lt;0.0001) and the use of PCSK9i from 1.2% to 2.4% (p&lt;0.0001). Conclusion: The results indicate the feasibility of using EMR as a platform to deliver educational intervention and overcoming treatment inertia and improving LDL-C lowering.

Thyroid storm induced congestive heart failure

Background: Uncontrolled thyrotoxicosis is known to lead to a state of prolonged tachycardia that may then progress to the onset of reversible congestive heart failure. Case: The patient is a 36-year-old female with a history of Asthma, bilateral ovarian benign cysts, chronic goiter presented due to persistent cough, wheezing, and shortness of breath for about two days duration, echocardiogram had been done for respiratory failure, showing reduced ejection fraction, diastolic dysfunction, and dilated cardiomyopathy. She was subsequently admitted to the MICU for treatment of respiratory failure due to asthma exacerbation. Then began feeling symptoms of anxiety, palpitations, tremulousness, facial flushing. Evaluation of her labs showed elevated T3 at &gt;650, elevated T4 at 22.6, with diminished TSH level at 0.01. The patient was diagnosed with thyroid storm in consideration of lab values with clinical features. TSI was ordered, which returned at 674. Endocrinology was consulted; the patient added a history of tremors for three weeks and weight loss of about 5 pounds over several months, with symptoms of generalized anxiety and dysphagia; she also reported diarrhea in the past weeks. She refers to a family history of goiter in her aunt. The recommendation from an endocrinology perspective was to obtain TSI level and ESR, continue methimazole. The patient was clinically stabilized, discharged on medications for heart failure and methimazole. However, she developed a rash on methimazole, and this was stopped. The patient went for radioactive iodine ablation, and a repeat echo showed an improvement of her ejection fraction. The patient was asymptomatic at a one-year cardiology follow-up, and cardiology medications were discontinued. Conclusion: Hyperthyroidism is a known cause of congestive heart failure secondary to tachycardia-induced cardiomyopathy if untreated. After the proper treatment, this heart failure can be reversed if tachycardia is controlled.

Thyroid storm induced congestive heart failure

Background: Uncontrolled thyrotoxicosis is known to lead to a state of prolonged tachycardia that may then progress to the onset of reversible congestive heart failure. Case: The patient is a 36-year-old female with a history of Asthma, bilateral ovarian benign cysts, chronic goiter presented due to persistent cough, wheezing, and shortness of breath for about two days duration, echocardiogram had been done for respiratory failure, showing reduced ejection fraction, diastolic dysfunction, and dilated cardiomyopathy. She was subsequently admitted to the MICU for treatment of respiratory failure due to asthma exacerbation. Then began feeling symptoms of anxiety, palpitations, tremulousness, facial flushing. Evaluation of her labs showed elevated T3 at &gt;650, elevated T4 at 22.6, with diminished TSH level at 0.01. The patient was diagnosed with thyroid storm in consideration of lab values with clinical features. TSI was ordered, which returned at 674. Endocrinology was consulted; the patient added a history of tremors for three weeks and weight loss of about 5 pounds over several months, with symptoms of generalized anxiety and dysphagia; she also reported diarrhea in the past weeks. She refers to a family history of goiter in her aunt. The recommendation from an endocrinology perspective was to obtain TSI level and ESR, continue methimazole. The patient was clinically stabilized, discharged on medications for heart failure and methimazole. However, she developed a rash on methimazole, and this was stopped. The patient went for radioactive iodine ablation, and a repeat echo showed an improvement of her ejection fraction. The patient was asymptomatic at a one-year cardiology follow-up, and cardiology medications were discontinued. Conclusion: Hyperthyroidism is a known cause of congestive heart failure secondary to tachycardia-induced cardiomyopathy if untreated. After the proper treatment, this heart failure can be reversed if tachycardia is controlled.

