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Background: Pulsed‐field ablation (PFA) is a cutting‐edge technique that employs non‐thermal energy to cause cell death by inducing irreversible electroporation of cell membranes. This systematic review evaluates the PFA effectiveness as a potential alternative to radiofrequency and cryo‐ablation for treating ventricular tachycardia. Methods: PubMed, Embase, Scopus, and Web of Science were systematically searched using keywords related to ventricular tachycardia and pulsed‐field ablation. Eligible Studies evaluating this therapeutic approach for ventricular tachycardia were included in the final analysis. Results: We included six studies (five case reports and one case series) in our systematic review. Eight (88.8%) of procedures were successful with 100% long‐term efficacy. No procedural complications or ventricular tachycardia (VT) recurrence were observed in the cases. Conclusion: The absence of complications, high effectiveness, and long‐term success rate make PFAs a good VT treatment option. However, PFA safety and efficacy studies for VT treatment are scarce. Thus, larger investigations on this topic are urgently needed. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to evaluate the effect of coronavirus disease (COVID-19) on the patients' referral in the pregnant population and also investigate each treatment approach's advantages and disadvantages for acute renal colic in pregnancy. Methods: In this retrospective study, we included all pregnant women with ureteral stones referred to a referral center between January 2019 and March 2021. Results: Among 53 pregnant women, 18 (33.9%) were on conservative therapy, which passed the stone without any complications. Double J stent or nephrostomy tube insertion was done for 24 patients (45.2%). Seventeen of these patients (70.8%) presented post-surgical complications, including hematuria (29.2%), pyelonephritis (20.8%), and lower urinary tract symptoms (20.8%). Transurethral lithotripsy (TUL) was done in 11 patients (20.7%). Only one of these patients developed hematuria following TUL. Thus, in our population study, double J stent or nephrostomy insertion was associated with a higher chance of postoperative complications than TUL (p -value = 0.001). Thirty-six patients were referred within 13 months before the entry of COVID-19, while 17 were referred during a similar approximate duration after the COVID-19 entry into the country. Only the initial presentation had a significant difference between these two periods (p -value = 0.034). Conclusions: When conservative treatment fails, we recommend TUL as the second-line treatment over temporary procedures, such as double J stent or nephrostomy insertion. Of note, in a group of patients with an emergent clinical setting, including active infection, deteriorating renal function, signs of preterm labor, solitary kidney, etc., double J or nephrostomy tube insertion remains the preferred management method for its fast resolution of obstruction and infection. Besides, a decrease in visits with an increase in complicated cases after COVID-19 was observed, maybe due to a delay in referring. [ABSTRACT FROM AUTHOR]

Background: Postoperative atrial fibrillation (POAF) is one of the most common types of acute AF and can complicate the treatment course of approximately one third of patients undergoing cardiac surgery. Sodium‐glucose cotransporter‐2 (SGLT2) inhibitors are among the newest antidiabetic drugs which can be therapeutic options for preventing POAF by different mechanisms. Methods: Empagliflozin to Prevent POAF (EMPOAF) is an interventional, investigator‐initiated, double‐blind, placebo‐controlled, multicenter, randomized controlled trial which will be conducted in two referral teaching cardiology hospitals in Tehran. Four‐hundred ninety‐two adult patients who are scheduled for elective isolated coronary artery bypass graft (CABG) surgery will be randomly assigned to one of the groups of intervention (empagliflozin 10 mg daily) or placebo starting at least 3 days before surgery until discharge. Key exclusion criteria are a history of diabetes mellitus, AF, ketoacidosis, or recurrent urinary tract infections along with severe renal or hepatic impairment, unstable hemodynamics, and patients receiving SGLT2 inhibitors for another indication. The primary outcome will be the incidence of POAF. Key secondary endpoints will be the composite rate of life‐threatening arrhythmias, postoperative acute kidney injury, hospitalization length, in‐hospital mortality, stroke, and systemic embolization. Key safety endpoints will be the rate of life‐threatening and/or genitourinary tract infections, hypoglycemia, and ketoacidosis. Conclusions: EMPOAF will prospectively evaluate whether empagliflozin 10 mg daily can reduce the rate of POAF in patients undergoing elective CABG. Enrolment into this study has started by November 2023 and is expected to be ended before the end of 2025. [ABSTRACT FROM AUTHOR]

