Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing
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J Interv Card Electrophysiol · Jan 2012
NT-proBNP, but not ANP and C-reactive protein, is predictive of paroxysmal atrial fibrillation in patients undergoing pulmonary vein isolation.
The purpose of this study is to evaluate the relationship between plasma high-sensitivity C-reactive protein (hs-CRP), atrial natriuretic peptides (ANP), N-terminal-pro-brain natriuretic peptide (NT-proBNP) levels, and the risk and recurrence of atrial fibrillation (AF) after pulmonary vein isolation (PVI) in patients with paroxysmal atrial fibrillation (PAF). ⋯ Elevated NT-proBNP level at baseline, but not ANP and hs-CRP, is a sensitive biomarker for early predicting AF recurrence in patients with PAF.
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J Interv Card Electrophysiol · Jan 2012
Randomized Controlled TrialAtrial function after left atrial epicardial cryoablation for atrial fibrillation in patients undergoing mitral valve surgery.
To explore the effects on atrial and ventricular function of restoring sinus rhythm (SR) after epicardial cryoablation and closure of the left atrial appendage (LAA) in patients with mitral valve disease and atrial fibrillation (AF) undergoing surgery. ⋯ In patients in SR, signs of atrial dysfunction were observed in the ABL but not the control group. Atrial dysfunction may have existed before surgery, but the difference between the groups implies that the cryoablation procedure and/or closure of the LAA might have contributed.
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J Interv Card Electrophysiol · Jan 2012
Incomplete occlusion of the left atrial appendage with the percutaneous left atrial appendage transcatheter occlusion device is not associated with increased risk of stroke.
Percutaneous approaches to left atrial appendage (LAA) closure are being developed for stroke prophylaxis in atrial fibrillation patients as an alternative to warfarin. Non-randomized clinical trials suggested that the first of these devices, the percutaneous left atrial appendage transcatheter occlusion (PLAATO) device, is safe and reduces stroke risk. Percutaneous closure has the potential limitation of incomplete exclusion of LAA from the systemic circulation, which could potentially lead to thrombus formation and stroke. This study investigated the interaction between residual blood flow in the LAA after percutaneous closure with PLAATO and risk of stroke. ⋯ The main finding of our analysis suggests that in long-term follow-up, residual flow after LAA occlusion with the PLAATO device, as documented by cardiac CT, is ubiquitous but is not associated with an increased risk of stroke.
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J Interv Card Electrophysiol · Dec 2011
"Just Because We Can Doesn't Mean We Should": views of nurses on deactivation of pacemakers and implantable cardioverter-defibrillators.
This study aims to identify nurses' concerns about the clinical, ethical, and legal aspects of deactivating cardiovascular implantable electronic devices (CIEDs). ⋯ Nurses identified concerns about CIED decision making from implantation through end-of-life care and device deactivation and suggested avenues for improving patient care including early and regular advance care planning.
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J Interv Card Electrophysiol · Nov 2011
Review Meta Analysis Comparative StudyCardiac resynchronization therapy in patients with mild heart failure: a systematic review and meta-analysis.
Cardiac resynchronization therapy (CRT) reduces symptoms and improves survival in patients with advanced heart failure (New York Heart Association (NYHA) functional class III-IV), reduced ejection fraction, and wide QRS complex. Whether CRT has the same benefit also in asymptomatic or mildly symptomatic heart failure patients is controversial. Our objective is to summarize the available evidence on the effects of CRT in asymptomatic or mildly symptomatic (NYHA I-II) heart failure patients. ⋯ Among patients with mild (NYHA II) heart failure, CRT reduces mortality and the risk of heart failure events, induces a favorable LV reverse remodeling and slows the progression of heart failure symptoms.