Abstract 12250: Trends in Retractions of Peer Reviewed Literature: Comparison Between Cardiology and Other Medical Specialties

Introduction: Peer-reviewed manuscript retractions are increasingly being recognized, wasting valuable scientific resources and magnifying false conclusions. The temporal trend and downstream impact of retracted cardiology articles on research and knowledge dissemination remain largely unexplored. We sought to compare retraction trends between cardiology and clinical medicine overall. Methods: We conducted a systematic review of retracted publications using the Retraction Watch database. Articles were selected based on manual classification. The Welch two-sample t-test and Mann-Kendall trend test were used for statistical inference. Results: Out of 22,740 articles, 6,594 (29%) and 445 (2%) were related to medicine overall and cardiology, respectively. The ratio of retractions to published articles has increased over recent years for medicine overall and cardiology (Figure upper panel, p &lt; 0.01 for trends). Relative to 1990 levels, retractions in medicine have increased at over double the rate in comparison to cardiology (p &lt; 0.01 for rate difference). There has been a downward trend in the time between publication and retraction for articles in cardiology and medicine (Figure lower panel, p &lt; 0.01 for trends). There was no significant difference in time to retraction between the two fields. Conclusions: We report a sharp increase in the retracted articles in the medical literature over time. Although retractions in cardiology are increasing, they are doing so at a slower rate than other specialties. Sharing research guidelines from cardiology to other medical specialties could improve their retraction statistics, thus decreasing patient harm and waste of valuable scientific resources. Retractions are being identified earlier, potentially due to improved policing of the published literature. However, more stringent quality checks should occur during the peer review processes to prevent eventually retracted articles from being published.

RUSSIAN AND INTERNATIONAL EXPERIENCE IN THE DEVELOPMENT OF ACTION PLANS FOR THE PROTECTION OF HUMAN HEALTH FROM CLIMATE RISKS

The Paris climate agreement confirmed that climate change continues to pose a global concern and required all Parties to put forward their best efforts to protect public health. In the conditions of global warming, climate-induced risks gained importance as a public health hazard and confirmed the need to develop national action plans. Such plans shall be developed locally, taking into account the requirements of the National Action Plan for adaptation to health risks induced by changing climate. This manuscript presents the data on climate-dependent mortality. The global annual burden of excess deaths attributed to climate change is over 150,000 cases, which leads to a loss of 5.5 million years of productive life per year. Early warning systems have been adopted in many countries, with the goal to prevent heat-related deaths. If such a system were implemented in Moscow, eleven thousand excess deaths could have been avoided during the extremely hot summer of 2010. Heat watch warning systems are based on scientific data on heat thresholds. On the days with temperatures above such thresholds, climate-dependent mortality increases. Such thresholds have been established in the environmental epidemiology studies conducted in Moscow, Northern and Southern cities, the cities with continental and monsoon climates. The experience of implementation of early warning systems during extreme weather events was analyzed. The relative powers of bioclimatic indices as predictors of daily mortality rates during extreme weather events were compared. To prevent complications of cardiovascular diseases, a set of protective measures was proposed which included cardiology medications, recommendations on personal behavior and drinking habits during extreme heat, and other measures. The risks and examples of occurrence and northward propagation of climate-dependent infectious diseases such as Siberian anthrax, West Nile fever, Crimean-Congo hemorrhagic fever, and dirofilariasis, were described.

Comparison of APACHE II, SAPS II and SOFA Scoring Systems as Predictors of Mortality in ICU Patients

Objective: The comparison of the APACHE II, SAPS II and SOFA scoring systems as predictors of mortality in ICU patients. Study Design: A prospective observational study. Place and Duration of Study: Intensive care unit of Ch. Pervaiz Ellahi Institute of Cardiology and Nishtar Medical University and Hospital, Multan, from May 13, 2018 to September 24, 2018. Methodology: For 36 patients included in study, results for APACHE II, SAPS II and SOFA were calculated with the worst values recorded. At the end of ICU stay, patient outcome was labelled as survivors and non-survivors. Data was analyzed with SPSS v.23. Descriptive data was stated as median (minimum-maximum) or percentages. Pearson Chi square test and non-parametric statistics were applied accordingly. Linear regression analysis was also performed. Cut off value for statistical significance was taken as ≤0.05. Results: Of 36 patients, 22 survived and 14 died after being observed for 12 (2-17) days. On linear regression analysis, all the scoring systems were significantly associated with the mortality rates (p<0.05). However, after adjustment, only the APACHE II was a significant predictor of mortality (p<0.001). APACHE II scoring system calculated highest estimated mortality rates i.e. 19.3%, while SAPS II and SOFA scoring systems estimated 8.6% and 13.5% mortality, respectively. Conclusion: APACHE II scoring system was much superior to SAPS II and SOFA scoring systems as a significant predictor of the mortality among the ICU patients. Keywords: Acute Physiology and Chronic Health Evaluation (APACHE II), Simplified Acute Physiology Score (SAPS II), Sequential Organ Failure Assessment (SOFA), Intensive care units (ICU), Mortality. DOI : 10.7176/JMPB/53-03 Publication date :March 31 st 2019

