Initiation of ivabradine in cardiogenic shock

We present a case series of four patients with cardiog enic shock started on ivabradine who were unable to tolerate beta‐blockers.Methods and resultsFive patients identified with cardiogenic shock defined as a severe reduction in cardiac index (100] who were intolerant to beta ‐blockers. Each patient had a cardiac magnetic resonance imaging, echocardiogram, and coronary angiogram for determination of aetiology. Invasive haemodynamics via pulmonary artery catheterization were measured during initiation and titration of ivabradine (baseline, 6, 12, 24, and 48 h after iva bradine administration) with continuous telemetry monitoring for any dysrhythmia or bradyarrhythmias. All patients tolerated ivabradine initiation, and at 24 h, an observed decrease in HR (106 ± 6.8 vs. 91.6 ± 6.4 b.p.m.,P = 0.04), pulmonary arterial occlusion pressure (30.4 ± 4.8 vs. 24 ± 5.1 mmHg,P = 0.04), and right atrial pressure (16.8 ± 6.2 vs. 9 ± 4.3 mmHg,P = 0.0002). An improvement was observed in mixed venous oxygen saturation (SvO2) (51  ± 8.8 vs. 64.8 ± 5.3%,P 
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Short Communication Source Type: research

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r Harst P, Juarez-Orozco LE Abstract BACKGROUND: Obstructive sleep apnea (OSA) conveys worse clinical outcomes in coronary artery disease patients. The STOP-BANG score is a simple tool that evaluates the risk of OSA and can be added to the large number of clinical variables and scores obtained during the management of myocardial infarction (MI) patients. Currently, machine learning (ML) is able to select and integrate numerous variables to optimize prediction tasks. RESEARCH QUESTION: Can the integration of STOP-BANG score with clinical data and scores through ML better identify patients who suffered an in-ho...
Source: Chest - Category: Respiratory Medicine Authors: Tags: Chest Source Type: research
Mechanical circulatory support systems for cardiogenic shock and heart failure are associated with ischemic strokes and intracranial hemorrhages. Impella is a percutaneously placed, ventricular assist device for short-term cardiac support. We aimed to study the prevalence of acute neurologic complications during short-term support with Impella.
Source: The Journal of Heart and Lung Transplantation - Category: Transplant Surgery Authors: Tags: (994) Source Type: research
AbstractAimsThe aim of this study was to determine the incidence, predictors, and short ‐term and long‐term outcomes associated with in‐hospital sustained ventricular tachycardia (VT) and ventricular fibrillation (VF) collectively termed ventricular arrhythmia (VA) in the heart failure (HF) patients.Methods and resultsThe HEart function Assessment Registry Trial in Saudi Arabia (HEARTS registry) is a prospective national registry of patients with chronic HF from18 tertiary care hospitals across Saudi Arabia. Diagnosis of HF was in accordance with American Heart Association/European Society of Cardiology definition cr...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
The bioreactance technique is a relatively new, totally noninvasive technique that is used to measure cardiac output (CO) and is easy to use. The Non-Invasive Cardiac Output Monitor (NICOM) is 1 such system. Although approved by the Food and Drug Administration for measurement of stroke volume, there is a paucity of literature validating this technology in decompensated heart failure and cardiogenic shock.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: Brief Report Source Type: research
The bioreactance technique is a relatively new, totally non-invasive technique used to measure cardiac output that is easy to use. Non Invasive Cardiac Output Monitor (NICOM) is one such system (Cheetah Medical Inc). Although approved by FDA for measurement of stroke volume, there is a paucity of literature validating this technology in decompensated heart failure and cardiogenic shock (CS).
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Tags: Brief Report Source Type: research
ConclusionsIn this observational analysis of STEMI patients who underwent primary percutaneous coronary intervention, ticagrelor was associated with improved outcomes compared with clopidogrel and prasugrel. An appropriately powered randomized trial is needed to confirm these findings.RésuméContexteIl n’existe pas d’analyse robuste comparant les inhibiteurs P2Y12 à prise orale (clopidogrel, prasugrel et ticagrélor) chez les patients ayant subi un infarctus du myocarde avec élévation du segment ST (STEMI) traités par une intervention coronaire percutanée (I...
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
Authors: Alsadat N, Hyun K, D'Souza M, Chew D, Weaver J, Juergens C, Kritharides L, Hammett C, Brieger D Abstract BACKGROUND: Approximately 50% of patients undergoing primary percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction (STEMI) have multivessel coronary disease (MVD). Evidence on the best PCI approach for these patients is conflicting. The aim of this study is to examine Australian data from the CONCORDANCE registry to describe the practice and outcomes of patients receiving multivessel vs culprit-only PCI. METHODS: Two cohorts were constructed from MVD-STEMI patients undergoi...
Source: The Journal of Invasive Cardiology - Category: Cardiology Tags: J Invasive Cardiol Source Type: research
ConclusionsIn this observational analysis of STEMI patients undergoing PPCI, ticagrelor was associated with improved outcomes compared to clopidogrel and prasugrel. An appropriately powered randomized trial is needed to confirm these findings.
Source: Canadian Journal of Cardiology - Category: Cardiology Source Type: research
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Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Ann Thorac Surg Source Type: research
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Source: The Annals of Thoracic Surgery - Category: Cardiovascular & Thoracic Surgery Source Type: research
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