RÉSUMÉ
BACKGROUND: Smartphone technologies have been recently developed to assess heart rate and rhythm, but their role in accurately detecting atrial fibrillation (AF) remains unknown. OBJECTIVE: We sought to perform a meta-analysis using prospective studies comparing Smartwatch technology with current monitoring standards for AF detection (ECG, Holter, Patch Monitor, ILR). METHODS: We performed a comprehensive literature search for prospective studies comparing Smartwatch technology simultaneously with current monitoring standards (ECG, Holter, and Patch monitor) for AF detection since inception to November 25th, 2019. The outcome studied was the accuracy of AF detection. Accuracy was determined with concomitant usage of ECG monitoring, Holter monitoring, loop recorder, or patch monitoring. RESULTS: A total of 9 observational studies were included comparing smartwatch technology, 3 using single-lead ECG monitoring, and six studies using photoplethysmography with routine AF monitoring strategies. A total of 1559 patients were enrolled (mean age 63.5 years, 39.5% had an AF history). The mean monitoring time was 75.6 days. Smartwatch was non-inferior to composite ECG monitoring strategies (OR 1.06, 95% CI 0.93 - 1.21, p=0.37), composite 12 lead ECG/Holter monitoring (OR 0.90, 95% CI 0.62 - 1.30, p=0.57) and patch monitoring (OR 1.28, 95% CI 0.84 - 1.94, p=0.24) for AF detection. The sensitivity and specificity for AF detection using a smartwatch was 95% and 94%, respectively. CONCLUSIONS: Smartwatch based single-lead ECG and photoplethysmography appear to be reasonable alternatives for AF monitoring.
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Premature ventricular complexes (PVCs) are common in the general population, usuallyasymptomatic, and deemed to be benign in structurally normal hearts. The spectrum of "benign" outflow tract PVCs ranges from single PVCs to recurrent non-sustained ventricular tachycardia (NSVT). Short-coupled right ventricular outflow tract (RVOT) PVCs may trigger polymorphic ventricular tachycardia (VT) in some patients and can be high risk. In many patients, PVCs can be morefrequent and cause symptoms ofpalpitations, shortness of breath, dizziness, and heart failure.In the presence of underlying heart disease, they may indicate an increasedrisk of adverse cardiovascular outcomes. A high PVC burdenmay lead to ventricular dysfunction and worsen underlying cardiomyopathy.PVCs may also be a marker of underlying pathophysiologic processes such as myocarditisand other acquired and inherited infiltrative cardiomyopathies. In this unique case report, we describe the use of a novel non-contact mapping array for mapping RVOT PVCs.
RÉSUMÉ
Sentinel cerebral embolic protection devices (CPDs) may limit periprocedural cerebrovascular events by preventing micro and macro-embolization to the brain, and has been used in many cardiology and radiology procedures. We hereby report the use of a Sentinel CPD to facilitate safe and effective atrial fibrillation ablation in a patient with a left atrial mass arising from the interatrial septum.
Sujet(s)
Fibrillation auriculaire , Septum interatrial , Ablation par cathéter , Veines pulmonaires , Fibrillation auriculaire/imagerie diagnostique , Fibrillation auriculaire/chirurgie , Septum interatrial/imagerie diagnostique , Septum interatrial/chirurgie , Humains , Veines pulmonaires/imagerie diagnostique , Veines pulmonaires/chirurgieRÉSUMÉ
Infection is one of the most devastating outcomes of cardiovascular implantable electronic device (CIED) implantation and is related to significant morbidity and mortality. In our country, there is no evaluation about CIED infection. Therefore, our aim was to investigate clinical characteristics and outcome of patients who had infection related to CIED implantation or replacement. The study included 144 consecutive patients with CIED infection treated at 11 major hospitals in Turkey from 2005 to 2014 retrospectively. We analyzed the medical files of all patients hospitalized with the diagnosis of CIED infection. Inclusion criteria were definite infection related to CIED implantation, replacement, or revision. Generator pocket infection, with or without bacteremia, was the most common clinical presentation, followed by CIED-related endocarditis. Coagulase-negative staphylococci and Staphylococcus aureus were the leading causative agents of CIED infection. Multivariate analysis showed that infective endocarditis and ejection fraction were the strongest predictors of in-hospital mortality.