Some aspects of tricuspid atresia.

During the period of 5 years, from the beginning of 1971 up tp the end of 1975, out of 2054 sick children seen in the Pediatric Outpatient Division of the Department of Cardiology Medical School, University of lndonesia/Dr. Cipto Mangunkusumo General Hospital Jakarta, 1073 patients were found to have congenital heant disease. Ten out of these 1073 CHD patients have been diagnosed as Tricuspid Atresia on the clinioal basis, giving the incidence of 0.93% of all CHD, of whom 5 were boys and 5 were girls, mean age being 36.5% months (range 2 months to 12 years). Hemodynamic studies have been done to 3 of the 10 patients, all of which confirmed the diagnosis. Two children went to surgery. Anatomic and radiologic classification and types of the disease in those 3 children and some clinical aspects and hemodynamic studies are discussed. It is stressed that early recognition and surgical intervention are indicated, and still should be improved.

Beware these common errors with cardiology medications

Beware these common errors with cardiology medications

A New Outlook on Clinical Course of Juvenile Dermatomyositis - Experience of a Single Center

Introduction: Juvenile dermatomyositis (JDM) is the most common inflammatory myopathy in children. Diagnostic criteria by Bohan & Peter are originally formulated for adults. A wide range of differences in clinical course of dermatomyositis between adults and children has provoked to set a new look at the existing criteria. Objective: The aim of our study was to analyze the clinical course and reaction to administered drug therapy in association with laboratory and electromyographic findings in pediatric patients with dermatomyositis. Materials and methods: The retrospective analysis included 5 children with JDM hospitalized in Department of Pediatric Cardiology and Rheumatology Medical University of Lodz, Poland between October 2000 and November 2014. Demographic data, characteristics of clinical symptoms, laboratory tests, EMG and muscle biopsy reports and reaction to administered treatment were analyzed. Results: Muscle weakness was the most common symptom observed in 80% of patients. Other symptoms present in more than a half of patients included heliotrope rash (60%) and Gottron sign (60%). Muscle enzyme levels were significantly elevated in 4 out of 5 patients. Electromyography (EMG) was performed in 3 patients and was positive in every case, as well as muscle biopsy. Initial therapy involved prednisone 1mg/kg b.w./day in all patients combined with disease modifying anti-rheumatic drug, whether methotrexate was the most common choice (60%). Complications which occurred in presented patients involve: rhabdomyolysis, severe calcinosis and contractures of elbows, exacerbation after reduction of GCS dose, hypertriglyceridemia, steatohepatitis, tachycardia.

Error reports, serious adverse events with cardiology medications

Error reports, serious adverse events with cardiology medications

Chest Pain and Diarrhea: A Case of Campylobacter Jejuni-Associated Myocarditis

BackgroundDiarrhea and chest pain are common symptoms in patients presenting to the emergency department (ED). However, rarely is a relationship between these two symptoms established in a single patient. ObjectiveDescribe a case of Campylobacter-associated myocarditis. Case ReportA 43-year-old man with a history of hypertension presented to the ED with angina-like chest pain and a 3-day history of diarrhea. Electrocardiogram revealed ST-segment elevation in the lateral leads. Coronary angiogram revealed no obstructive coronary artery disease. Troponin T rose to 1.75 ng/mL. Cardiac magnetic resonance imaging showed subepicardial and mid-myocardial enhancement, particularly in the anterolateral wall and interventricular septum, consistent with a diagnosis of myocarditis. Stool studies were positive for Campylobacter jejuni. ConclusionsCampylobacter-associated myocarditis is rare, but performing the appropriate initial diagnostic testing, including stool cultures, is critical to making the diagnosis. Identifying the etiology of myocarditis as bacterial will ensure that appropriate treatment with antibiotics occurs in addition to any cardiology medications needed for supportive care.

