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Background: Electrical isolation of the pulmonary veins is known as the fundamental of for atrial fibrillation (AF) treatment invasively, and thus, has been suggested as the first-line therapy in AF curation. In this study, we presented our single center pulmonary vein isolation (PVI) experience and long-term clinical outcome. Methods: One hundred and six symptomatic AF patients resistant to medical therapy underwent cryoablation of the pulmonary veins. Participants were divided into two groups regarding AF categorization as persistent or paroxysmal. Recurrence and peri-procedural complications were evaluated after the treatment. Results: A 106 patients, 67 males (63.2%), with mean age of 51.8 ±13.1 years, underwent cryoablation. While the paroxysmal AF group was composed of 90 patients (84.9%); the persistent AF group consisted of 16 patients (15.1%). The procedure mean time was 115,9±9,1 minute while the fluoroscopy mean time was 29,2±5,6 minutes. A total of 8 (7.5%) non-fatal complications were experienced. A total of 18 recurrences (17%) were observed during mean duration of 25.2 months follow-up period. The survival rates without AF were 85.6% and 61.8 % in in the paroxysmal and persistent groups, respectively. Conclusion: The cryoballoon PVI seems to be a successful and reliable method of treating AF and may be preferred as a primary procedure even in patients with persistent AF.

Objective: Cardiac resynchronization therapy (CRT) is a reliable treatment modality in patients with systolic dysfunction. However, not every patient appears to benefit from CRT. The systemic immune inflammation index (SII) is closely linked to the poor prognosis of various cardiovascular disorders. However, there is no study investigating whether SII has predictive value in determining response to CRT in dilated cardiomyopathy patients. Therefore, we intend to investigate the association between SII and response to CRT. Methods: A total of 220 patients (mean age 61.2±10.8 years; 120 men) implanted with CRT were involved in this study. Echocardiographic and laboratory measurements were evaluated prior to CRT. Response to CRT was determined as a≥ 15% decrease in left ventricular end-systolic volume at one-year follow-up. Results: Patients grouped as CRT responders and non-responders. Of these, 143 (64.6%) were considered to be CRT responders, while the remaining 77 (33.4%) were non-responders. Female sex (OR: 3.823, CI: 1.568-9.324 p=0.003), QRS duration (OR: 1.224, CI: 1.158-1.335 p

Aim: Premature ventricular complexes are one of the most common arrhythmias and, when not treated, can cause serious complications such as dilated cardiomyopathy and ventricular tachycardia. In our study, we investigated the relationship between QRS duration and symptoms in patients with idiopathic premature ventricles complex (IPVC). Material and Methods: This is a multicenter, cross-sectional study involving 242 consecutive patients with more than 1,000 idiopathic PVC and normal QRS duration in 24-hour Holter follow-up who attended cardiology clinics in 18 different centers between January 2019 and May 2019. The relationship between the QRS durations was investigated by dividing the patients into 2 groups as symptomatic (n: 128) and asymptomatic (n: 114). Result: The average age of 242 patients was 51 ± 13 and 52.4% (127) of them were male patients. In the symptomatic IPVC group, sinus QRS duration, PVC QRS duration, coupling interval, and prematurity index were statistically significantly higher than the asymptomatic IPVC group. In the multivariate logistic regression analysis, a significant relationship was found between the sinus QRS duration (odds ratio (OR) = 1.3, 95% confidence interval (CI) = 1.01-1.05, p = 0.002) and symptoms in patients with IPVC. In the ROC analysis performed to show the power of sinus QRS duration in predicting symptoms in patients with IPVC, Area Under Curve (AUC) value was found as = 0.547 95% CI: 0.454-0.640, p = 0.320 (Figure 1). Conclusion: In patients with IPVC; The prolonged sinüs QRS duration was found to be superior to other parameters in patients being symptomatic.

