Cardiovascular Medicine

5 pages, 1051 KB

Open AccessCase Report

Isolated Right Ventricular Myocardial Infarction

by Andrea Papa, Edira Bekiri, Marco Giacchi and Gregor Leibundgut

Cardiovasc. Med. 2023, 26(6), 206; https://doi.org/10.4414/cvm.2023.1190638221 - 22 Nov 2023

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A 67-year-old man with known coronary artery disease was rescued after an out-of-hospital cardiac arrest due to ventricular fibrillation (VF) and admitted to the catheterization laboratory with inferior ST-segment elevation, right bundle branch block and atrial fibrillation on the electrocardiogram. The patient had [...] Read more.

A 67-year-old man with known coronary artery disease was rescued after an out-of-hospital cardiac arrest due to ventricular fibrillation (VF) and admitted to the catheterization laboratory with inferior ST-segment elevation, right bundle branch block and atrial fibrillation on the electrocardiogram. The patient had had an elective percutaneous coronary intervention (PCI) with implantation of a bare metal stent to the dominant mid left circumflex artery three years before and a second PCI with implantation of a drug-eluting stent to the proximal/mid left anterior descending artery at another local institution three months earlier. The prescribed dual antiplatelet therapy was interrupted by the patient right after discharge. Therefore, a stent thrombosis was initially deemed the most probable cause of his clinical presentation (the elephant in the room). Nevertheless, the coronary angiography showed patent stents and the left ventriculography revealed a normal left ventricular function. After excluding aortic dissection and pulmonary embolism, cardiac magnetic resonance imaging showed signs of acute isolated right ventricular myocardial infarction. Upon review of previous angiograms, a small occluded right ventricular branch appeared to be the lesion that triggered the VF. Full article

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3 pages, 1855 KB

Open AccessCase Report

Treatment of Complex Atrial Arrhythmias in Lamin Heart Disease

by Stefano Caselli, Lam Dang, Kurt Mayer, Christine Attenhofer Jost and Christoph Scharf

Cardiovasc. Med. 2023, 26(6), 202; https://doi.org/10.4414/cvm.2023.1243927837 - 22 Nov 2023

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Abstract

We report unusual manifestations of Lamin mutations (noncompaction, vertical pulmonary vein connection) associated with highly complex atrial arrhythmias, which were not mappable by contact mapping due to unstable reference and activation patterns. The advantages of a novel noncontact mapping technology allowing beat-to-beat analysis [...] Read more.

We report unusual manifestations of Lamin mutations (noncompaction, vertical pulmonary vein connection) associated with highly complex atrial arrhythmias, which were not mappable by contact mapping due to unstable reference and activation patterns. The advantages of a novel noncontact mapping technology allowing beat-to-beat analysis of electrical activation in the entire heart chamber simultaneously by localizing electrical charge density (Coulomb/area) are discussed. Full article

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3 pages, 817 KB

Open AccessCase Report

Right-Sided Atrial Flutter Ablation After Tricuspid Valve-in-Valve Replacement

by Gonca Suna, Fu Guan, Jonathan M. Michel and Ardan M. Saguner

Cardiovasc. Med. 2023, 26(6), 199; https://doi.org/10.4414/cvm.2023.1246902735 - 22 Nov 2023

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Abstract

A patient with previous transcatheter tricuspid valve-in-valve replacement underwent catheter ablation for symptomatic atrial flutter. An incisional and cavo-tricuspid isthmus (CTI) dependent right atrial flutter was confirmed. Ablation of the critical isthmus at the lateral right atrial wall and CTI ablation sustainably terminated [...] Read more.