Sujet(s)
Défibrillateurs implantables/effets indésirables , Infections/étiologie , Pacemaker/effets indésirables , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Défibrillateurs implantables/microbiologie , Endocardite bactérienne/étiologie , Endocardite bactérienne/microbiologie , Mortalité hospitalière , Humains , Infections/mortalité , Adulte d'âge moyen , Pacemaker/microbiologie , Valeur prédictive des tests , Infections dues aux prothèses/étiologie , Infections dues aux prothèses/microbiologie , Études rétrospectives , Staphylococcus , Débit systolique , TurquieRÉSUMÉ
OBJECTIVE: We proposed a new technique for the treatment of coronary bifurcation lesions, called jailed semi-inflated balloon technique (JSBT). BACKGROUND: Currently, provisional approach is recommended to treat most of coronary bifurcation lesions. However, it is associated with the risk of side branch (SB) occlusion after main vessel (MV) stenting due to plaque or carina shift into the SB. The SB occlusion may cause peri-procedural myonecrosis or hemodynamic compromise. Therefore, strategies are needed to reduce the SB occlusion during provisional approach. METHODS: Between September 2014 and April 2015, we selected 137 patients (104 male, 33 female; mean age 63.6 ± 11.7 years) with 148 distinct coronary bifurcation lesions underwent percutaneous coronary intervention using JSBT. All patients were followed with hospital visits or telephone contact up to 1 month. RESULTS: The majority of the patients had acute coronary syndrome (64.2%) and Medina 1.1.1. bifurcation lesions (62.8%). The lesion localization was distal left main (LM) coronary artery in 28 patients. After the MV stenting, thrombolysis in myocardial infarction (TIMI) 3 flow was established in 100% of both MV and SB. There was no SB occlusion in any patient. There was no major adverse cardiac event during in-hospital stay and 1 month follow-up. CONCLUSIONS: The JSBT technique can be successfully performed in both LM and non-LM bifurcation lesion. This technique provides high rate of procedural success, excellent SB protection during MV stenting and excellent immediate clinical outcome.
Sujet(s)
Syndrome coronarien aigu , Angioplastie coronaire par ballonnet , Vaisseaux coronaires , Endoprothèses , Syndrome coronarien aigu/diagnostic , Syndrome coronarien aigu/thérapie , Sujet âgé , Angioplastie coronaire par ballonnet/effets indésirables , Angioplastie coronaire par ballonnet/instrumentation , Angioplastie coronaire par ballonnet/méthodes , Coronarographie/méthodes , Vaisseaux coronaires/anatomopathologie , Vaisseaux coronaires/physiopathologie , Femelle , Hémodynamique , Humains , Mâle , Adulte d'âge moyen , Résultat thérapeutiqueSujet(s)
Endocardite bactérienne/épidémiologie , Valvulopathies/épidémiologie , Femelle , Humains , MâleRÉSUMÉ
OBJECTIVE: Successful revascularization of chronic total occlusions has been associated with improved left ventricular systolic function, reduced anginal symptoms, increased exercise capacity, and increased survival. This study was conducted to determine the impact of revascularization in chronic total occlusion on left ventricular function using novel echocardiographic techniques. METHODS: A total of 129 patients with chronic total occlusion who underwent revascularization between April 2011 and November 2012 were included in this study. Echocardiographic assessments with two-dimensional speckle tracking echocardiography and real-time three-dimensional echocardiography were performed before the procedure and one month after the procedure. The left ventricular ejection fraction, left ventricular volumes, and three-dimensional systolic dyssynchrony index were quantified. RESULTS: An immediate procedural success was obtained in 118 patients (91.5%). There were no acute or subacute stent thromboses during follow-up. The mean left ventricular ejection fraction significantly increased (p<0.001), while the left ventricular end-diastolic and end-systolic volumes significantly decreased (p = 0.001 and p<0.001, respectively). The three-dimensional systolic dyssynchrony index also decreased significantly (p<0.001). The global longitudinal strain showed a significant increase after successful revascularization (p<0.001). An increase in the global longitudinal strain was correlated with an increase in the left ventricular ejection fraction (r = 0.27, p = 0.02). The patients with a left ventricular ejection fraction ≥50% displayed a greater improvement in the global longitudinal strain, and the patients with diabetes showed less improvement. CONCLUSIONS: Using novel echocardiographic techniques, our results showed that restoring the coronary blood flow in chronic total occlusion patients reduces the left ventricular volumes and improves the left ventricular ejection fraction and the global longitudinal strain of hibernating myocardium.
