A case of wide complex tachycardia with regular fusion beats

A 90-year-old man was admitted with palpitation and chest tightness for 2 h. He was known to have persistent atrial fibrillation (AF) and had a single chamber pacemaker (VVIR) implantation 9 years ago. His echocardiogram, about a year ago, showed moderate left ventricular dysfunction and moderate aortic stenosis.
Source: Europace - Category: Cardiology Source Type: research

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CONCLUSIONS: Our meta-analysis indicates that, in the short term, TAVI probably has little or no mortality difference compared to SAVR for severe AS in individuals with low surgical risk. Similarly, there is probably little or no difference in risk of stroke, MI, and cardiac death between the two approaches. TAVI may reduce the risk of rehospitalisation, but we are uncertain about the effects on LOS. TAVI reduces the risk of atrial fibrillation, AKI, and bleeding. However, this benefit is offset by the increased risk of PPM implantation. Long-term follow-up data are needed to further assess and validate these outcomes, esp...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Tags: Cochrane Database Syst Rev Source Type: research
ConclusionTAVR in low-risk patients is superior to SAVR for the majority of outcomes.Graphical abstract
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
CONCLUSION: Cardiac and extra-cardiac pathologies should be kept in mind in patients with acute arterial occlusion. Thus, detected pathologies could be treated, and the development of additional peripheral emboli could be prevented.RESUMO OBJETIVO: O objetivo do estudo é investigar patologias cardíacas e extracardíacas em pacientes operados por oclusão arterial aguda. MÉTODOS: Entre março de 2010 e março de 2018, um total de 120 pacientes submetidos a tratamento cirúrgico para oclusão arterial aguda foram incluídos neste estudo retrospectivo. RESULTADO S...
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research
CONCLUSIONS: Within nonagenarians with AS, patients treated with TAVI had lower risk of cardiovascular events than matched patients treated medically. The patients undergoing a TAVI at this age were often highly selected and the procedure was associated with acceptable long term outcomes. PMID: 31763981 [PubMed - as supplied by publisher]
Source: EuroIntervention - Category: Cardiovascular & Thoracic Surgery Tags: EuroIntervention Source Type: research
Transcatheter aortic valve replacement (TAVR) has been increasingly utilized as an intervention for the management of symptomatic intermediate and high risk severe aortic stenosis, and utilization rates are expected to increase exponentially worldwide.1,2 One of the most frequent complication of TAVR is the development of New-onset Atrial Fibrillation (NOAF), with an estimated incidence ranging from 16% to 51.1%.3 NOAF corresponds to the detection of atrial fibrillation (AF) during or after the TAVR procedure in a patient without previously known AF.
Source: Heart and Lung - Category: Intensive Care Authors: Source Type: research
Written by Meyers, edits by SmithA 50-ish year old man was working construction when he suddenly collapsed. Coworkers started CPR within 1 minute of collapse. EMS arrived within 10 minutes and continued CPR and ACLS, noting alternating asystole and sinus bradycardia during rhythm checks. He received various ACLS medications and arrived at the ED with a perfusing rhythm.Initial vitals included heart rate around 100 bpm and BP 174/96. Here is his initial ECG, very soon after ROSC:What do you think?Sinus tachycardia.  There is incomplete RBBB (QRS duration less than 120 ms).  There is diffuse STD, maximal in V4-V5 a...
Source: Dr. Smith's ECG Blog - Category: Cardiology Authors: Source Type: blogs
AbstractBackgroundThe aim of this retrospective study was to determine changes in outcomes after surgical aortic valve replacement (SAVR) for aortic stenosis (AS) in Iceland over a 15 ‐year period.MethodsWe included 587 patients who underwent SAVR for AS in Iceland during the period 2002 ‐2016, with a total follow‐up of 3245 patient‐years. Short‐term and long‐term outcomes, 30‐day mortality, and long‐term survival (Kaplan–Meier) were analyzed. Univariate linear regression and univariate and multinomial logistic regression analyses were performed on preoperative and p erioperative variables. Poisson re...
Source: Journal of Cardiac Surgery - Category: Cardiovascular & Thoracic Surgery Authors: Tags: ORIGINAL ARTICLE Source Type: research
CONCLUSION: In this study, we could not detect an advantage in survival when SAVR or TAVR were utilized in intermediate to high surgical risk patients needing aortic valve replacement for severe aortic stenosis. PMID: 31596707 [PubMed - in process]
Source: The Heart Surgery Forum - Category: Cardiovascular & Thoracic Surgery Authors: Tags: Heart Surg Forum Source Type: research
AbstractAims  Transcatheter aortic valve implantation (TAVI), now a common procedure to treat high-risk patients with severe aortic stenosis, has rapidly been expanding into younger and lower-risk populations, creating a need to better understand long-term outcome after TAVI. The aim of the present investigation was to determine the incidence, risk factors for, clinical presentation of, and outcome after prosthetic valve endocarditis (PVE) in patients treated with TAVI in a nationwide study.Methods and results  Three registries were used: a national TAVI registry, a national diagnosis registry, and a national inf...
Source: European Heart Journal - Category: Cardiology Source Type: research
Conclusions: TAVR is comparable to SAVR in terms of mortality and disabling stroke in severe AS patients at low and intermediate risk, but higher proportion of AV re-intervention observed in TAVR. Those results should encourage caution when extending the indications of TAVR into low risk patients, especially for young low risk patients. Systematic review registration: PROSPERO CRD 42018112626. PMID: 31285888 [PubMed]
Source: Journal of Thoracic Disease - Category: Respiratory Medicine Tags: J Thorac Dis Source Type: research
More News: Aortic Stenosis | Atrial Fibrillation | Cardiology