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Background: Smartphone technologies have been recently developed to assess heart rate and rhythm, but their role in accurately detecting atrial fibrillation (AF) remains unknown. Objective: We sought to perform a meta-analysis using prospective studies comparing Smartwatch technology with current monitoring standards for AF detection (ECG, Holter, Patch Monitor, ILR). Methods: We performed a comprehensive literature search for prospective studies comparing Smartwatch technology simultaneously with current monitoring standards (ECG, Holter, and Patch monitor) for AF detection since inception to November 25th, 2019. The outcome studied was the accuracy of AF detection. Accuracy was determined with concomitant usage of ECG monitoring, Holter monitoring, loop recorder, or patch monitoring. Results: A total of 9 observational studies were included comparing smartwatch technology, 3 using single-lead ECG monitoring, and six studies using photoplethysmography with routine AF monitoring strategies. A total of 1559 patients were enrolled (mean age 63.5 years, 39.5% had an AF history). The mean monitoring time was 75.6 days. Smartwatch was non-inferior to composite ECG monitoring strategies (OR 1.06, 95% CI 0.93 - 1.21, p=0.37), composite 12 lead ECG/Holter monitoring (OR 0.90, 95% CI 0.62 - 1.30, p=0.57) and patch monitoring (OR 1.28, 95% CI 0.84 - 1.94, p=0.24) for AF detection. The sensitivity and specificity for AF detection using a smartwatch was 95% and 94%, respectively. Conclusions: Smartwatch based single-lead ECG and photoplethysmography appear to be reasonable alternatives for AF monitoring. [ABSTRACT FROM AUTHOR]

Sentinel cerebral embolic protection devices (CPDs) may limit periprocedural cerebrovascular events by preventing micro and macro‐embolization to the brain, and has been used in many cardiology and radiology procedures. We hereby report the use of a Sentinel CPD to facilitate safe and effective atrial fibrillation ablation in a patient with a left atrial mass arising from the interatrial septum. [ABSTRACT FROM AUTHOR]

Premature ventricular complexes (PVCs) are common in the general population, usually a symptomatic, and deemed to be benign in structurally normal hearts. The spectrum of "benign" outflow tract PVCs ranges from single PVCs to recurrent non-sustained ventricular tachycardia (NSVT). Short-coupled right ventricular outflow tract (RVOT) PVCs may trigger polymorphic ventricular tachycardia (VT) in some patients and can be high risk. In many patients, PVCs can be more frequent and cause symptoms of palpitations, shortness of breath, dizziness, and heart failure. In the presence of underlying heart disease, they may indicate an increase drisk of adverse cardiovascular outcomes. A high PVC burden may lead to ventricular dysfunction and worsen underlying cardiomyopathy.PVCs may also be a marker of underlying pathophysiologic processes such as myocarditis and other acquired and inherited infiltrative cardiomyopathies. In this unique case report, we describe the use of a novel non-contact mapping array for mapping RVOT PVCs. [ABSTRACT FROM AUTHOR]

Infection is one of the most devastating outcomes of cardiovascular implantable electronic device (CIED) implantation and is related to significant morbidity and mortality. In our country, there is no evaluation about CIED infection. Therefore, our aim was to investigate clinical characteristics and outcome of patients who had infection related to CIED implantation or replacement. The study included 144 consecutive patients with CIED infection treated at 11 major hospitals in Turkey from 2005 to 2014 retrospectively. We analyzed the medical files of all patients hospitalized with the diagnosis of CIED infection. Inclusion criteria were definite infection related to CIED implantation, replacement, or revision. Generator pocket infection, with or without bacteremia, was the most common clinical presentation, followed by CIED-related endocarditis. Coagulase-negative staphylococci and Staphylococcus aureus were the leading causative agents of CIED infection. Multivariate analysis showed that infective endocarditis and ejection fraction were the strongest predictors of in-hospital mortality. [ABSTRACT FROM AUTHOR]

