Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 4 de 4
Filter
Add more filters










Database
Language
Publication year range
2.
J Cardiol Cases ; 26(6): 432-435, 2022 Dec.
Article in English | MEDLINE | ID: mdl-36506494

ABSTRACT

This case series presents patients who presented to the hospital with an outside hospital cardiac arrest and were initially resuscitated successfully. All patients suffered fatal traumatic injuries during the resuscitation process with the common variable being the use of mechanical cardiopulmonary resuscitation (CPR) device. The goal of this case series is to describe the limitations and potential fatal side effects of CPR. We also present a review of literature with our impressions of the appropriate indications for the use of mechanical CPR. Learning objectives: 1) Recognize appropriate indications for the use of mechanical vs manual cardiopulmonary resuscitation (CPR). 2) Identify signs and symptoms of mechanical CPR-related complications.

3.
J Cardiovasc Magn Reson ; 24(1): 3, 2022 01 03.
Article in English | MEDLINE | ID: mdl-34980165

ABSTRACT

BACKGROUND: Atrial fibrillation (AF) is a progressive condition, which is characterized by inflammation/fibrosis of left atrial (LA) wall, an increase in the LA size/volumes, and decrease in LA function. We sought to investigate the relationship of anatomical and functional parameters obtained by cardiovascular magnetic resonance (CMR), with AF recurrence in paroxysmal AF (pAF) patients after catheter ablation. METHODS: We studied 80 consecutive pAF patients referred for ablation, between January 2014 and December 2019, who underwent pre- and post-ablation CMR while in sinus rhythm. LA volumes were measured using the area-length method and included maximum, minimum, and pre-atrial-contraction volumes. CMR-derived LA reservoir strain (ℇR), conduit strain (ℇCD), and contractile strain (ℇCT) were measured by computer assisted manual planimetry. We used a multivariate logistical regression to estimate the independent predictors of AF recurrence after ablation. RESULTS: Mean age was 58.6 ± 9.4 years, 75% men, mean CHA2DS2-VASc score was 1.7, 36% had prior cardioversion and 51% were taking antiarrhythmic drugs. Patients were followed for a median of 4 years (Q1-Q3 = 2.5-6.2 years). Of the 80 patients, 21 (26.3%) patients had AF recurrence after ablation. There were no significant differences between AF recurrence vs. no recurrence groups in age, gender, CHA2DS2-VASc score, or baseline comorbidities. At baseline, patients with AF recurrence compared to without recurrence had lower LV end systolic volume index (32 ± 7 vs 37 ± 11 mL/m2; p = 0.045) and lower ℇCT (7.1 ± 4.6 vs 9.1 ± 3.7; p = 0.05). Post-ablation, patients with AF recurrence had higher LA minimum volume (68 ± 32 vs 55 ± 23; p = 0.05), right atrial volume index (62 ± 20 vs 52 ± 19 mL/m2; p = 0.04) and lower LA active ejection fraction (24 ± 8 vs 29 ± 11; p = 0.05), LA total ejection fraction (39 ± 14 vs 46 ± 12; p = 0.02), LA expansion index (73.6 ± 37.5 vs 94.7 ± 37.1; p = 0.03) and ℇCT (6.2 ± 2.9 vs 7.3 ± 1.7; p = 0.04). Adjusting for clinical variables in the multivariate logistic regression model, post-ablation minimum LA volume (OR 1.09; CI 1.02-1.16), LA expansion index (OR 0.98; CI 0.96-0.99), and baseline ℇR (OR 0.92; CI 0.85-0.99) were independently associated with AF recurrence. CONCLUSION: Significant changes in LA volumes and strain parameters occur after AF ablation. CMR derived baseline ℇR, post-ablation minimum LAV, and expansion index are independently associated with AF recurrence.


Subject(s)
Atrial Fibrillation , Catheter Ablation , Aged , Atrial Fibrillation/diagnostic imaging , Atrial Fibrillation/surgery , Catheter Ablation/adverse effects , Female , Heart Atria/diagnostic imaging , Heart Atria/surgery , Humans , Magnetic Resonance Spectroscopy , Male , Middle Aged , Predictive Value of Tests , Recurrence , Treatment Outcome
4.
Handb Clin Neurol ; 177: 57-63, 2021.
Article in English | MEDLINE | ID: mdl-33632457

ABSTRACT

While risk factors for the development of neurovascular and coronary heart disease (CHD) are similar, it is important to consider neurologic complications of CHD separately, as many of these complications are a direct result of the underlying condition or procedures performed to treat atherosclerotic coronary disease. Stroke after myocardial infarction (MI) and acute coronary syndromes (ACSs) is not infrequent, occurring in 0.7%-2.5% of patients within 6 months of the coronary event. The etiology of these events can be frequently traced to the development of left ventricular thrombus (LVT) formation after large MI episodes. Often, however, these events are directly related to catheter-based procedures or anticoagulation strategies utilized to treat the ACS. Ischemic strokes outnumber hemorrhagic strokes in this population. While there is a modest evidence base for use of anticoagulation to treat LVT, catheterization-related ischemic stroke and anticoagulation-related hemorrhagic stroke are typically managed via standard approaches.


Subject(s)
Coronary Disease , Myocardial Infarction , Thrombosis , Blood Coagulation , Humans , Stroke/complications , Stroke/therapy
SELECTION OF CITATIONS
SEARCH DETAIL
...