Robert J Puchalski, Russell A Denman, Haris M Haqqani, Vincent R Deen
INTRODUCTION: Left-bundle branch area pacing (LBBAP) is a relatively new technique for conduction system pacing. Australian safety and efficacy data is currently lacking. We aim to evaluate the learning curve, medium-term safety, and lead performance in a high-volume Australian setting. METHODS: We performed a retrospective cohort study of 200 consecutive LBBAP procedures performed by a single operator at two centres between January 2019 and May 2020. Left bundle branch area pacing was performed predominantly via left subclavian access using a 69 cm Medtronic SelectSecure 3830 pacing lead and a preformed non-steerable C315-His sheath...
May 24, 2023: Heart, Lung & Circulation
Yuanzhao Cao, Meredith A Redd, Chen Fang, Dalia Mizikovsky, Xichun Li, Peter S Macdonald, Glenn F King, Nathan J Palpant
Acute myocardial infarction (AMI) is the leading cause of morbidity and mortality worldwide and the primary underlying risk factor for heart failure. Despite decades of research and clinical trials, there are no drugs currently available to prevent organ damage from acute ischaemic injuries of the heart. In order to address the increasing global burden of heart failure, drug, gene, and cell-based regeneration technologies are advancing into clinical testing. In this review we highlight the burden of disease associated with AMI and the therapeutic landscape based on market analyses...
May 23, 2023: Heart, Lung & Circulation
Andrew J Kerr, Yeunhyang Catherine Choi, Helen L Pilmore
AIMS: Guidelines recommend management with an invasive coronary angiogram in acute coronary syndromes (ACS), but most studies excluded patients with advanced chronic kidney disease (CKD). Our aims were to describe, in a comprehensive ACS cohort, the incidence of CKD, coronary angiography utilisation and outcomes, according to CKD stage. METHODS: National datasets were used to identify hospitalised ACS patients (2013 to 2018) in the Northern region of New Zealand...
May 23, 2023: Heart, Lung & Circulation
Simon Rocheleau, Joanne Eng-Frost, Kristina Lambrakis, Ehsan Khan, Brian Chiang, Naomi Wattchow, Simon Steele, Scott Lorensini, Sam J Lehman, Cynthia Papendick, Derek P Chew
BACKGROUND: Diagnosis of acute myocardial infarction (AMI) requires a combination of elevated cardiac troponins, and clinical or echocardiographic evidence of coronary ischaemia. Identification of patients with a high likelihood of coronary plaque rupture (Type 1 myocardial infarction [MI]) is crucial as it is these patients for whom coronary intervention has been well-established to provide benefit and reduce subsequent coronary ischemic events. However, high-sensitivity cardiac troponin (hs-cTn) assays have increasingly identified patients with hs-cTn elevations not due to Type 1 MI where recommendations for ongoing care are currently limited...
May 22, 2023: Heart, Lung & Circulation
Jeremy William, Jack Shembrey, Edward Quine, Mark Perrin, Daryl Ridley, Ramanathan Parameswaran, Peter M Kistler, Aleksandr Voskoboinik
BACKGROUND: Polymorphic ventricular tachycardia (PMVT) is a highly lethal arrhythmia which is commonly caused by acute myocardial ischaemia. PMVT mediated by short-coupled ventricular ectopy patients with ischaemic heart disease but in the absence of acute ischaemia may relate to transient peri-infarct Purkinje fibre irritability and has been termed 'Angry Purkinje Syndrome'. METHODS: We present a case series of three patients with PMVT storm 3-5 days following coronary artery bypass graft surgery (CABG)...
May 18, 2023: Heart, Lung & Circulation
Maya Guglin, Roopa A Rao
BACKGROUND: Aortic valve (AV) thrombosis is an uncommon but ominous complication in patients managed with mechanical circulatory support (MCS) devices. In this systematic review, we summarised the data on clinical presentations and outcomes in such patients. METHODS: We searched articles on PubMed and Google Scholar, reporting at least one adult patient with aortic thrombosis on MCS support and where the individual patient data could be extracted. We grouped the patients by the type of MCS (temporary or durable), and the type of the AV (prosthetic, surgically modified, or native) RESULTS: We identified reports on six patients with aortic thrombus on short-term MCS, and on 41 patients on durable left ventricular assist devices (LVADs)...