Objective: We proposed a new technique for the treatment of coronary bifurcation lesions, called jailed semi-inflated balloon technique (JSBT).Background: Currently, provisional approach is recommended to treat most of coronary bifurcation lesions. However, it is associated with the risk of side branch (SB) occlusion after main vessel (MV) stenting due to plaque or carina shift into the SB. The SB occlusion may cause peri-procedural myonecrosis or hemodynamic compromise. Therefore, strategies are needed to reduce the SB occlusion during provisional approach.Methods: Between September 2014 and April 2015, we selected 137 patients (104 male, 33 female; mean age 63.6 ± 11.7 years) with 148 distinct coronary bifurcation lesions underwent percutaneous coronary intervention using JSBT. All patients were followed with hospital visits or telephone contact up to 1 month.Results: The majority of the patients had acute coronary syndrome (64.2%) and Medina 1.1.1. bifurcation lesions (62.8%). The lesion localization was distal left main (LM) coronary artery in 28 patients. After the MV stenting, thrombolysis in myocardial infarction (TIMI) 3 flow was established in 100% of both MV and SB. There was no SB occlusion in any patient. There was no major adverse cardiac event during in-hospital stay and 1 month follow-up.Conclusions: The JSBT technique can be successfully performed in both LM and non-LM bifurcation lesion. This technique provides high rate of procedural success, excellent SB protection during MV stenting and excellent immediate clinical outcome. [ABSTRACT FROM AUTHOR]

Objective: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiography findings and management strategies of infective endocarditis (IE) in Turkey. Methods: The study population consisted of 248 Turkish patients with IE treated at 13 major hospitals in Turkey from 2005 to 2012 retrospectively. All hospitals are tertiary referral centers, which receive patients from surrounding hospitals. Data were collected from the medical files of all patients hospitalized with IE diagnosed according to modified Duke Criteria. Results: One hundred thirty seven of the patients were males. Native valves were involved in 158 patients while in 75 participants there was prosthetic valve endocarditis. Vegetations were detected in 223 patients (89%) and 52 patients had multiple vegetations. Mitral valve was the most common site of vegetation (43%). The most common valvular pathology was mitral regurgitation. The most common predisposing factor was rheumatic valvular disease (28%). Positive culture rate was 65%. Staphylococci were the most frequent causative microorganisms isolated (29%) followed by enterococci (11%). In-hospital mortality rate was 33%. Conclusions: Compared to IE in developed countries younger age, higher prevalence of rheumatic heart disease, more frequent enterococci infection and higher rates of culture negativity were other important aspects of IE epidemiology in Turkey. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to investigate the predictors of warfarin use in patients with non-valvular atrial fibrillation (AF). This study was the first to be conducted in a Turkish population. Materials and methods: Patients who presented to our outpatient clinic with the diagnosis of AF between September 2008 and October 2009 were enrolled. The patients were classified according to the CHADS2 risk scoring system recommended by the AHA/ACC/ESC guidelines for the classification of stroke risk in non-valvular AF patients. The probable variables influencing the use of warfarin were determined as age, sex, income level, healthcare coverage, lifestyle, place of residence, classification of AF, hypertension, diabetes mellitus, coronary artery disease, thyrotoxicosis, cardiac insufficiency, left ventricular dysfunction, stroke risk stratification, and history of stroke or systemic embolism (SE). Results: Among the 570 patients enrolled in the study, 144 were excluded because of insufficient patient information or refusal to participate, while 101 patients were excluded due to valvular AF. Thus, the evaluation was based on 325 patients (133 males and 192 females; mean age: 65 ± 10). According to the CHADS2 scoring, 62.2% of the patients were at high risk, 26.8% were at moderate risk, and 11.1% were at low risk. Only 19.7% of the patients were on warfarin treatment. In the logistic regression analysis, a history of stroke or SE, high income level, and the presence of persistent and permanent AF were found to be positive predictors of warfarin use, while advanced age was a negative predictor of warfarin use. Conclusion: This study demonstrated that a history of stroke or SE, high income level, presence of persistent and permanent AF, and advanced age are independent predictors of warfarin use in non-valvular AF patients. [ABSTRACT FROM AUTHOR]

The aim of the this study was to investigate the relationship between the degree of mitral regurgitation (MR), left ventricular (LV) dysfunction determined by strain (S)/strain rate (SR) imaging and plasma brain natriuretic peptide (BNP) levels. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Medical Sciences is the property of Scientific and Technical Research Council of Turkey and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: Post-stress left ventricular ejection fraction (LVEF) and LV volumes have incremental value in predicting cardiac death (CD) in patients with coronary artery disease. In this study, we aimed to investigate the effect of imaging time after exercise on post-stress LVEF, end-diastolic volume (EDV) and end-systolic volume (ESV) calculated by cardiac quantification software program called Quantitative Gated SPECT (QGS-Cedars-Sinai). Materials and methods: This study was consisted of 36 patient referred to Nuclear Medicine Department from Cardiology Clinics because of chest pain in 'Elazig Research and Training Hospital' in 2008-2009. In all patients, ECG Gated (8-bin frame mode) myocardial perfusion SPECT scintigraphy was performed 20 and 40 min later following 99mTc-Mibi injection during exercise. By means of the cardiac quantification software program called Quantitative Gated SPECT (QGS-Cedars-Sinai); LVEF, EDV and ESV were calculated. LVEF, EDV and ESV values obtained from initial and second acquisition were compared statistically. Results: There was no statistically significant difference between post-stress LVEF, EDV and ESV measures of initial and second acquisition (p>0.05). Conclusion: Left ventricular functional parameters after exercise are important for assess prognosis in patients with CAD. Post-stress LVEF, EDV and ESV measured on gated myocardial perfusion SPECT images within 20-40 min after completion of exercise give reproducible information. [ABSTRACT FROM AUTHOR]