Response to Letters Regarding Article, “Comparison Between Transcatheter and Surgical Prosthetic Valve Implantation in Patients With Severe Aortic Stenosis and Reduced Left Ventricular Ejection Fraction”

We thank Subramanian et al and Ranucci et al for their insightful comments with regard to our study.1 In response to the comments of Ranucci et al, we provide the following statements. 1. The important variability in the 30-day mortality rates (8% to 33%) reported in previous studies is essentially related to the differences in the cutoff values used for the left ventricular ejection fraction (LVEF), but also, and more importantly, it is related to the differences in the baseline risk profile of the study populations. The fact that the mortality (12%) observed in our surgical aortic valve replacement (SAVR) series is higher than that (8% to 10%) of some previous series is essentially related to the worse-risk profile of the patients included in this series. 2. The assessment of SAVR operative risk was based on a comprehensive analysis of the factors included in the risk scores, and those (eg, frailty) not included in these scores, as well. All patients included in the transcatheter aortic valve implantation (TAVI) series had been refused for SAVR by at least 2 cardiac surgeons. 3. We agree that the presence of reduced LVEF should not be used as the sole argument to recommend TAVI rather than SAVR in patients with severe aortic stenosis. SAVR remains the standard of care in the vast majority of patients with reduced LVEF and high …

A Systematic Approach to Improve Lipids in Coronary Artery Disease Patients Participating in a Cardiac Rehabilitation Program

To determine the effectiveness of an intervention, directed toward the primary care physician (PCP), to improve the number of patients treated to low-density lipoprotein cholesterol (LDL-C) goal in a cardiac rehabilitation (CR) population. A pre-post intervention cohort comparison using data collected from participants in a CR program with LDL-C > or =100 mg/dL at entry. The control cohort participated in CR between 1/00 and 10/02, 41.5% (n = 178) had an entry LDL-C > or =100 mg/dL. The intervention cohort participated in CR between 10/03 and 1/05, 26.4% (n = 67) had an entry LDL-C > or =100 mg/dL. The intervention group had identical treatment as the control group as well as the following: each participant with an LDL-C > or =100 mg/dL in the intervention cohort had an entry letter sent to his or her cardiologist and PCP from the programs Cardiology Medical Director, detailing the lipid goals and therapeutic options. In addition, monthly faxes on progress toward lipid goals were sent to the PCP. The control cohort was less likely to achieve LDL-C goal compared with the intervention cohort (43% vs 67%, respectively; P = .001). A patient was also less likely to have a lipid medication change during CR in the control group compared with the intervention group (29% vs 42%, respectively; P = .05). Use of systematic reminders directed at the PCP during CR can substantially increase the percentage of patients achieving nationally recognized LDL-C goals.

A Simple Faint?

Journal of Cardiovascular ElectrophysiologyVolume 17, Issue 9 p. 1004-1004 A Simple Faint? BLAIR P. GRUBB M.D., BLAIR P. GRUBB M.D. Medical University of Ohio, Toledo, Ohio, USASearch for more papers by this author BLAIR P. GRUBB M.D., BLAIR P. GRUBB M.D. Medical University of Ohio, Toledo, Ohio, USASearch for more papers by this author First published: 26 July 2006 https://doi.org/10.1111/j.1540-8167.2006.00575.xCitations: 33 Address for correspondence: Blair P. Grubb, M.D., Cardiology Medical University of Ohio, 3000 Arlington Avenue, Rm. 1192, Toledo, OH 43614. Fax: 419-383-3041; E-mail: [email protected] J Cardiovasc Electrophysiol, Vol. 17, pp. 1004, September 2006. Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article.Citing Literature Volume17, Issue9September 2006Pages 1004-1004 RelatedInformation