A patient with previous transcatheter tricuspid valve-in-valve replacement underwent catheter ablation for symptomatic atrial flutter. An incisional and cavo-tricuspid isthmus (CTI) dependent right atrial flutter was confirmed. Ablation of the critical isthmus at the lateral right atrial wall and CTI ablation sustainably terminated the flutter. This case highlights the feasibility and safety of CTI-dependent atrial flutter ablation after tricuspid valve-in-valve replacement, which has not been reported so far. Full article

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4 pages, 275 KB

Open AccessArticle

Leadless Pacemaker Implantation via the Internal Jugular Vein

by Nadine Molitor and Alexander Breitenstein

Cardiovasc. Med. 2023, 26(6), 194; https://doi.org/10.4414/cvm.2023.1216876634 - 22 Nov 2023

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Abstract

Background: Leadless pacemaker therapy was introduced in 2013 to overcome lead- and pocket- related complications in conventional transvenous pacemaker therapy. These leadless devices are self-contained, right ventricular, single-chamber pacemakers, implanted via a femoral percutaneous approach. However, the femoral route is not always possible [...] Read more.

Background: Leadless pacemaker therapy was introduced in 2013 to overcome lead- and pocket- related complications in conventional transvenous pacemaker therapy. These leadless devices are self-contained, right ventricular, single-chamber pacemakers, implanted via a femoral percutaneous approach. However, the femoral route is not always possible due to various reasons. The aim of this analysis is to share our first experience using a jugular approach for the implantation procedure. Methods: The first ten patients who underwent leadless pacemaker implantation via the right internal jugular venous route at our center were analyzed prospectively. Follow-up period was three months. Interventional and electrical parameters of the jugular approach were compared with the data of the first 100 patients who underwent a femoral leadless pacemaker implantation at our center (implanted from 2015–2019). Results: Data from ten consecutive patients (mean age 83.3 ± 3.6 years, six males) were collected. All leadless pacemakers were implanted successfully via the internal right jugular vein. Mean procedure time was 31.9 ± 6.4 min with a mean fluoroscopy time of 3.4 ± 2.4 min. The device was positioned at the inferior septum in three patients and midseptal in seven patients. The mean pacing threshold was 0.47 ± 0.14 V at 0.24 ms pulse width with a sensed amplitude of 9.1 ± 3.8 mV. There were no complications during the procedure as well as during the three months follow-up. Pacing parameters remained stable in all patients. Conclusion: The jugular approach seems to be a safe and efficient alternative to the femoral implantation method for currently available leadless pacemakers. Full article

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3 pages, 208 KB

Open AccessReview

Digitalization and Artificial Intelligence in (Heart-) Medicine

by Guido Schüpfer and Peter Matt

Cardiovasc. Med. 2023, 26(6), 190; https://doi.org/10.4414/cvm.2023.1236103712 - 22 Nov 2023

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Abstract

Digitalization of the healthcare sector is changing its landscape. Artificial intelligence is bound to have a major impact on care providers and their interactions with their patients. As promising as new technologies may be, there will be side effects. New Technologies will place [...] Read more.

Digitalization of the healthcare sector is changing its landscape. Artificial intelligence is bound to have a major impact on care providers and their interactions with their patients. As promising as new technologies may be, there will be side effects. New Technologies will place new and higher demands on its users and will require an extremely high level of expertise to check plausibility. Alongside increases in efficiency and effectiveness, the demands on the humans in healthcare will also rise. Full article

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2 pages, 353 KB

Open AccessEditorial

Strong German Hearts 2023

by Laura Rings and Luca Koechlin

Cardiovasc. Med. 2023, 26(6), 182; https://doi.org/10.4414/cvm.2023.1249054251 - 22 Nov 2023

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Abstract

What do the special task forces of the Federal Police and heart surgeons have in common [...] Full article

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1 pages, 76 KB

Open AccessEditorial

Diversity and Variety of Cardiovascular Medicine

by Andreas Flammer

Cardiovasc. Med. 2023, 26(6), 179; https://doi.org/10.4414/cvm.2023.1293793614 - 22 Nov 2023

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Abstract

Dear readers [...] Full article

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Cardiovasc. Med., Volume 26, Issue 6 (11 2023) – 7 articles

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