A patient underwent the LARIAT left atrial appendage (LAA) ligation procedurewith persistent atrial fibrillation history. The procedure was done successfully. A transthoracic echocardiography did not show pericardial effusion. The patient was examined under fluoroscopy where the tip of the drain was not in the pericardial space and contrast injection pericardial drain confirmed its location in the inferior vena cava. [ABSTRACT FROM AUTHOR]

Dual coronary artery fistulae (CAF) involving both right and left coronary trees are uncommon; accounting for only 5% of all CAFs. A 48-year-old male patient was admitted to our institution for evaluation of chest pain. The coronary angiography revealed fistulae from left main coronary artery(LMCA) and right coronary artery (RCA) to the pulmonary artery. We concluded that angina pectoris was caused by a steal phenomenon and the patient was recommended surgical intervention. To our knowledge, this is the first paper reporting three fistulae associated with multiple aneurysms originating from proximal coronary arteries, which were connected to the pulmonary artery. [ABSTRACT FROM AUTHOR]

A 55-year-old man with multiple pellet injuries was brought to the Emergency room. In his physical examination, there were multiple wounds in face, neck, shoulders, arms, thorax and upper abdomen. The therapeutic options include pericardial drainage, conservative treatment, and surgical removal of the pellet. But, he was successfully managed with conservative medical treatment. This case showed that the treatment of heart injuries due to shotgun pellet should be individualized. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Physical Medicine & Rehabilitation / Turkiye Fiziksel Tip ve Rehabilitasyon Dergisi is the property of Turkish Society of Physical Medicine & Rehabilitation and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

With the expanding integration of complementary and alternative medicine (CAM) practices in conjunction with modern medicine, yoga has quickly risen to being one of the most common CAM practices across the world. Despite widespread use of yoga, limited studies are available, particularly in the setting of dysrhythmia. Preliminary studies demonstrate promising results from integration of yoga as an adjunct to medical therapy for management of dysrhythmias. In this review, we discuss the role of autonomic nervous system in cardiac arrhythmia,interaction of yoga with autonomic tone and its subsequent impact on these disease states. The role of yoga in specific disease states, and potential future direction for studies assessing the role of yoga in dysrhythmia. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article on epidemiologic factors that contribute infective endocarditis (IE) in Turkey by M. A. Elbey and others that was published in the September 2013 issue of the periodical.

Several diagnostic images of mitral prosthetic valve of a 35-year-old man are presented.

Myocarditis refers to inflammation of the myocardium caused by infectious and non-infectious process. It should be considered in any patient presenting with unexplained congestive heart failure, ventricular arrhythmias, atrial fibrillation or dilated cardiomyopathy . Prompt diagnosis and treatment is required, otherwise unrecognized myocarditis can rapidly progress to cardiogenic shock with increase in mortality and morbidity. Although various etiologies such as viruses and autoimmune phenomenon have been proposed, there are many unanswered questions regarding the underlying pathophysiology that initiate and trigger myocardial inflammation. These gaps in knowledge need to addressed by developing appropriate myocarditis disease models for understanding the interaction of initial insult, autoimmunity, and host genetics so as to develop novel therapeutic modalities that can halt the disease progression for better clinical outcomes. This review focuses on etiology, pathophysiology, symptomatology, diagnosis, treatment and directions of myocarditis. [ABSTRACT FROM AUTHOR]