Atrioventricular junction ablation is the indication for bipolar cardiac pacing

ATRIOVENTRICULAR JUNCTION ABLATION IS THE INDICATION FOR BIPOLAR CARDIAC PACING. R. Stecklewtcz, E. ~wi~tofi, M. Pieniak, P. Stolarz, G. Opolski. Department of Internal Medicine and Cardiology Medical University of Warsaw, Poland. Aim: The aim of the study was to determine the incidence of external signal ddven events, using standard pacing parameters, in patients (pts) with implanted stimulators and following ablation of atdoventdcular junction(a-v). Materials and methods: We studied 114 a-v junction ablation procedures performed on 54 females, 60 males (aged between 49 and 89 years, mean age 67.5 years). Episodes of paroxysmal or sustained atdal fibdllation in pts with permanent heart stimulation (DDD/DDDR 21, W I N V R 93) which proved refractory to pharmacological treatment and proceeded with hemodynamic dysfunction were an indication for ablation. Ablation was performed preserving the substitute rhythm from the a-v junction. On 1 t or 2 nd day following the procedure an ECG Holter recording was made in the course of pts' normal physical activity. Heart stimulation was performed using the standard programme (unipolar stimulation and pacing), only following ablation the basic frequency of stimulation was increased to 8O/min in order to extinguish potential arrhythmia events. Ddving by a false signal (the pectoral muscle's potential, among others) occurred in 73 pts (64%). In 24 pts (21%) the advanced degree of dysrhythmia resulted in clinical symptoms disquieting to the pts: faintness, giddiness, irregular heartbeat. This resulted from non-activation or considerably delayed activation of the substitute pacemaker, despite its function being preserved in the period immediately following the ablation procedure. Increasing the sensitivity threshold of the unipolar system sometimes transformed the problem of oversensing into one of undersensing in cases of arrhythmia events of variable morphology. By making such changes in the programme it was possible to eliminate pacing dysfunction in instances where bipolar electrodes were used. Conclusions: The necessity of ensudng correct functioning of heart stimulation following a-v junction ablation procedures is an indication for using, in every case, bipolar electrodes which permit changes in pacing parameters. PERFORMANCE AND HANDLING OF A NEW FRACTALLY COATED ATRIAL SCREW IN LEAD H. Ramchum' MD, F. Coots=,MD, F. Berton~ MD,V.Piscedda =, R. Van Twembeke = '_CH R Wsrquignies, Belgium, =Klina Brasschsat, Belgium, =Biotronik Belgium, OBJECTIVE: In order to increase the stability and improve the sensing and pacing performances, in the athal chamber, a new fractally coated screw in lead has been designed : Elox EX 53-BP ( Bioltonik GmbH). In this ongoing study parameters related to pacing, lead manipulation and complications relatod to lead implantation have been evaluated. METHODS: The 8iotronik Elox lead is an transvenous, bipolar, endocardial lead, using an electrically active extendable and retractable active fixation helix. The helix is electhcatiy active and is made of platinium with s fractal iridium coating. The lead is insulated with silicone. 30 patients (pts) (12 male, 18 female, mean age70+/-5 years) needing a double chamber pacemaker received an Elox atrial lead. Implantation indication were: symptomatic sick sinus dysfunction in 20 pts, complete AV block in 5 pts and symptomatic second degree AV block in 5 pts. All leads were introduced through the left subclavian vein by the single puncture method. The following parameters were measured at implantation, pre-discharge, 1 month, 3 months and 6 months (ongoing) post implantation: P wave amplitude, atrial pacing threshold st 0,4ms and pacing impedance at 0,4ms/4,av. The lead handling and complications related to the implant ,,J ced u re were evaluated. RESULTS : Results are expressed in the following table mean+i-standard deviation. IMPEDANCE (O) PACING TRESHOLD~V) p WAVE AMPLITUDE (mV) Implant 470 +/80 0T8 +/0~2 2,4 +/1T2 Pre-discharge 370 +/35 0,9 +/0t2 2T2 +/0,9 1 month 380 +/50 0,7 +/0,1 2~4 +/0T7 3 months 340 +140 0,6 +/0,2 2,8 +/0,9 Impedance values are low due to the large surface area of 11,2 mm =. The mean pacing threshold at implant is below 1V and shows a typical slight increase in the acute phase followed by a restabilization in the chronic phase. Sensing parameters also follow a typical pattern of decrease and increase in amplitude. Concerning lead manipulation screwing and retracting the helix did not affect the implantation procedure. No lead dislodgement has been observed. CONCLUSIONS: These preliminary results show the safety and reliability of this new Iddium fractally-ceated atrial screw in lead. One interesting feature is the early achievement of stable parameters. The handling performance of this lead during implantation was excellent resulting in a secure fixation behaviour. No complications were observed during the follow up period.