Objective: Electrocardiographic alterations were investigated following the second dosage of COVID-19 mRNA vaccination. Methods: A total of 260 individuals after two doses of COVID-19 vaccine with Pfizer-BioNTech were included in the study. The electrocardiographic parameters recorded at baseline and approximately one week later after two doses of Pfizer-BioNTech vaccine were compared for all patients. Results: PR interval was increased and QTc maximum interval was decreased significantly after second dose COVID-19 mRNA vaccination. Baseline and post-second dose vaccination states regarding P wave dispersion and QT dispersion/Tp-e interval which have been recognized to imply inhomogeneous atrial conduction and heterogeneity in ventricular repolarization were similar between groups. Conclusion: Our findings suggest that there should be no concern related to asymptomatic involvement of the myocardium subsequent the second dose of COVID-19 mRNA vaccination., Amaç: Bu çalışmanın amacı, ikinci doz COVID-19 mRNA aşılamasından sonra elektrokardiyografik değişi-klikleri değerlendirmektir. Yöntem: Çalışmaya Pfizer-BioNTech ile iki doz COVID-19 aşısı yapılan toplam 260 hasta dahil edildi. Başlangıçta ve iki doz Pfizer-BioNTech aşısından yaklaşık 1 hafta sonra kaydedilen elektrokardiyo-grafik parametreler tüm hastalar için karşılaştırıldı. Bulgular: İkinci doz COVID-19 mRNA aşılamasından sonra PR aralığı arttı ve QTc maksimum aralığı önemli ölçüde azaldı. Sırasıyla ventriküler repolarizasyonda homojen olmayan atriyal iletimi ve heterojenliği yansıttığı varsayılan P dalgası dispersiyonu ve QT dispersiyonu/Tp-e aralığı ile ilgili olarak başlangıç ve ikinci doz aşılama durumları arasında anlamlı bir fark yoktu. Sonuç: Bulgularımız, ikinci doz COVID-19 mRNA aşılamasından sonra miyokardın asemptomatik tutulumu ile ilgili herhangi bir endişe olmaması gerektiğini düşündürmektedir.

Introduction:This study compared the frequency of permanent pacemaker implantation (PPI) following mitral valve replacement (MVR) with tricuspid annuloplasty (TAP) and isolated MVR.Patients and Methods:This retrospective study analysed 409 patients who had undergone MVR with or without concomitant TAP, from January 2015 through May 2020. Patients were divided into two groups (the isolated MVR group and the MVR plus TAP group). The two groups were compared according to whether PPI was present or not.Results:A total of 409 consecutive patients [in the isolated MVR group, n= 212 patients; 129 (60.8%) female and in the MVR plus TAP group, n= 197 patients; 138 (70.1%) female] were assessed. The number of female, functional mitral regurgitation, mixed mitral disease, and the use of bio-prosthetic valve was higher in the MVR plus TAP group (p< 0.01). A total of 8 (2%) patients needed a PPI. There was no statistically significant difference between the two groups in terms of PPI (p> 0.01). The frequency of postoperative PPI was 2.2% (7 of 311 patients) in patients with rheumatic etiology and 1.1% (1 of 98 patients) in patients with non-rheumatic etiology (OR: 2.026, 95% CI: 0.24-16.68, p= 0.5). The median time to implantation was seven days [minimum postoperative days (POD) 5 , maximum POD 45].Conclusion:When isolated MVR is considered and if the patient also has tricuspid regurgitation (TR), it is apparent that TAP will be inevitable, because TR inflicts a considerable burden on the patient’s quality of life. Recent studies reported varying frequencies of PPI after TAP accompanying left valve surgery. The present study observed no increase in the use of PPI after MVR accompanied by TAP as compared with isolated MVR.