The purpose of this prospective study was to determine the relationship between circadian blood pressure and left ventricular diastolic function in essential hypertension. The study population included 25 patients aged 56 ± 18 years with non-dipper hypertension and 25 age-and sex-matched patients with dipper hypertension. They underwent conventional Doppler echocardiography and color tissue Doppler from apical 4-and 2-chamber views. In non-dipper patients, diastolic left ventricular function was reduced significantly. The transmitral E wave decreased (0.55 ± 0.2 vs 0.62 ± 0.2 m/s, < 0.05), the transmitral A wave increased (0.77 ± 0.01 vs 0.70 ± 0.1 m/s, P < 0.01), the transmitral E/A ratio decreased (0.78 ± 0.1 vs 0.86 ± 0.2, P < 0.05), and the transmitral E-wave deceleration time increased in non-dipper patients (211 ± 44 vs 196 ± 42 ms, P < 0.05). The isovolumic relaxation time increased (112 ± 15 vs 105 ± 14 m/s, P < 0.05). The mean left ventricular myocardial velocities also differed significantly; the early diastolic velocity decreased (5.9 ± 2.1 vs 7.7 ± 3.1 cm/s, P < 0.01), the late diastolic velocity increased 9.5 ± 2.7 vs 8.7 ± 1.6 cm/s, P < 0.05), and the E/A ratio decreased (0.68 ± 0.55 vs. 0.94 ± 0.39, P < 0.01). These findings suggest that non-dipper hypertensive patients who have impaired left ventricular diastolic function should be identified early for careful follow-up and possible referral to a specialized center. [ABSTRACT FROM AUTHOR]

Background: Smartphone technologies have been recently developed to assess heart rate and rhythm, but their role in accurately detecting atrial fibrillation (AF) remains unknown., Objective: We sought to perform a meta-analysis using prospective studies comparing Smartwatch technology with current monitoring standards for AF detection (ECG, Holter, Patch Monitor, ILR)., Methods: We performed a comprehensive literature search for prospective studies comparing Smartwatch technology simultaneously with current monitoring standards (ECG, Holter, and Patch monitor) for AF detection since inception to November 25th, 2019. The outcome studied was the accuracy of AF detection. Accuracy was determined with concomitant usage of ECG monitoring, Holter monitoring, loop recorder, or patch monitoring., Results: A total of 9 observational studies were included comparing smartwatch technology, 3 using single-lead ECG monitoring, and six studies using photoplethysmography with routine AF monitoring strategies. A total of 1559 patients were enrolled (mean age 63.5 years, 39.5% had an AF history). The mean monitoring time was 75.6 days. Smartwatch was non-inferior to composite ECG monitoring strategies (OR 1.06, 95% CI 0.93 - 1.21, p=0.37), composite 12 lead ECG/Holter monitoring (OR 0.90, 95% CI 0.62 - 1.30, p=0.57) and patch monitoring (OR 1.28, 95% CI 0.84 - 1.94, p=0.24) for AF detection. The sensitivity and specificity for AF detection using a smartwatch was 95% and 94%, respectively., Conclusions: Smartwatch based single-lead ECG and photoplethysmography appear to be reasonable alternatives for AF monitoring.

Chylopericardium is an uncommon but potentially life-threatening clinic entity. Here we reported a case with chylopericardium causing tamponade and shock as an unusual presentation of lymphoma. The patient was managed by immediate pericardiocentesis. Further analysis of the pericardial fluid revealed immature T-cells compatible with precursor T-lymphoblastic lymphoma., (Copyright © 2012 Elsevier Inc. All rights reserved.)

Objectives: Neurally mediated syncope is defined as a transient loss of blood flow to the brain, resulting in vasodilatation, bradycardia, or both. The pathophysiologic mechanisms of neurally mediated syncope are not clear. In this study, we investigated carotid artery elasticity parameters in patients with neurally mediated syncope., Methods: The study was conducted on 41 patients who were examined by the tilt table test. Group 1 constituted of 21 patients who had a positive response to the tilt table test. Clinical and hemodynamic parameters were compared with patients in a negative tilt table test group (group 2). The systolic and diastolic diameters of the carotid arteries, carotid distensibility, carotid strain, carotid stiffness index, and carotid elastic modulus of the left carotid arteries were calculated by a high-resolution ultrasound device., Results: No differences in hemodynamic variables or clinical parameters were detected between the groups. Carotid distensibility (mean ± SD, 1.6 ± 0.6 versus 2.2 ± 0.8 cm(2) × dyne(-1) × 10(-6); P = .044) and strain (6.8% ± 1.7% versus 8.2% ± 1.9%; P = .026) were lower in group 1 than in group 2. The carotid elastic modulus (0.88 ± 0.33 versus 0.74 ± 0.25 cm(2) × dyne(-1) × 10(-6); P = .002) and stiffness index (6.7 ± 0.4 versus 6.2 ± 0.5; P = .038) were higher in group 1., Conclusions: In this study, we concluded that elastic properties of the carotid artery are impaired in patients with neurally mediated syncope. This finding suggests that impaired carotid arterial elasticity may be a factor in the pathophysiologic mechanisms of neurally mediated syncope.