Continuing medical education

Clinical CardiologyVolume 17, Issue 8 p. 458-459 Book ReviewFree Access Continuing medical education Bernd Eber M.D., Bernd Eber M.D. Division of Cardiology Medical Clinic Karl-Franzens-University Graz Graz, AustriaSearch for more papers by this author Bernd Eber M.D., Bernd Eber M.D. Division of Cardiology Medical Clinic Karl-Franzens-University Graz Graz, AustriaSearch for more papers by this author First published: August 1994 https://doi.org/10.1002/clc.4960170812AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume17, Issue8August 1994Pages 458-459 RelatedInformation

Serial chest thumps for the treatment of ventricular tachycardia in patients with coronary artery disease

Clinical CardiologyVolume 15, Issue 7 p. A28-A28 Letters to the EditorFree Access Serial chest thumps for the treatment of ventricular tachycardia in patients with coronary artery disease David Shander M.D., David Shander M.D. 4545 East 9th Street Suite 390 Denver, CO 80220Search for more papers by this authorM. Gertsch M.D., M. Gertsch M.D. Department of Cardiology Medical University Clinic Inselspital Bern 3010 Bern, SwitzerlandSearch for more papers by this author David Shander M.D., David Shander M.D. 4545 East 9th Street Suite 390 Denver, CO 80220Search for more papers by this authorM. Gertsch M.D., M. Gertsch M.D. Department of Cardiology Medical University Clinic Inselspital Bern 3010 Bern, SwitzerlandSearch for more papers by this author First published: July 1992 https://doi.org/10.1002/clc.4960150703Citations: 1AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. References 1 Gertsch M, Hottinger S, Hess T: Conversion of ventricular tachycardia in patients with coronary artery disease by serial chest thumps. Clin Cardiol 15, 181 (1992) 2 Conner D, Shander D, Deegan C, Craddock D, Wolf PS, Baum RS: Self-administered chest thumps for cardioversion of recurrent ventricular tachycardia. Chest 73, 877 (1978) 3 Gertsch M, Hottinger S, Mettler D, Leupi F, Gurtner HP: Conversion of induced ventricular tachycardia by single and serial chest thumps: A study in domestic pigs 1 week after experimental myocardial infarction. Am Heart J 118, 248 (1989) 4 Rozanski JJ: Ventricular tachycardia and the chest thump (letter to the editor). Chest 74, 694 (1978) 5 Pennington JE, Taylor J, Lown B: Chest thump for reverting ventricular tachycardia. N Engl J Med 283, 1192 (1970) 6 Miller J, Tresch D, Horwitz L, Thompson BM, Aprahamian C, Darin JC: The precordial thump. Ann Emerg Med 13, 791 (1984) 7 Sclarovsky S, Kracoff OH, Agmon J: Acceleration of ventricular tachycardia induced by a chest thump. Chest 80, 596 (1981) 8 Krijne R: Rate acceleration of ventricular tachycardia after a precordial chest thump. Am J Cardiol 53, 964 (1984) 9 Yakaitis RW, Redding JS: Precordial thumping during cardiac resuscitation. Crit Care Med 1, 22 (1973) 10 Volkmann H, Klumbies A, Kuhnert H, Paliège R, Dannberg G, Siegert K: Terminierung von Kammertachykardien durch mechanische Herzstimulation mit Praekordialschlägen. Z Kardiol 79, 717 (1990) Citing Literature Volume15, Issue7July 1992Pages A28-A28 ReferencesRelatedInformation