Sujet(s)
Occlusion coronarienne/chirurgie , Échocardiographie tridimensionnelle/méthodes , Intervention coronarienne percutanée/méthodes , Fonction ventriculaire gauche/physiologie , Sujet âgé , Loi du khi-deux , Occlusion coronarienne/imagerie diagnostique , Diabète/physiopathologie , Femelle , Humains , Mâle , Adulte d'âge moyen , Biais de l'observateur , Débit systolique/physiologie , Facteurs temps , Résultat thérapeutiqueRÉSUMÉ
OBJECTIVE: Successful revascularization of chronic total occlusions has been associated with improved left ventricular systolic function, reduced anginal symptoms, increased exercise capacity, and increased survival. This study was conducted to determine the impact of revascularization in chronic total occlusion on left ventricular function using novel echocardiographic techniques. METHODS: A total of 129 patients with chronic total occlusion who underwent revascularization between April 2011 and November 2012 were included in this study. Echocardiographic assessments with two-dimensional speckle tracking echocardiography and real-time three-dimensional echocardiography were performed before the procedure and one month after the procedure. The left ventricular ejection fraction, left ventricular volumes, and three-dimensional systolic dyssynchrony index were quantified. RESULTS: An immediate procedural success was obtained in 118 patients (91.5%). There were no acute or subacute stent thromboses during follow-up. The mean left ventricular ejection fraction significantly increased (p<0.001), while the left ventricular end-diastolic and end-systolic volumes significantly decreased (p = 0.001 and p<0.001, respectively). The three-dimensional systolic dyssynchrony index also decreased significantly (p<0.001). The global longitudinal strain showed a significant increase after successful revascularization (p<0.001). An increase in the global longitudinal strain was correlated with an increase in the left ventricular ejection fraction (r = 0.27, p = 0.02). The patients with a left ventricular ejection fraction ≥50% displayed a greater improvement in the global longitudinal strain, and the patients with diabetes showed less improvement. CONCLUSIONS: Using novel echocardiographic techniques, our results showed that restoring the coronary blood flow in chronic total occlusion patients reduces the left ventricular volumes ...
Sujet(s)
Sujet âgé , Femelle , Humains , Mâle , Adulte d'âge moyen , Occlusion coronarienne/chirurgie , Échocardiographie tridimensionnelle/méthodes , Intervention coronarienne percutanée/méthodes , Fonction ventriculaire gauche/physiologie , Loi du khi-deux , Occlusion coronarienne , Diabète/physiopathologie , Biais de l'observateur , Débit systolique/physiologie , Facteurs temps , Résultat thérapeutiqueRÉSUMÉ
OBJECTIVE: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiographic findings and management strategies of infective endocarditis (IE) in Turkey. METHODS: The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. RESULTS: One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. CONCLUSIONS: Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey.
