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Premature ventricular complexes (PVCs) are common in the general population, usuallyasymptomatic, 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 morefrequent and cause symptoms ofpalpitations, shortness of breath, dizziness, and heart failure.In the presence of underlying heart disease, they may indicate an increasedrisk of adverse cardiovascular outcomes. A high PVC burdenmay lead to ventricular dysfunction and worsen underlying cardiomyopathy.PVCs may also be a marker of underlying pathophysiologic processes such as myocarditisand 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.

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.

51 years old male patient with palpitations, who had ischemic T changes and nonsustained ventricular tachycardia attacks in the electrocardiography was admitted at another hospital. There was no any cardiac symptom before addmission in medical history. In echocardiography , Ejection Fraction: 35%, left ventricular global hypokinesia and apical hypertrophy were detected. Coronary angiography was revealed normal coronary arteries. The patient was referred to our clinic for further treatment. We took cardiac magnetic resonance image for etiology of cardiomyopathy. According to MRI results, we determined very wide scar areas in the left ventricle. We implanted ICD to the patient and discharged him without any complication.

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., Amaç: Efor sonrası sol ventrikül ejeksiyon fraksiyonu (LVEF) ve sol ventrikül volüm değerlerinin koroner arter hastalığı bulunan hastalardaki kardiyak ölüm tahmininde katkısı vardır. Bu çalışmada, efor sonrası görüntüleme zamanının Quantitative Gated SPECT (QGS-Cedars-Sinai) programı ile hesaplanan efor sonrası LVEF, end-diastolik volüm (EDV) ve end-sistolik volüm (ESV) üzerine etkisini araştırmayı amaçladık. Hastalar ve yöntem: Bu çalışma 2008 ve 2009 yıllarında Elazığ Eğitim ve Araştırma Hastanesi Nükleer Tıp Birimine göğüs ağrısı nedeniyle Kardiyoloji Kliniğinden gönderilen 36 hasta üzerinde yapıldı. Tüm hastalara efor esnasında yapılan 99mTc-Mibi enjeksiyonunu takiben 20. ve 40. dakikalarda EKG-gated (8-bin frame modunda) miyokard perfüzyon SPECT sintigrafisi uygulandı. Kardiyak kantifikasyon yazılımı olan QGS programı kullanılarak LVEF, EDV ve ESV hesaplandı. İlk ve ikinci görüntülemelerden elde edilen LVEF, EDV ve ESV değerleri istatistiksel olarak birbirleri ile karşılaştırıldı. Bulgular: İlk ve ikinci görüntülemelerden elde edilen LVEF, EDV ve ESV değerleri arasında istatistiksel olarak anlamlı farklılık bulunmadı (p>0.05). Sonuç: Efor sonrası sol ventrikül fonksiyon parametreleri koroner arter hastalığı bulunan hastalardaki prognoz değerlendirmesinde önemlidir. Efor bitiminden 20-40 dakika sonra yapılan miyokard perfüzyon SPECT sintigrafisi efor sonrası LVEF, EDV ve ESV değerleri açısından tekrarlanabilir değerler vermektedir.

Background: This study aims to investigate the demographic and clinical characteristics and echocardiographic and microbiological findings of the patients as well as the outcomes of surgery undergoing surgical treatment with the diagnosis of infective endocarditis in Turkey.

Amaç: Bu çalışmada, kalıcı pacemaker (PM) ve implante edilebilir kardiyoversiyon defibrilatörleri (ICD) ile ilişkili endokarditin demografik, klinik ekokardiyografik ve mikrobiyolojik özellikleri ve sonuçlarının araştırılması amaçlandı. Çalışma planı: Kalıcı PM ve ICD endokarditi tanısı olan 15 hasta çalışmaya alındı. Hastaların demografik özelikleri, kullandıkları ilaçlar, klinik ve mikrobiyolojik özellikleri, ekokardiyografi sonuçları, cerrahi tedavi ve sonuçları kaydedildi. Bulgular: Hastaların ortalama yaşı 57±16 ve 7’si (%47) kadındı. Kalıcı PM ve ICD’si olan 15 hastadan 5’i takip sırasında kaybedildi (%33). Dört hastada pulmoner emboli gelişti (%27). Kan kültürü 5 hastada (%33) negatif bulundu. Hastaların %60’ında üretilen stafilokoklar en sık saptanan mikrobiyolojik ajanlardı. Üç hastaya (%20) cerrahi tedavi uygulandı. Sonuç: Kardiyak cihazlarla ile ilişkili endokardit, kardiyak cihaz implantasyonun nadir bir komplikasyonu olmasına rağmen mortalitesi halen yüksek olan bir hastalıktır., Objectives: We aimed to investigate the demographic and clinical characteristics, echocardiographic and microbiologic features, and outcomes of patients with permanent pacemak- er (PM) and implantable cardioverter-defibrillator (ICD) endo- carditis in this study. Study design: The study population consisted of 15 patients with permanent PM and ICD endocarditis. Data on demo- graphics, medications, clinical procedures, microbiology, echocardiography, surgery, and outcome were collected. Results: The mean age of the patients was 57±16. Seven pa- tients (47%) were female. Of the 15 permanent PM and ICD endocarditis patients, 5 died during hospital follow-up (33%). Four patients (27%) experienced a pulmonary embolism. Cul- ture-negative endocarditis was seen in 5 cases (33%). Staph- ylococci were the most common causative organisms (60%). Three patients had undergone surgical treatment (20%). Conclusion: Cardiac device-related endocarditis remain a rare but potentially fatal complication of device implantation.

