Assessment of the Impact of Cardiac Implantable Electronic Devices on Patients' Quality of Life.

INTRODUCTION: Assessing the quality of life serves as a crucial metric during various therapeutic or surgical procedures. The rise in cardiac electronic device implantations in recent years underscores the significance of evaluating the quality of life among such patients. MATERIALS AND METHODS: We conducted a study focusing on the quality of life of 438 patients with cardiac implantable electronic devices (cardiac pacemakers, cardioverter-defibrillators, cardiac resynchronization therapy devices). These patients were diagnosed with sick sinus syndrome, high-degree atrioventricular (AV) block, or severe heart failure (New York Heart Association (NYHA) classes III- IV (NYHA III-IV)), with left ventricular ejection fraction (LVEF) ≤ 35%, with/without complete left bundle branch block (QRS ≥ 130 µs), or with a history of ventricular tachycardia/ventricular fibrillation. The study utilized the EuroQol 5-Dimension 5-level (EQ-5D-5L) questionnaire and the EQ visual analog scale, which patients completed both prior to cardiac device implantation and during six post-implantation follow-up visits. The analysis of the research findings was conducted using the IBM SPSS Statistics software program (Armonk, NY). RESULTS: Cardiac pacemaker implantation in patients with sick sinus syndrome and high-grade AV block demonstrated significant and highly reliable positive effects on quality of life concerning mobility, self-care, and usual activity. Similarly, cardiac resynchronization device implantation in individuals with severe heart failure with reduced LVEF and wide QRS showed significant positive effects in these areas. However, cardioverter-defibrillator implantation did not yield positive effects on these modules. Regarding pain/discomfort, neither pacemaker nor cardiac resynchronization device implantation resulted in improved quality of life, while there was a somewhat positive effect observed in the cardioverter-defibrillator group. In terms of anxiety/depression, pacemaker implantation in patients with sick sinus syndrome and high-degree AV block had a significant and highly reliable positive impact on quality of life. Additionally, relatively positive impacts were noted at various periods following cardioverter-defibrillator and cardiac resynchronization device implantations. CONCLUSIONS: Cardiac implantable electronic devices play a crucial role not only in saving lives but also in positively impacting the quality of life of patients when appropriately selected.

Tietze Syndrome as a Cause of Chest Pain in the Post-COVID-19 Period.

Tietze syndrome is a rare disease. It is mainly characterized by chest pain caused by a unilateral and monoarticular lesion of the second-fifth costal joints. Tietze syndrome is one of the potential complications in the post-COVID-19 period. It is one of the differential diagnoses for non-ischemic chest pain. With early diagnosis and appropriate treatment, this syndrome is easily manageable. The authors present a case of a 38-year-old male who had been diagnosed with Tietze syndrome in the post-coronavirus disease 2019 (COVID-19) period.

Technical difficulties during electronic cardiac device implantation in patients with persistent left superior vena cava.

We report a case of persistent left superior vena cava (PLSVC), discovered by chance during the cardiac electronic device placement procedure. PLSVCs are congenital anomalies of the thoracic vasculature, during which remnants of the left superior vena cava drain into the right atrium through the coronary sinus. PLSVCs can vary in their location and overall anatomy. In patients with PLSVC, implantation of a cardiac electronic device is associated with an increased risk of technical difficulties the entire procedure.

Iatrogenic tracheal rupture after extubation in the context of acute decompensated heart failure and cardiac device implantation: a case report.

Iatrogenic tracheal rupture is a life-threatening airway complication. It has a very low reported incidence and is more prevalent in women and patients over 50 years of age. The most frequent clinical manifestations of tracheal injury are subcutaneous emphysema and respiratory distress. We report a case of a 65-year-old woman with cardiac resynchronization therapy defibrillator implantation under general anesthesia. Shortly after extubation, dyspnea and subcutaneous emphysema appeared. The X-ray showed pneumomediastinum, pneumopericardium and pneumoperitoneum. The tracheal rupture was confirmed by bronchoscopy. After conservative treatment, the patient's well-being improved, and she was discharged from the hospital in a satisfactory condition.