Sujet(s)
Endocardite bactérienne/épidémiologie , Valvulopathies/épidémiologie , Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Service hospitalier d'urgences , Endocardite bactérienne/microbiologie , Endocardite bactérienne/thérapie , Femelle , Bactéries à Gram négatif/isolement et purification , Bactéries à Gram positif/isolement et purification , Valvulopathies/microbiologie , Valvulopathies/thérapie , Hospitalisation , Humains , Mâle , Adulte d'âge moyen , , Études rétrospectives , Turquie/épidémiologieRÉSUMÉ
BACKGROUND: Our aim was to investigate the clinical and prognostic features of the patients with prosthetic valve endocarditis (PVE) in a multicenter nation-wide study. METHODS: The present nation-wide study consisted of 75 consecutive patients with PVE treated at 13 major hospitals in Turkey from 2005 to 2012. RESULTS: The patients who died during follow-up were significantly older than the survivors and had higher C-reactive protein (CRP), creatinine, poor NYHA functional class and large vegetations. High creatinine level (odds ratio [OR] 2.6, 95% confidence interval [CI] 1.14-6.13), poor functional status (OR 24.5; 95% CI 3.1-196.5) and high CRP (OR 1.02; 95% CI1.00-1.03) measured on admission were independent risk associates for in-hospital mortality. CONCLUSIONS: High creatinine level, poor functional status and high CRP measured on admission were independent risk associates for in-hospital mortality, whereas a NYHA class ofIII/IV and high CRP reflected independent risk for stroke/mortality end point.
Sujet(s)
Endocardite/mortalité , Implantation de valve prothétique cardiaque/effets indésirables , Prothèse valvulaire cardiaque/effets indésirables , Infections dues aux prothèses/mortalité , Adolescent , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Marqueurs biologiques/sang , Protéine C-réactive/analyse , Loi du khi-deux , Créatinine/sang , Endocardite/sang , Endocardite/diagnostic , Femelle , État de santé , Implantation de valve prothétique cardiaque/instrumentation , Mortalité hospitalière , Humains , Modèles logistiques , Mâle , Adulte d'âge moyen , Analyse multifactorielle , Odds ratio , Pronostic , Infections dues aux prothèses/sang , Infections dues aux prothèses/diagnostic , Facteurs de risque , Accident vasculaire cérébral/mortalité , Facteurs temps , Turquie/épidémiologie , Jeune adulteSujet(s)
Aorte/malformations , Sténose aortique/chirurgie , Calcinose/imagerie diagnostique , Tumeurs du coeur/imagerie diagnostique , Myxome/imagerie diagnostique , Adulte , Calcinose/chirurgie , Cathétérisme cardiaque , Diagnostic différentiel , Échocardiographie transoesophagienne , Femelle , Tumeurs du coeur/chirurgie , Humains , Myxome/chirurgieRÉSUMÉ
OBJECTIVES: We aimed to investigate the demographic and clinical characteristics, echocardiographic and microbiologic features, and outcomes of patients with permanent pacemaker (PM) and implantable cardioverter-defibrillator (ICD) endocarditis in this study. STUDY DESIGN: The study population consisted of 15 patients with permanent PM and ICD endocarditis. Data on demographics, medications, clinical procedures, microbiology, echocardiography, surgery, and outcome were collected. RESULTS: The mean age of the patients was 57 ± 16. Seven patients (47%) were female. Of the 15 permanent PM and ICD endocarditis patients, 5 died during hospital follow-up (33%). Four patients (27%) experienced a pulmonary embolism. Culture-negative endocarditis was seen in 5 cases (33%). Staphylococci were the most common causative organisms (60%). Three patients had undergone surgical treatment (20%). CONCLUSION: Cardiac device-related endocarditis remain a rare but potentially fatal complication of device implantation.
