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ABSTRACT Background Objective Methods Results Conclusion Predicting premature ventricular contraction (PVC) origin pre‐ablation is a fundamental step, as right ventricular outflow tract (RVOT) PVC often leads to higher success rates.To compare nine published ECG criteria to differentiate between RVOT and non‐RVOT origins of PVCs and develop a stepwise algorithm using those criteria to better determine PVC origin to predict ablation success.Two centers were involved in this study, the derivation group and the validation group. The derivation group included 65 patients with PVC left bundle branch block (LBBB) pattern morphology (predominantly negative in lead V1) and inferior axis (predominantly positive in leads II and III), who underwent ablation at Cipto Mangunkusumo Hospital (RSCM) (2017–2022). The validation group included 291 patients who underwent ablation at the Taipei Veteran General Hospital (2020–2023). We calculated and compared six diagnostic accuracy measures from nine previously published ECG morphology criteria to develop an algorithm to enhance the accuracy of predicting RVOT PVC origin for successful ablation.Our multistep algorithm using Criteria 5, 8, and 1 enhanced diagnostic performance compared to using each criterion alone. The accuracy, sensitivity, and specificity in the derivation group were 86.2%, 93.6%, and 66.7%, respectively; those in the validation group were 85.9%, 90.8%, and 64.7%, respectively. The ROC curve AUCs were 0.802 and 0.775, respectively.In cases of inferior axis and LBBB pattern PVCs, a multistep algorithm using multiple criteria increases the accuracy of predicting RVOT PVC origin instead of using a single criterion. [ABSTRACT FROM AUTHOR]

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Introduction: Acute recurrent purulent pericarditis is an uncommon pericardium infection that can be life-threatening due to pus production, leading to cardiac tamponade. Case presentation: We report a 36-year-old man referring to our hospital with impending cardiac tamponade who needed urgent pericardiocentesis. The patient's complaints were worsening dyspnea and palpitations in the last two days. The patient had been hospitalized for the same complaint and had pericardiocentesis due to cardiac tamponade approximately three weeks earlier. Physical exam, ECG, and CXR suggest impending cardiac tamponade. Echocardiography indicated massive right and left pericardial effusion and right atrial collapse. The Covid-19 screening test was positive; however, RT-PCR revealed a negative result. The patient was diagnosed with recurrent acute purulent pericarditis with impending cardiac tamponade requiring urgent pericardiocentesis. After the procedure, 1.5 million units of intrapericardial fibrinolytic were administered to patients. His improved hemodynamic and clinical symptoms indicate a successful procedure. Conclusion: This case highlights the challenges of managing an acute recurrent purulent pericarditis patient due to Staphylococcus A. infection in the current pandemic era, including distinguishing it from other contagious diseases due to nonspecific dyspnea, limited therapeutic options, and the effectiveness of intrapericardial fibrinolytic in improving the overall patient conditions, and reducing the mortality rate. [ABSTRACT FROM AUTHOR]

Atrial fibrillation (AF) is the most common rhythm disorder seen in doctors' offices and emergency departments (EDs). In both settings, an AF holistic pathway including anticoagulation or stroke avoidance, better symptom management, and cardiovascular and comorbidity optimization should be followed. However, other considerations need to be assessed in the ED, such as haemodynamic instability, the onset of AF, the presence of acute heart failure and pre-excitation. Although the Advanced Cardiovascular Life Support guidelines (European Society of Cardiology guidelines, Acute Cardiac Care Association/European Heart Rhythm Association position statements) and several recent AF publications have greatly assisted physicians in treating AF with rapid ventricular response in the ED, further practical clinical guidance is required to improve physicians' skill and knowledge in providing the best treatment for patients. Herein, we combine multiple strategies with supporting evidence-based treatment and experiences encountered in clinical practice into practical stepwise approaches. We hope that the stepwise algorithm may assist residents and physicians in managing AF in the ED. [ABSTRACT FROM AUTHOR]

Endothelial Progenitor Cells (EPCs) have an important role in endothelial dysfunction repairment through neovasculogenesis and cardiac myocytes regeneration. However, EPCs migration is greatly reduced in the patient with Coronary Artery Disease (CAD). Allicin and Vitamin C are hypothesized to improve EPCs migration due to its antioxidant properties. Objective: To investigate the effect of Allicin and its combination with Vitamin C in EPCs migration of CAD patients. Material and Method: Mononuclear cells were isolated from CAD patients and cultured on fibronectin-coated plates with colony-forming unit Hill medium. The cells were divided into untreated (control), Allicin treatment (dose 100 mcg/ml, 200 mcg/ml, 400 mcg/ml), and each dose of Allicin combined with 250 mcg/mL of Vitamin C. EPCs migration was assessed with Transwell Migration Assay Kit and evaluated by using statistical tests. Results: This research shows that EPC migration was significantly higher in the treatment. Allicin at all dose (dose 100 mcg/ml, 200 mcg/ml, 400 mcg/ml) and its combination with 250 mcg/mL of vitamin C compared to untreated group (p<0.05). Allicin increase EPCs migration in a dosedependent manner. However, the only combination of 400 mcg/ml Allicin with 250 mcg/mL of vitamin C which has significantly higher EPCs migration compared to Allicin treatment alone. Conclusion: Allicin improves EPCs migration in a dose-dependent manner. Improvement of the migration only observed on the Allicin dose 400 mcg/ml with Vitamin C. [ABSTRACT FROM AUTHOR]