Cardiol J
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Review
A review of the utility of a hypothermia protocol in cardiac arrests due to non-shockable rhythms.
Therapeutic hypothermia and targeted temperature management are considered standard of care in the management of patients following out-of-hospital cardiac arrests due to shockable rhythms to improve neurological outcomes. In those presenting out-of-hospital cardiac arrests associated with non-shockable rhythms, the benefit of hypothermia is less clear. In this review we try to clarify the utility of implementing a hypothermia protocol after cardiac arrests due to non-shockable rhythms. ⋯ It was concluded that further study is needed to characterize patients presenting nonshockable rhythms who would benefit from hypothermia to better guide its use in this population given the costs and implications of treatment and long-term care in those who survive with poor outcomes.
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Randomized Controlled Trial
Efficacy of nicorandil treatment for prevention of contrast-induced nephropathy in high-risk patients undergoing cardiac catheterization: A prospective randomized controlled trial.
Contrast-induced nephropathy (CIN) remains to be a potentially serious complication of radiographic procedures and is the third leading cause of the acute kidney injury (AKI) among hospitalized patients. This clinical trial was performed to assess the preventive effect of oral nicorandil on CIN in high-risk patients undergoing cardiac catheterization. ⋯ The findings revealed that oral nicorandil had substantial efficacy over hydration protocol for the development of CIN in high-risk patients undergoing cardiac catheterization.
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Ischemic stroke is a common complication of atrial fibrillation (AF). Currently, oral anticoagulant drugs are the most commonly used method of stroke prevention. Left atrial appendage occlusion is thought to be the main source of thrombi in patients with AF. ⋯ Currently, there are several types of devices available for left atrial appendage occlusion. Since the first percutaneous left atrial appendage occlusion in 2002 many studies have investigated both the safety and efficacy of this therapy using different closure devices. Still unresolved issues include a lack of data on optimal patient selection, risk of complications, and anticoagulant treatment after left atrial appendage occlusion.
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Conduction disturbances requiring permanent pacemaker implantation following transcatheter aortic valve replacement (TAVR) are a common problem. Pacemaker implantation rates after TAVR appear to be higher compared to conventional aortic valve replacement. The aim of this study was to analyze whether a high annulus implantation conveys the benefit of a decreased rate of permanent pacemaker implantation while being safe and successful according to Valve Academic Research Consortium 2 (VARC2)-criteria. ⋯ The approach of the modified implantation technique of Lotus TAVR device was safe and effective. The incidence of need for a permanent pacemaker following TAVR could be significantly reduced due to adopted implantation protocol.
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Multicenter Study Observational Study
The impact of transferring patients with ST-segment elevation myocardial infarction to percutaneous coronary intervention-capable hospitals on clinical outcomes.
Primary percutaneous coronary intervention (PCI) is recommended for ST-segment elevation myocardial infarction (STEMI) patients even when the patient must be transported to a PCI-capable hospital. This study aimed to evaluate the long-term clinical outcomes of STEMI patients who were transferred for primary PCI compared to patients who arrived directly to PCI-capable hospitals. ⋯ Transferring STEMI patients to PCI-capable hospitals with a time delay did not affect clinical outcomes after 1 year. This study suggests that inter-hospital transfer should be encouraged even with delay for STEMI patients who require primary PCI in areas with a similar geographic accessibility.