International journal of cardiology
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The ECG studies of the international HERO-2 trial in ST elevation myocardial infarction (STEMI) patients evaluated the prognostic value of ECGs systematically recorded at baseline and at 60-min post-administration of fibrinolytic therapy. Patients were overall managed conservatively with a low percentage undergoing angiography. Many of the analyses were pre-specified. ⋯ The strength of having serial ECG recordings is discussed as is the weakness of lacking angiographic correlation. The paper discusses with take-home points (Table 1) the prognostic implications of bundle branch blocks, QRS duration, Q waves in infarct leads, V1 ST elevation during inferior STEMI, lead aVR ST changes and new ST depression in the infarct leads after fibrinolysis. With the ever increasing emphasis on early (including pre-hospital) therapies for STEMI, a diagnosis based on the 12-lead ECG, the current summary article provides helpful hints to fully extract ECG information, and a vision for future STEMI diagnosis and management.
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Review Meta Analysis Comparative Study
PFO closure vs. medical therapy in cryptogenic stroke or transient ischemic attack: a systematic review and meta-analysis.
This study aims to assess whether patent foramen ovale (PFO) closure is superior to medical therapy in preventing recurrence of cryptogenic ischemic stroke or transient ischemic attack (TIA). ⋯ This meta-analysis does not support PFO closure for secondary prevention with unselected devices in cryptogenic stroke/TIA. In subgroup analysis, selected closure devices may be superior to medical therapy without increasing the risk of new-onset AF, however. This observation should be confirmed in further trials using inclusion criteria for patients with high likelihood of PFO-related stroke recurrence.
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Review Meta Analysis
Benefits and risks of additional ablation of complex fractionated atrial electrograms for patients with atrial fibrillation: a systematic review and meta-analysis.
The benefits and risks of additional complex fractionated atrial electrograms (CFAE) ablation in patients with atrial fibrillation (AF) remain unclear. ⋯ The adjunctive CFAE ablation could provide additional benefit in terms of reducing recurrence of atrial tachyarrhythmia for patients with nonparoxysmal AF but not for patients with paroxysmal AF after a single procedure with or without antiarrhythmic drugs (AADs). The main risk of adjunctive CFAE ablation is the increasing rate of untraceable postablation ATs.
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Review Meta Analysis
Benefits and risks of additional ablation of complex fractionated atrial electrograms for patients with atrial fibrillation: a systematic review and meta-analysis.
The benefits and risks of additional complex fractionated atrial electrograms (CFAE) ablation in patients with atrial fibrillation (AF) remain unclear. ⋯ The adjunctive CFAE ablation could provide additional benefit in terms of reducing recurrence of atrial tachyarrhythmia for patients with nonparoxysmal AF but not for patients with paroxysmal AF after a single procedure with or without antiarrhythmic drugs (AADs). The main risk of adjunctive CFAE ablation is the increasing rate of untraceable postablation ATs.