Sujet(s)
Défibrillateurs implantables/effets indésirables , Endocardite/étiologie , Pacemaker/effets indésirables , Infections à Pseudomonas/étiologie , Infections à staphylocoques/étiologie , Adulte , Sujet âgé , Sujet âgé de 80 ans ou plus , Endocardite/complications , Endocardite/mortalité , Femelle , Humains , Mâle , Adulte d'âge moyen , Pseudomonas aeruginosa , Embolie pulmonaire/étiologie , Infections à staphylocoques/complications , Infections à staphylocoques/mortalité , Staphylococcus aureus , Staphylococcus epidermidis , Jeune adulteRÉSUMÉ
OBJECTIVES: Neurally mediated syncope is defined as a transient loss of blood flow to the brain, resulting in vasodilatation, bradycardia, or both. The pathophysiologic mechanisms of neurally mediated syncope are not clear. In this study, we investigated carotid artery elasticity parameters in patients with neurally mediated syncope. METHODS: The study was conducted on 41 patients who were examined by the tilt table test. Group 1 constituted of 21 patients who had a positive response to the tilt table test. Clinical and hemodynamic parameters were compared with patients in a negative tilt table test group (group 2). The systolic and diastolic diameters of the carotid arteries, carotid distensibility, carotid strain, carotid stiffness index, and carotid elastic modulus of the left carotid arteries were calculated by a high-resolution ultrasound device. RESULTS: No differences in hemodynamic variables or clinical parameters were detected between the groups. Carotid distensibility (mean ± SD, 1.6 ± 0.6 versus 2.2 ± 0.8 cm(2) × dyne(-1) × 10(-6); P = .044) and strain (6.8% ± 1.7% versus 8.2% ± 1.9%; P = .026) were lower in group 1 than in group 2. The carotid elastic modulus (0.88 ± 0.33 versus 0.74 ± 0.25 cm(2) × dyne(-1) × 10(-6); P = .002) and stiffness index (6.7 ± 0.4 versus 6.2 ± 0.5; P = .038) were higher in group 1. CONCLUSIONS: In this study, we concluded that elastic properties of the carotid artery are impaired in patients with neurally mediated syncope. This finding suggests that impaired carotid arterial elasticity may be a factor in the pathophysiologic mechanisms of neurally mediated syncope.
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Artères carotides/imagerie diagnostique , Artères carotides/physiopathologie , Échocardiographie/méthodes , Syncope vagale/physiopathologie , Adulte , Module d'élasticité , Femelle , Hémodynamique , Humains , Mâle , Statistique non paramétrique , Test d'inclinaisonRÉSUMÉ
Chylopericardium is an uncommon but potentially life-threatening clinic entity. Here we reported a case with chylopericardium causing tamponade and shock as an unusual presentation of lymphoma. The patient was managed by immediate pericardiocentesis. Further analysis of the pericardial fluid revealed immature T-cells compatible with precursor T-lymphoblastic lymphoma.
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Tamponnade cardiaque/étiologie , Épanchement péricardique/complications , Leucémie-lymphome lymphoblastique à précurseurs T/complications , Tamponnade cardiaque/diagnostic , Tamponnade cardiaque/chirurgie , Association thérapeutique , Diagnostic différentiel , Échocardiographie , Électrocardiographie , Cytométrie en flux , Études de suivi , Humains , Mâle , Épanchement péricardique/diagnostic , Épanchement péricardique/chirurgie , Péricardiocentèse , Leucémie-lymphome lymphoblastique à précurseurs T/diagnostic , Leucémie-lymphome lymphoblastique à précurseurs T/thérapie , Tomodensitométrie , Jeune adulteRÉSUMÉ
Ingestion of acid-containing household products, either accidentally or as a suicide attempt, is a common form of intoxication. A clear and odorless liquid, hydrogen peroxide is an oxidizing agent found in most households and many industrial environments. Cardiovascular manifestations of hydrogen peroxide ingestion are extremely rare. Here we report a 60 year-old woman with acute inferolateral myocardial infarction (MI) after hydrogen peroxide ingestion, who had no history of coronary artery disease. Physicians dealing with hydrogen peroxide ingestion in the emergency department should be aware of the probability of MI and obtain an electrocardiogram, even if the patient has no cardiac complaint.