To evaluate the regional left atrial (LA) myocardial functions and time to peak deformations by the longitudinal strain (S) and strain rate (Sr) echocardiography in isolated mitral stenosis (MS) patients for 3 LA periods (contractile, reservoir, and conduit periods). Materials and methods: Included in the study were 30 MS patients and 30 healthy controls. Longitudinal peak S and Sr indices, time to peak S and time to peak Sr, and systolic and diastolic velocities were measured from the color Doppler myocardial imaging data, for each LA period. Results: For all 3 periods, all of the segment S values and most of the segment Sr values were significantly lower in the patients than in the controls (P < 0.0001 and P < 0.05, respectively). There were no significant differences between the groups in terms of velocities. Time to peak S in the contractile and conduit periods was significantly higher in the patients than in the controls, in most of the segments (P < 0.05). Time to peak Sr was significantly higher in the patients than in the controls, in all of the periods in all of the segments (P < 0.05) except for mid-septal segments. Conclusion: This study demonstrated that LA longitudinal myocardial functions were impaired in MS patients with S/Sr echocardiography. Our study is the first to demonstrate prolonged time to peak S/Sr of the LA in rheumatic MS. This condition might be an additional factor in the deterioration of regional LA myocardial function in MS patients.

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Amaç: Bu çalışma kalp yetersizliği olan hastalarda metoprolol tedavisinin miyokardiyal hızlar üzerine etkisini gözlemek amacıyla planlandı. Gereç ve Yöntem: Kalp yetersizliği bulunan 32 hasta (yaş ort 58$\pm$10) ve 20 sağlıklı birey çalışmaya dahil edildi. Hastalara 12.5 mg'dan başlayıp, haftalık aralıklarla titre edilerek 50 mg metoprolol, kontrollü salınım tableti verildi. Tedavi öncesi ve 1 ay sonrası konvansiyonel ekokardiyografi ve miyokardiyal doku Doppler görüntüleme uygulandı. Miyokardiyal hızlar doku Doppler görüntüleme tekniği ile mitral ve triküspit halka düzeyinden sağlandı. Mitral halka düzeyinde apikal 4 ve 2 boşlukta septal, lateral, inferior ve anterior kenarlardan ölçüm yapıldı. Mitral halka hızları için 4 kenarın ölçümlerinin ortalamaları alındı. Sağ ventrikül longitidünal fonksiyonunu değerlendirmek için triküspit halkasının lateral kenarı seçildi. Sistolik hız, erken diyastolik hız ve geç diyastolik hızlar kaydedildi. Tedavi sonrası elde edilen sonuçlar tedavi öncesi ile karşılaştırıldı. Bulgular: Kalp yetersizliği bulunan hastalarda kontrole göre mitral ve triküspit halka sistolik hızları anlamlı olarak düşük bulundu (mitral halka için 3.8$\pm$1.1'e karşı 9.3$\pm$0.9 cm/s, p, Aim: Beneficial effects of beta blockers on cardiac failure has been clearly defined. This study was planned to observe effect of metoprolol treatment on myocardial velocities in patients with heart failure. Material and Method: Thirty-two patients with heart failure (mean age: 58$\pm$10) and 20 healthy individuals were included in the study. Patients were given metoprolol, starting with 12.5 mg daily dose, and dose is increased weekly up to 50 mg/d given as controlled release tablets. Conventional echocardiography and myocardial tissue Doppler imaging were performed before the treatment and 1 month after. Myocardial velocities were acquired at the level of mitral and tricuspid annulus by tissue Doppler imaging method. Measurements were made at septal, lateral, inferior and anterior sides of (4 and 2 chambers) at mitral annulus. Average of measurements at 4 sides was taken for mitral annular velocities. Lateral side of tricuspid annulus was selected to evaluate longitudinal function of right ventricule. Systolic, early and late diastolic velocities were recorded. Posttreatment outcomes were compared with the pretreatment data. Results: Mitral and tricuspid annular systolic velocities were found to be significantly lower in patients with heart failure (3.8$\pm$1.1versus 9.3$\pm$0.9 cm/s for mitral annulus, p

WOS: 000326896200011, PubMed ID: 23835297, Objective: The aim of this retrospective multicenter study was to investigate the clinical manifestations, microbiological profile, echocardiographic 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.

Objectives: 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. Materials and methods: This is an observational cross- sectional study which included 31 consecutive patients (15[48.4%] male) who had applied to our outpatient clin- ics and diagnosed as mitral regurgitation and 25 (12 [48.0%] male) healthy persons as control subjects. The mitral regurgitation patients were divided into two groups: those with moderate MR (n=14[45.2%]) and those with severe MR (n=17[54.8%]), and maximum strain / strain rate measurements of left ventricular wall segments and plasma brain natriuretic peptide levels were determined in these two groups and controls. Results: S/SR values of all wall segments of left ventricle were found to be decreased in patient with severe MR when compared with the control subjects and patients with moderate MR (p