Hospital Chronicles (E-Journal)
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Electronic Cigarette: Bridge to Quitting & Not a Substitute!
Get PDFSmoking is the leading cause of preventable death in the world and hence significant effort is made in order to promote, assist and maintain smoking cessation. Several methods have been recruited to this cause. Behavioral therapy had a relatively modest effect
Latest-Generation Drug Eluting and Bioabsorbable Stents
Get PDFPercutaneous transluminal coronary angioplasty (PTCA) was introduced in the late 1970s as an alternative to coronary artery bypass graft surgery for coronary revascularization; since then, it has been accepted as a safe, reliable, and effective treatment for coronary artery disease, and its use has spread worldwide
The Role of Vitamin D – Iron – Thiamine in Clinical Outcomes in Patients with Heart Failure
Get PDFSeveral clinical and epidemiological studies have suggested the significant role of essential micronutrients in patients with heart failure, although in clinical practice the use of these agents is controversial. An overview is herein attempted of recent data regarding current knowledge on benefits of vitamin D and B1 supplementation and iron therapy in patients with chronic heart failure
Patent Foramen Ovale Closure: The Debate Goes On
Get PDFMeta-analyses of retrospective and case-control studies support an association between a patent foramen ovale (PFO) and “cryptogenic stroke†(stroke without an identifiable cause), especially in young patients (age <55 years). Several reports have also suggested an increased risk of recurrent strokes in patients with PFO. Comparison of the two main strategies to reduce the risk of recurrent stroke in patients with cryptogenic stroke and PFO, antithrombotic therapy vs transcatheter closure of the PFO with a device, has shown PFO closure to confer a lower risk in non-randomized studies, which though has not been confirmed in randomized trials, although a tendency for a lower risk has been indicated, particularly in on-treatment or per-protocol analyses (compared with the intention-to-treat analysis), and appears to be device specific. Thus, PFO closure cannot be presented as the recommended treatment, but it may be offered as an alternative option in select patients, e.g. those with large shunts or with atrial septal aneurysms
Recognition and Management of Incomplete Stent Expansion Facilitated by StentBoost and Guideliner Tools
Get PDFSuboptimal or incomplete coronary stent expansion is associated with increased restenosis rate and target vessel revascularization. Stent visualisation with plain fluoroscopy has become challenging due to reduction of stent strut thickness. Inability of stent or balloon delivery is a frequent cause of procedural failures in percutaneous coronary interventions. This case report highlights the role of a novel stent enhancing technique, StentBoost, in recognition and management of incomplete stent expansion and of the Guideliner catheter, which is an essential assist device in complex and challenging coronary interventions, especially via the radial access
Cardiac Resynchronization Therapy– How to Increase Responders
No full textCardiac resynchronization therapy (CRT) has been established as a valuable treatment option in certain subgroups of chronic heart failure patients. However, a consistent percentage of CRT recipients, about one third, are considered non-responders. Accumulating data support that targeted patient selection, proper left ventricular lead implantation and optimal device programming may enhance patient response to CRT. The present review addresses these issues from a practical perspective
Infections Involving Cardiac Implantable Electronic Devices
Get PDFInfections of cardiac implantable electronic devices (CIEDs) are an emerging problem because of increasing implant rates and comorbidities. If undiagnosed and untreated, CIED infection is associated with high mortality. Following the new guidelines concerning the use of cardiac resynchronization therapy devices in patients with congestive heart failure,1 CIED implantation has grown further. Unfortunately, this trend has been accompanied by an increase in infection rate, probably due to an increase in comorbidities. A recent analysis of US data2 showed that infection rate grew from 1.61% in 1993 to 2.41% in 2008, possibly due to two factors: ageing of population and increased use of more complex devices. Several studies3,4 have found that the most important risk factors for infection are re-intervention, with device replacement increasing with ageing of the population, and use of dual and triple chamber devices having increased over the last several years
Early Repolarization: How to Differentiate the “Malignant†from the “Benign†Pattern
Get PDFThe early repolarization syndrome (ERS) on the electrocardiogram is characterized by J-point elevation, distinct J waves with or without ST-segment elevation, symmetric tall T wave, and slurring of the terminal part of the QRS in inferior limb and lateral precordial leads, but not in the V2 to V5 leads. The new definition of ERS proposed by Haissaguerre et al, centers more on the J wave notch or slur, irrespective of the ST-segment changes, which often helps to avoid overlap with the Brugada syndrome
Radial Approach for Percutaneous Coronary Intervention: Practical Issues
Get PDFIn this brief article we are discussing practical issues that we have to deal with when  choosing the radial approach for coronary angiography and percutaneous coronary intervention (PCI)
Salt Controversy Stirred by “PURE†but Settled by “NUTRICODEâ€
Get PDFHypertension is a modifiable risk factor for cardiovascular disease and death. On a worldwide scale, it is estimated that over 1 billion adult individuals are afflicted by hypertension, and hypertension is responsible for over 9 million deaths annually. Among dietary strategies to counter this epidemic, principal role has been assigned to reducing dietary sodium which has been included in many guidelines for the treatment of hypertension and prevention of cardiovascular disease. However, recent studies have raised questions about potential harmful effects associated with low sodium intake. Ensuing the tumult stirred by these studies reporting on the role of salt intake restriction on blood pressure and cardiovascular mortality, we are herein providing a brief overview of the topic. Despite the “controversy’, the data appear compelling toward the need for reducing salt intake as one of the most cost-effective measures to control blood pressure and reduce cardiovascular disease worldwide at the population level