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Background: Several clinical trials have assessed predictors for atrial fibrillation recurrence following cryoballoon catheter ablation. With these predictors, a practical and new scoring system can be developed to evaluate atrial fibrillation recurrence. The present study aimed to analyze the predictive value of the age, creatinine, and ejection fraction-left atrium score for potential recurrence of atrial fibrillation following cryoballoon catheter ablation in patients with symptomatic paroxysmal or persistent atrial fibrillation. Methods: We retrospectively analyzed records of patients undergoing cryoballoon catheter ablation. atrial fibrillation recurrence was defined as an emerging atrial fibrillation episode around 12-month follow-up (with the exclusion of a 3-month blanking period). Univariate and multivariate analyses were performed to assess predictors of atrial fibrillation recurrence. In addition, receiver operating characteristic analysis was harnessed to evaluate the performance of the age, creatinine, and ejection fraction, left atrium score in determining the risk of atrial fibrillation recurrence. Results: The study population comprised 106 subjects (age 52 +- 13 years, 63.2% women) with paroxysmal (84.9%, n = 90) or persistent (15.1%, n = 16) atrial fibrillation. age, creatinine, and ejection fraction, left atrium score was significantly higher in subjects with atrial fibrillation recurrence in comparison to those with the maintenance of sinus rhythm. However, on multivariate logistic regression analysis, only the age, creatinine, and ejection fraction, left atrium score (OR = 12.93, 95% CI: 2.22-75.21, P =.004) served as an independent predictor of atrial fibrillation recurrence following cryoballoon catheter ablation. Conclusion: Age, creatinine, and ejection fraction, left atrium score had an independent association with the risk of atrial fibrillation recurrence in subjects with atrial fibrillation undergoing cryoballoon catheter ablation. Therefore, this score might potentially serve as a useful tool for risk stratification of patients with atrial fibrillation.

Background: Although chemotherapy-induced cardiotoxicity is an emerging problem, limited information is available on the effects of chemotherapy on left ventricular (LV) mechanical functions in patients with non-small cell lung cancer (NSCLC). Objective: We aimed to explore chemotherapy-induced alterations in cardiac mechanical functions in patients with NSCLC using speckle tracking echocardiography (STE). Methods: Seventy-one patients with NSCLC and 34 age and sex matched control subjects were consecutively included. Based on their good performance status (Eastern Cooperative Oncology Group performance status), 39 patients were treated with paclitaxel plus carboplatin (PC) regimen and 32 patients were treated with vinorelbine plus cisplatin (VC) regimen. All patients and controls underwent conventional two-dimensional echocardiography and STE at baseline to assess their LV functions. The echocardiographic examinations of NSCLC patients were repeated after the chemotherapy regimens. Results: None of the NSCLC patients developed any signs or symptoms of clinical heart failure during or after the chemotherapy. There were not any significant differences in LV ejection fraction between NSCLC patients and controls before and after chemotherapy. There were not any significant differences in baseline LV global longitudinal strain (GLS), radial strain (RS), and circumferential strain (CS) between NSCLC patients and controls. However, all LV GLS, RS and CS significantly decreased in patients treated with the PC regimen resulting in a significant difference compared to both VC group and controls while no significant decreases were observed in strain measures in VC group. Conclusion: Paclitaxel plus carboplatin, but not VC, may induce subclinical cardiotoxicity in patients with NSCLC, which may be detected by STE. Resumo: Introdução: Embora a cardiotoxicidade induzida pela quimioterapia seja um problema emergente, existe informação limitada sobre os efeitos da quimioterapia na função do ventrículo esquerdo (VE) em doentes com cancro do pulmão não de pequenas células (CPNPC). Objetivo: Avaliar alterações induzidas pela quimioterapia na função cardíaca em doentes com CPNPC utilizando a ecocardiografia de speckle tracking (EST). Métodos: Foram incluídos consecutivamente 71 doentes com CPNPC e 34 indivíduos caso controlo emparelhados por idade e género. Com base no seu desempenho (Eastern Cooperative Oncology Group performance status), 39 doentes foram tratados com regime de paclitaxel e carboplatina (PC) e 32 doentes foram tratados com regime de vinorelbina e cisplatina (VC). Todos os doentes e casos controlo foram submetidos a ecocardiografia bidimensional convencional (2DE) e a EST na fase basal para avaliar a função VE. As avaliações ecocardiográficas dos doentes com CPNPC foram repetidas após quimioterapia. Resultados: Nenhum dos doentes com CPNPC desenvolveu qualquer sinal ou sintoma clínico de insuficiência cardíaca durante ou após a quimioterapia. Não houve diferenças significativas na fração de ejeção do VE entre os doentes com CPNPC e os casos controlo antes e depois da quimioterapia. Não houve diferenças significativas nos valores basais da deformação longitudinal global do VE (GLS), deformação radial (RS) e deformação circunferencial (CS) do VE entre os doentes com CPNPC e os casos controlo. No entanto, todos os valores de deformação miocárdica VE diminuíram significativamente nos doentes tratados com o regime CP, resultando numa diferença significativa em comparação tanto com o grupo CV como com os casos controlo, embora não se tenham observado diminuições significativas nas medidas de strain no grupo VC. Conclusão: Apenas a PC, mas não a VC, pode induzir cardiotoxicidade subclínica em doentes com CPNPC, o que pode ser detetado por ecocardiografia de speckle tracking.

Objective:We assessed the impact of pacing mode on long-term clinical outcomes in cases with the complete atrioventricular block (CAB).Method:We retrospectively analyzed 161 patients with CAB, who undergone a cardiac permanent pacemaker. Of the patients involved in the physiologic pacing (PP) group, 95 patients were with the VDD pacing mode and 14 patients were with the DDD pacing mode. In the ventricular pacing (VP) group, with the VVI pacing mode, there were 52 patients.Results:The average age of the patients was 66±13 years and the average follow-up duration was 40.2±22.6 months. Atrial fibrillation (AF) was observed to be significantly more common in the VP group than in the PP group (p=0.007). However, the occurrence of stroke was similar between the two groups (p=0.753). Newly developed congestive heart failure (CHF) was seen more commonly in the VP group (p=0.015). When we evaluated the patients with and without CHF before pacemaker placement, the number of patients with CHF was reduced in the PP group (p=0.039) and insignificantly increased in the VP group (p=0.219).Conclusion:We conclude that in patients with CAB, the use of PP, compared to VP, may decrease the rate of AF and CHF in the long-term.

Abstract Some premature ventricular complexes (PVCs) originate from the coronary venous system. The great cardiac vein and the anterior cardiac vein are the most frequent localizations. The middle cardiac vein is an unusual anatomy for a point of origin for PVC. We present here a case of frequent PVCs with characteristic electrocardiographic features, which we successfully ablated inside the middle cardiac vein.

Coronary artery fistula is an abnormal connection between a coronary artery and a cardiac chamber, a great artery or the vena cava. Although coronary artery fistulas are known to be congenital malformations they might occur due to infection, trauma or may be iatrogenic. We present a case with acquired coronary microfistula, without any history of interventional procedure.