Heart : official journal of the British Cardiac Society
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To investigate long-term efficacy of catheter ablation for atrial fibrillation (AF) and the impact of ablating complex or fractionated electrograms (CFEs) in addition to pulmonary vein isolation and linear lesions in persistent AF (PeAF). ⋯ Long-term freedom from AF is achievable in most patients with PAF and PeAF with low rates of late recurrence. Additional targeting of CFE improves outcome for PeAF. Late adverse events including stroke are few.
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The use of the HeartMate II continuous-flow left ventricular assist device (LVAD) improves survival, quality of life and functional capacity of patients with advanced heart failure. However, no study so far has shown the benefits of these devices for cardiac function during peak exercise. ⋯ It has been shown for the first time that the HeartMate II LVAD can confer both resting and peak cardiac functional benefits to patients with end-stage heart failure, thus improving exercise capacity.
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We sought to evaluate prognostic markers of clinical outcome in asymptomatic patients with moderate to severe aortic stenosis (AS). ⋯ In asymptomatic patients with moderate to severe AS, measurements that integrate the ventricular, vascular and valvular components of the disease improve risk stratification.
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Vasoreactivity testing is recommended in the management of pulmonary arterial hypertension (PAH), but its clinical relevance in congenital heart disease (CHD)-associated PAH has not been established. ⋯ Pulmonary vasoreactivity is a significant predictor of clinical worsening in patients with CHD-PAH.
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To evaluate the predictors of pulmonary artery systolic pressure (PASP) in organic mitral regurgitation (MR) and its prognostic value after surgery. ⋯ In organic MR, mitral deceleration time, mitral E/E' and left atrial volume correlate with PASP. Pulmonary artery systolic pressure > or = 50 mmHg is an independent predictor of overall and cardiovascular mortality after surgery in organic MR.