Idioventricular Rhythm: A Rare Presentation of Left Ventricular Pseudoaneurysm Following Radiofrequency Ablation.

Left ventricular pseudoaneurysm (PsA) is a rare complication of radiofrequency ablation (RFA) of cardiac arrhythmias. Presentation can vary widely in terms of timeline, signs, and symptoms. Idioventricular rhythm is a rare presentation of PsA post-ablation. No cases of post-ablation PsA presenting with idioventricular rhythm have been reported in the literature to date. A 72-year-old male presented with symptomatic idioventricular rhythm 34 days post RFA for premature ventricular complexes (PVCs). A PsA involving the distal anterolateral of his left ventricle wall was identified on transthoracic echo and computed tomography (CT). This patient underwent surgical patch repair which resolved his ventricular arrhythmia.

Coccidioidomycosis Cases at a Regional Referral Center, West Texas, USA, 2013-2019.

We describe 73 patients with coccidioidomycosis diagnosed or treated at a regional referral center in West Texas, USA. Patients most at risk worked in oil production or agriculture; the most-associated health factors were smoking and diabetes. Patient demographics suggest that access to care may affect coccidioidomycosis diagnosis in this region.

The Joint Association of Septicemia and Cerebrovascular Diseases with In-Hospital MortalityAmong Patients with Left Ventricular Assist Device in the United States.

OBJECTIVES: Left ventricular assist device (LVAD) is associated with complications such as cerebrovascular diseases (CEVD) as well as septicemia which is often preventable. With their use increasing in the U.S., identifying patients with LVAD who are at high risk for short-term mortality is essential for targeted effective patient management strategies to prevent adverse outcomes. We investigated the individual and joint association of CEVD and septicemia with the risk of in-hospital mortality in patients with LVAD in the U.S. MATERIALS AND METHODS: We used data from the National Inpatient Sample from 2004 to 2015 to identify patients ≥18 years of age who underwent LVAD implantation by means of International Classification of Disease, 9th Revision, codes. Multivariable hierarchical negative binomial regression models were used to estimate risk ratios (RR) and 95% confidence intervals (CI) for in-hospital mortality by CEVD-septicemia status. RESULTS: The mean age of the 4638 patients was 56 years, and 23% of them were women. Approximately 13% of patients had septicemia; 7% had CEVD and 2% had both conditions. In models adjusted for demographic, lifestyle/behavior factors and comorbid conditions, the risk of in-hospital mortality was almost threefold higher among patients with septicemia alone (RR=2.84, CI:2.24-3.60); two-and-half fold higher among patients with CEVD alone (RR=2.53, CI:1.85-3.48); and almost fourfold among patients with both septicemia and CEVD (RR=3.76, CI: 2.38-5.94, Pinteraction = <0.001) CONCLUSION: The presence of both septicemia and CEVD was associated with a substantially higher risk of in-hospital mortality among LVAD patients when compared to septicemia or CEVD alone.