May 16, 2023: Heart, Lung & Circulation
Edward Buratto, Fraser Wallace, Antonia Schulz, Michael Zhu, Shuta Ishigami, Christian P Brizard, Igor E Konstantinov
BACKGROUND: It has been proposed that delaying the Ross procedure to later in childhood, allowing autograft stabilisation and placement of a larger pulmonary conduit, may improve outcomes. However, the effect of age at the time of Ross procedure on outcomes remains unclear. METHODS: All patients who underwent the Ross procedure between 1995 and 2018 were included in the study. Patients were divided into four groups: infants, age 1 to 5 years, age 5 to 10 years and age 10 to 18 years...
May 10, 2023: Heart, Lung & Circulation
Jonathan Shurlock, Stewart Brown, Mark Dayer, Guy Furniss
OBJECTIVE: To assess the safety, efficacy, and patient acceptability of a pacemaker home monitoring (HM) service. METHODS: All patients receiving a new Biotronik (Biotronik, Berlin, Germany) pacemaker between March 2020 and February 2021 were contacted for participation. Participants were surveyed on their experience of pacemaker HM. HM alerts and remote wound monitoring rates were also assessed. RESULTS: Of the patients contacted, 77% responded, with a mean age of 80...
May 5, 2023: Heart, Lung & Circulation
Allan Davies, Paul Bamford, Stephen Briennese, Robert Smith
Transcatheter mitral valve repair (TMVr) has emerged as a safe and effective alternative to conventional surgery in patients with primary and secondary mitral regurgitation, especially those at high surgical risk. This review summarises alternative indications for TMVr outside of the traditional criteria derived from the major randomised trials and focusses on less common mitral valve anatomies such as commissural prolapse and bileaflet prolapse, patients with mitral annuloplasty rings, as well as acutely unwell patients with papillary muscle rupture and/or cardiogenic shock...
May 5, 2023: Heart, Lung & Circulation
Jen-Li Looi, Christina Chan, James Pemberton, Alison Nankivell, Peter McLeod, Mark Webster, Andrew To, Mildred Lee, Andrew J Kerr
BACKGROUND AND AIMS: Clinical presentation of Takotsubo Syndrome (TS) mimics acute coronary syndrome (ACS). A score to differentiate TS from ACS would be helpful to facilitate appropriate investigation and management. We have previously developed a clinical score (NSTE-Takotsubo Score) to distinguish women with non-ST-segment elevation myocardial infarction (NSTEMI) from TS with non-ST-segment elevation (NSTE-TS). This study sought to assess the diagnostic validity of this score in an external validation cohort...
April 28, 2023: Heart, Lung & Circulation
Rohan V Navani, Luke P Dawson, Emily Nehme, Ziad Nehme, Jason Bloom, Shelley Cox, David Anderson, Michael Stephenson, Jeffrey Lefkovits, Andrew J Taylor, David Kaye, Karen Smith, Dion Stub
BACKGROUND: Previous studies examining temporal variations in cardiovascular care have largely been limited to assessing weekend and after-hours effects. We aimed to determine whether more complex temporal variation patterns might exist in chest pain care. METHODS: This was a population-based study of consecutive adult patients attended by emergency medical services (EMS) for non-traumatic chest pain without ST elevation in Victoria, Australia between 1 January 2015 and 30 June 2019...
April 24, 2023: Heart, Lung & Circulation
Ureni Halahakone, Sameera Senanayake, Victoria McCreanor, William Parsonage, Sanjeewa Kularatna, David Brain
BACKGROUND: Screening for Atrial Fibrillation (AF) is recommended for people aged above 65 years. Screening for AF in asymptomatic individuals can be beneficial by enabling earlier diagnosis and the commencement of interventions to reduce the risk of early events, thus improving patient outcomes. This study systematically reviews the literature about the cost-effectiveness of various screening methods for previously undiagnosed AF. METHODS: Four databases were searched to identify articles that are cost-effectiveness studies conducted on screening for AF published from January 2000 to August 2022...
