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The article focuses on the diagnosis of catecholaminergic polymorphic ventricular tachycardia (CPVT) in a young female patient initially misdiagnosed with reflex syncope. Topics include the ECG characteristics of CPVT during exercise, the importance of genetic testing and implantable cardioverter-defibrillators for prevention, and the potential misdiagnosis of arrhythmogenic diseases in young women presenting with syncope.

Background: Successful management of chronic total occlusion (CTO)by percutaneous coronary intervention (PCI) is known to be associated with better clinical outcomes than failed PCI. However, whether angiographic and clinical outcomes following PCI for long CTO lesions differ from those following PCI for short CTO lesions in the drug eluting stent (DES) era remains unknown. We therefore investigated whether CTO lesion length can significantly influence6-month angiographic and 2-year clinical outcomes following successful CTO PCI. Methods and results: A total of 235 consecutive patients who underwent successful CTO intervention were allocated into either the long or short CTO group according to CTO lesion length. Six-month angiographic and 2-year clinical outcomes were then compared between the 2groups. We found that baseline clinical characteristics were generally similar between the 2 groups. Exceptions were prior PCI, which was more frequent in the long CTO group, and bifurcation lesions, which were more frequent in the short CTO group. Apart from intimal dissection, which was more frequent in the long than short CTO group, in-hospital complications were also similarly frequent between the 2groups. Furthermore, both groups had similar angiographic outcomes at 6 months and clinical outcomes at 2 years. However, the incidence of repeat PCI(predominantly target vessel revascularization),was higher in the long than short CTO group, with our multivariate analysis identifying long CTO as an important predictor of repeat PCI (odds ratio, 4.26;95% confidence interval, 1.53–11.9; p = 0.006). Conclusion: The safety profile, 6-month angiographic, and 2-year clinical outcomes of CTO PCI were similar between patients with long and short CTO. However, there was a higher incidence of repeat PCI in long CTO patients despite successful PCI with DESs. [ABSTRACT FROM AUTHOR]

Background: Post-stenting balloon dilation is associated with improvement of stent deploymanet and better angiographic results in percutaneous coronary intervention (PCI). However, it had not been evaluated competently in setting of acute coronary syndrom (ACS) undergoing PCI. There are limited data regarding the impact of post-stenting balloon dilatation on long term clinical outcomes in ACS patients. Methods: Procedural details of total 2533 ACS patients (693 ST elevation myocardial infarction, STEMI patients, 640 Non-ST elevation MI, NSTEMI patients, and 1220 Unstable Angina patients) underwent PCI were examined. Patients were divided into two groups; 1) NO Post dilatation group (N=1047) and 2) Post dilatation group (N=1506). Individual and composite major clinical otucomes including major adverse cardiac events (MACE), the composite of total death, MI,stroke and revascularization, were compared between the two groups up to 5 years. Results: At 5 years follow up, post dilatation group had signficantly lower target vessel revascularization (TVR, HR: 0.716, 95% CI: 0.524 to 0.978 ;p = 0.035), non-TVR (HR: 0.538, 95% CI: 0.319 to 0.908; p = 0.020), stroke (HR: 0.778, 95% CI: 0.638 to 0.948; p = 0.013) and MACE (HR: 0.749, 95% CI : 0.592 to 0.947; p = 0.016) than No post dilatation group (Table). Using multivariate logestic regression, and after adjusting for potential risk factors, post diltation patients had lower total MACE (HR: 0.711, 95% CI : 0.524 to 0.965; p = 0.029), including TVR and stroke. Conclusion: In ACS patients undergoing PCI, post dilatation was associated with lower risk of TVR, CVA and total MACE up to 5 years clinical follow up. [ABSTRACT FROM AUTHOR]

Background: Percutaneous coronary intervention (PCI) for ostial coronary lesions associated with inappropriate angiographic results, challenging adjustment of stent position and higher risk of cardiovascular complications. However there are limited data regarding the impact of ostial stenting on short and long-term clinical outcomes. Methods: A total 3747 patients underwent PCI were included. Patients were divided into two groups; 1) non-ostial lesion group (N= 2936) and 2) ostial lesion group (N=811). Due to potential confounders, a propensity score matching (PMS) analysis was performed using the logistic regression model. Individual major clinical outcomes and major adverse cardiac events (MACE), the composite of total death, myocardial infarction (MI), stroke, stent thrombosis and revascularization, were compared between the two groups at 30-day and up to 5 years. Results: After PSM analysis, two matched groups (712 pairs, n=1424) were generated and the baseline characteristics were balanced. At 30 days, ostial lesion group had higher mortality including cardiac death (HR: 0.276, 95% CI: 0.103 to 0.744; p = 0.011), revascularization (HR: 0.355, 95% CI: 0.128 to 0.985; p = 0.047) and all MACE (HR: 0.510, 95% CI: 0.284 to 0.915; p = 0.024) than the Non- ostial lesion group. At 5 years, the ostial lesion group patients also had higher mortality including cardiac death (HR: 0.423, 95% CI: 0.194 to 0.923 ; p = 0.031), revascularization (HR: 0.686, 95% CI : 0.447 to 0.986 ; p = 0.042), target vessel revascularization TVR (HR: 0.604, 95% CI : 0.405 to 0.902 ; p = 0.014) and all MACE (HR: 0.683, 95% CI : 0.507 to 0.919 ; p = 0.012) than the Non- ostial lesion group (Table). Conclusions: This study implies that the presence of coronary ostial lesion is an independent risk factor for adverse clinical outrcomes including higher incidence of cardiac death, revascularization and total MACE at 30 days and up to 5 years. [ABSTRACT FROM AUTHOR]