Objective: Acute coronary syndromes (ACS) are still the main cause of mortality in the world. Scoring systems are important for risk evaluation in ACS. Angiographic The Synergy between Percutaneous Coronary Intervention (SYNTAX) score is universal. For cardiac pump function, left ventricular (LV) longitudinal shortening has a major role. It can be assessed by some echocardiographic parameters. Mitral annular plane systolic excursion (MAPSE) is well defined for the LV longitudinal function evaluation and clues with LV systolic function. In this study, we aimed to research the relationship between SYNTAX score and MAPSE in Non-ST elevation myocardial infarction (NSTEMI) patients. Methods: 138 consecutive patients who underwent coronary angiography after diagnosis of NSTEMI were included. Transthoracic echocardiography was performed to all patients by an experienced physician who was uninformed patient’s data. Coronary angiography via the femoral approach was performed for all patients within 48 hours. ≥ 50% coronary lesion stenosis in vessels ≥ 1.5 mm was scored separately and SYNTAX scores were obtained. Results: The median age was 64.5 (54.0-70.8) years and 80.4% were male. Hypertension was the most common risk factor (72.5%). Left anterior descending artery (LAD) stenosis was the most common artery stenosis (58.7%). The mean MAPSE was 14.0 (13.0-15.8) and the mean SYNTAX score was 10.0 (7.0-14). Correlation of our outcome variable SYNTAX score between physiological and clinical variables of age, troponin and LVEF were calculated. No significant p value was detected. The relationship between SYNTAX Score and categorical variables such as gender, hypertension, diabetes mellitus, hyperlipidemia, left main coronary artery (LMCA), LAD, right coronary artery (RCA), circumflex artery (CX), peripheral arterial disease (PAD) was evaluated. None of the variables included in the regression model were associated with the SYNTAX score Conclusion: In this study, we have investigated the relationship between MAPSE and SS in NSTEMI patients. No significant correlation was found between MAPSE and SS.

Aim: Statins are one of the most important agents in the treatment of atherosclerotic peripheral arterial disease. We aim to compare high- and moderate-dose statin therapy in patients with lower extremity artery disease (LEAD) who have undergone percutaneous transluminal angioplasty (PTA). Patients and Methods: Ninety-four patients treated with PTA were selected consecutively and retrospectively and were divided into two groups according to the high- or moderate-dose statin treatments they were given. Groups were compared for the absence of restenosis and occlusion as primary patency and the need for reintervention in the treated arterial segment as secondary patency. All patients underwent computed tomography (CT) angiography or duplex scan one year after receiving PTA. Results: Coronary revascularization (p

The CHA

BACKGROUND: Endothelial cell-specific molecule 1 (ESM-1 or endocan) is an immunoinflammatory marker strongly associated with inflammation, vascular endothelial dysfunction and atherosclerosis. We explored the relationship between serum endocan concentrations and coronary in-stent restenosis (ISR). METHODS: Fifty consecutive patients with ISR and 50 control subjects were included in this study. Clinical data and angiographic characteristics were collected. Serum endocan concentrations were measured using an enzyme-linked immunosorbent assay. RESULTS: All included patients were divided into four quartiles based on their concentrations of endocan: quartile 1 (0.62-1.31 ng/mL), quartile 2 (1.33-1.74 ng/mL), quartile 3 (1.75-2.77 ng/mL) and quartile 4 (2.78-4.24 ng/mL). The rates of ISR were 16%, 24%, 68%, and 92%, respectively. The patients in quartile 4 had significantly higher rates of ISR than the other groups (p < 0.001). Logistic regression analysis indicated that endocan concentration [odds ratio = 8.65, 95% confidence interval 3.56-20.94; p < 0.001] was an independent predictor of ISR. Receiver operating characteristic curve analysis was used to explore the relationship between endocan and ISR. Using a cutoff value of 1.625 ng/mL, endocan predicted ISR with a sensitivity of 86% and a specificity of 78%. CONCLUSIONS: Our findings suggest that plasma endocan levels may be a novel biomarker of endothelial dysfunction in patients with ISR.