April 24, 2023: Heart, Lung & Circulation
András Vereckei, András Simon, Gábor Szénási, John M Miller
BACKGROUND: The three-step Brugada group algorithm is the only published electrocardiographical (ECG) algorithm for differentiating ventricular tachycardia (VT) from pre-excited tachycardia (PXT) as a cause of regular wide QRS complex tachycardia (WCT). This study aimed to improve the diagnostic accuracy of the Brugada group algorithm. METHODS: This study modified the Brugada group algorithm by adding a new aVR lead criterion (initial positive deflection in lead aVR and the QRS complex area above the baseline is greater than the area below the baseline)...
April 22, 2023: Heart, Lung & Circulation
Charles Krisnanda, Celly Anantaria Atmadikoesoemah, Virandra Biramanandi Kusmanto, Rarsari Soerarso, Elen, Sugisman, Manoefris Kasim
No abstract text is available yet for this article.
April 19, 2023: Heart, Lung & Circulation
Benjamin Anderson, Robert Justo, Cameron Ward
BACKGROUND: Aortic arch pathology in older children is often treated preferentially with stenting. Both bare metal and covered stents have been utilised, with potential advantages of covered stents. The search for the ideal covered stent continues. METHODS: Retrospective review of all paediatric patients undergoing treatment of aortic arch pathology utilising the Bentley BeGraft Aortic stent (BeGraft Aortic, Bentley InnoMed, Hechingen, Germany) from June 2017 to May 2021...
April 16, 2023: Heart, Lung & Circulation
Giulia Peacock, Darshan Kothari, Luigi D'Orsogna, Jan E Dickinson, David Andrews, Deane Yim
BACKGROUND: Vascular rings, including right aortic arch with aberrant left subclavian artery (RAA-ALSCA), double aortic arch (DAA) and pulmonary artery sling (PAS), are congenital anomalies that may cause airway and oesophageal compression. As prenatal detection has improved, literature comparing clinical outcomes of antenatally versus postnatally diagnosed cases continues to emerge. The aim is to define a statewide tertiary paediatric institution's clinical profile and outcomes of prenatal versus postnatally diagnosed isolated vascular rings...
April 13, 2023: Heart, Lung & Circulation
Anjali J Ravichandran, Francisco J Romeo, Renata Mazurek, Kiyotake Ishikawa
No abstract text is available yet for this article.
April 11, 2023: Heart, Lung & Circulation
Kristina Torngren, Rebecca Rylance, Li-Ming Gan, Elmir Omerovic, Sara Svedlund, David Erlinge
BACKGROUND: The pleiotropic action of ticagrelor, with effects in addition to platelet inhibition, has been shown to improve endothelial function in patients with coronary artery disease. These positive effects are possibly adenosine mediated. This study investigated the association of ticagrelor therapy and coronary artery flow reserve in survivors of myocardial infarction (MI). METHODS: This was an exploratory, cross-sectional, open substudy of PROFLOW. High-risk individuals with a history of MI were identified...
April 10, 2023: Heart, Lung & Circulation
Paloma Remior Pérez, Robyn J Hylind, Thomas M Roston, Vassilios J Bezzerides, Dominic J Abrams
Over the last three decades, the genetic basis of various inherited arrhythmia syndromes has been elucidated, providing key insights into cardiomyocyte biology and various regulatory pathways associated with cellular excitation, contraction, and repolarisation. As varying techniques to manipulate genetic sequence, gene expression, and different cellular pathways have become increasingly defined and understood, the potential to apply various gene-based therapies to inherited arrhythmia has been explored. The promise of gene therapy has generated significant interest in the medical and lay press, providing hope for sufferers of seemingly incurable disorders to imagine a future without repeated medical intervention, and, in the case of various cardiac disorders, without the risk of sudden death...
April 7, 2023: Heart, Lung & Circulation
Bérénice C Collet, Darryl R Davis
Heart failure is an important cause of morbidity and mortality. More than 20 years ago, special interest was drawn to cell therapy as a means of restoring damaged hearts to working condition. But progress has not been straightforward as many of our initial assumptions turned out to be wrong. In this review, we critically examine the last 20 years of progress in cardiac cell therapy and focus on several of the popular beliefs surrounding cell therapy to illustrate the mechanisms involved in restoring heart function after cardiac injury...
April 6, 2023: Heart, Lung & Circulation
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