A 79 ‐year‐old woman with atrial fibrillation and new onset of heart failure

AbstractAs an alternative to oral anticoagulation, percutaneous left atrial appendage (LAA) closure is an increasingly performed procedure to prevent arterial embolism in patients with non ‐valvular atrial fibrillation. Besides procedure‐related complications, residual leaks, device‐related thrombus formation, and dislocation of the LAA occluder have been observed during follow‐up. Heart failure as a consequence of interventional LAA closure has not been reported so far. This case report describes a 79‐year‐old lady with permanent non‐valvular atrial fibrillation presenting with New York Heart Association Class IV heart failure. Symptoms had started immediately after attempted LAA closure 11 months before. Transoesophageal echocardiography demonstrated two devices in the LAA, a large peri‐device leak, a mobile LAA thrombus, a right atrial appendage thrombus, and shunting via a patent foramen ovale. Under a maximally tolerated dose of heart failure medication and edoxaban, the patient remains without bleeding or embolism in New York Heart Association Class II. Because of its unique anatomical and endocrine properties, the LAA plays an important role in situations of pressure and volume overload. Interventional LAA closure interacts unfavourably with left atrial compliance and reservoir function. Atrial and brain natriuretic peptide secretion is known to be significantly reduced after LAA closure. Both mechanisms may result in the development of heart failu...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Case Report Source Type: research

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Authors: Feres M, Retamal-Valdes B, Faveri M, Duarte P, Shibli J, Soares GMS, Miranda T, Teles F, Goodson M, Hasturk H, Van Dyke T, Ehmke B, Eickholz P, Schlagenhauf U, Meyle J, Koch R, Kocher T, Hoffmann T, Kim TS, Kaner D, Figueiredo LC, Doyle H Abstract OBJECTIVE: The selection of proper outcome measures is a critical step in clinical research. Most randomized clinical trials (RCTs) assessing the effects of initial anti-infective periodontal therapies use surrogate outcomes as primary outcome variables, such as mean changes in probing depth (PD) or in clinical attachment. However, these parameters do not reflect...
Source: Journal of the International Academy of Periodontology - Category: Dentistry Tags: J Int Acad Periodontol Source Type: research
CONCLUSIONS: Non-surgical periodontal therapy was effective during the first 18 months, but periodontal conditions were worse at 48 months after therapy. The distal sites of abutment teeth with direct retainers presented the worst periodontal conditions. PMID: 32224546 [PubMed - in process]
Source: Journal of the International Academy of Periodontology - Category: Dentistry Tags: J Int Acad Periodontol Source Type: research
ConclusionsConversion of prior Nissen fundoplication to RnY anatomy is technically challenging, although it is safe and feasible even in the setting of multiple prior foregut operations. A minimally invasive approach should be offered to patients by surgeons with experience in revisional foregut and bariatric surgery.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
ConclusionsIntracorporeal anastomosis using linear staplers reduced anastomotic bleeding and stenosis compared to extracorporeal anastomosis after LTG. Future research will be required to determine the ideal method for intracorporeal anastomosis in LTG.
Source: Surgical Endoscopy - Category: Surgery Source Type: research
Nov ák, Tibor / Németh, Gábor / Kozinszky, Zoltan / Urbán, Edit / Gorzó, István / Radnai, MártaPage 165 - 170Purpose: The aim of the present study was to analyse the role of the main diagnostic signs of poor periodontal status, probing depth (PD) ≥4 mm and bleeding on probing (BOP) ≥50%, both simultaneously and individually in preterm birth (PB) and their effect on the birth weight (BW). Prematurity is a major health concern and it is the leading contributing factor to neonatal morbidity and mortality worldwide. Conflicting results exist on the relation between poor ma...
Source: Oral health and Preventive dentistry - Category: Dentistry Source Type: research
The Heart Rhythm Society said it is planning a virtual alternative to its annual sessions, while that option is under consideration for the European Society of Cardiology's specialty meeting.Medscape Medical News
Source: Medscape Cardiology Headlines - Category: Cardiology Tags: Cardiology News Source Type: news
April 01, 2020 -- The U.S. Food and Drug Administration today approved Sevenfact [coagulation factor VIIa (recombinant)-jncw] for the treatment and control of bleeding episodes occurring in adults and adolescents 12 years of age and older with...
Source: Drugs.com - New Drug Approvals - Category: Drugs & Pharmacology Source Type: news
Authors: Corrà U, Piepoli M, Giordano A Abstract Exercise oscillatory ventilation (EOV) is an ominous sign in heart failure due to reduced left ventricular ejection fraction (HFrEF) whatever it is represented. But EOV is detected also in normal healthy individuals and in other cardiovascular disease (CVD) patients, however, its prevalence in these is not completed clear. The aim was to describe the occurrence of EOV in healthy subjects and the overall population all CVD patients who performing symptom limited cardiopulmonary exercise testing (CPET). Healthy subjects were divided in athletes and normal subjec...
Source: Monaldi Archives for Chest Disease - Category: Respiratory Medicine Tags: Monaldi Arch Chest Dis Source Type: research
CONCLUSION Relatively low use of technology may limit potential for health technology innovation for people of advanced age. Socioeconomic and ethnic disparities will amplify this. PMID: 32223848 [PubMed - in process]
Source: Journal of Primary Health Care - Category: Primary Care Tags: J Prim Health Care Source Type: research
Authors: Chalikias G, Kikas P, Thomaidis A, Rigopoulos P, Pistola A, Lantzouraki A, Zisimopoulos A, Tziakas D Abstract We assessed the effect of Sacubitril/Valsartan on circulating catecholamine levels in patients with HF in an observational cohort study. We included 108 consecutive HF patients attending our HF Outpatients Clinic who were eligible to Sacubitril/Valsartan according to the PARADIGM-HF inclusion and exclusion criteria. We furthermore included 58 stable HF patients under optimal medical therapy as a control group. Norepinephrine and epinephrine were measured with immunoradiometric assays at baseline, a...
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research
More News: Atrial Fibrillation | Bleeding | Brain | Cardiology | Heart | Heart Failure | Neurology | Patent Foramen Ovale | Thrombosis