Background and Aims: Paravalvular leak (PVL) is a serious complication of prosthetic valve replacement. Both surgical and percutaneous closure techniques are used for PVL closure, but optimal strategies and comparative outcomes are uncertain. This study aimed to compare the efficacy and safety of percutaneous versus surgical PVL closure by analyzing changes in leak severity, functional status, echocardiographic parameters, and clinical outcomes. Methods: A total of 72 patients were included in this retrospective cross‐sectional single‐center study comparing percutaneous (n = 25) and surgical (n = 47) PVL closure from 2015 to 2022. Demographics, medical history, echocardiograms, laboratory data, complications, and mortality data were extracted from the records. Changes in leak severity, NYHA class, echocardiographic parameters, and clinical outcomes were compared between the percutaneous and surgical groups. Results: Both percutaneous and surgical PVL closure significantly reduced leak severity and improved NYHA class (both p < 0.01), with no difference between the quantity of changes in each group. The 30‐day mortality was 4% after percutaneous and 6.4% after surgical closure (p = 0.65). At 90 days, mortality was 24% percutaneous versus 17% surgical (p = 0.48). The length of stay in the hospital and post‐procedural decrease in hemoglobin were considerably lower in the percutaneous group. The rate of complication rates was similar between the groups. Echocardiographic changes were also comparable. Conclusion: Percutaneous and surgical PVL closure had similar efficacy in reducing leaks and improving symptoms, with no significant difference in early outcomes. Both options should be considered viable for PVL repair after heart team evaluation. [ABSTRACT FROM AUTHOR]

Background: Cystic echinococcosis (CE) is one of the most important neglected diseases and a public health concern worldwide. Due to the poor efficacy of current drugs, novel therapeutic approaches are urgently needed. Objectives: This study evaluated the scolicidal effects of the hydroalcoholic extract of Urtica dioica and the chloroformic extract of Pyrus boissieriana on protoscoleces of CE cysts. Methods: Protoscoleces were aseptically aspirated from the livers of sheep naturally infected with CE cysts. To assess the scolicidal effect of these herbal extracts, various concentrations of both extracts (5, 10, 20, 40, and 80 mg/mL) were added to a suspension of 3 x 10³ washed protoscoleces. After 10, 20, 30, 60, and 120 minutes of exposure, eosin stain was added to each tube, and the viability of protoscoleces was evaluated by flame cell motility under a light microscope, as well as impermeability to 0.1% eosin solution. All experiments were performed in triplicate. Results: The scolicidal effects of U. dioica extracts at a concentration of 80 mg/mL were 81% and 89% after 60 and 120 minutes of exposure, respectively. Almost the same results were obtained for P. boissieriana extracts at a concentration of 80 mg/mL (81.33% and 89% after 60 and 120 minutes of exposure, respectively), which were significantly different from the negative control group (P < 0.001). However, the extract of U. dioica exhibited stronger scolicidal effects compared to the extract of P. boissieriana at concentrations lower than 40 mg/mL (P < 0.001). Conclusions: The present findings indicate that both U. dioica and P. boissieriana extracts possess high protoscolicidal activities and could be used as alternative natural medicines in the treatment of CE. However, further studies are required to verify these findings through assessment in animal models and clinical subjects. [ABSTRACT FROM AUTHOR]

Background: Vitamins D, E, A, B, C, and Omega-3 play crucial roles in modulating inflammatory and oxidative stress pathways, both implicated in abdominal aortic aneurysm (AAA) development. Recent research has explored the potential impact of dietary supplements on AAA progression. The systematic review aims to assess interventional studies investigating the effects of various dietary supplements on the development and severity of abdominal aortic aneurysms. Method: A systematic search using relevant keywords related to abdominal aortic aneurysm and dietary supplements was conducted across four databases (PubMed, Embase, Scopus, and Web of Science). Quality assessment for animal studies employed SYRCLE and the Cochrane Collaboration Risk of Bias Tool for randomized control trials. The study protocol is registered in PROSPERO under the registry code CRD42023455958. Results: Supplementation with Omega-3, Vitamins A, C, D, E, and the Vitamin B family exhibited positive effects in AAA progression. These supplements contributed to a reduction in AAA diameter, elastin degradation, inflammatory responses, and reactive oxygen species. Additional supplements such as Zinc, methionine, and phytoestrogen also played roles in mitigating AAA progression. Conclusion: The findings of this study underscore the potential role of dietary supplements in the progression of AAA. Predominantly based on animal studies, the results indicate that these supplements can limit AAA progression, primarily evidenced by their ability to mitigate inflammatory processes and oxidative stress pathways. [ABSTRACT FROM AUTHOR]

Rationale: Synthetic cannabinoids are increasingly used as recreational drugs and have been associated with adverse cardiovascular effects. However, reports of synthetic cannabinoids accompanied by constrictive pericarditis are limited. Patient's concern: A 28-year-old male with a history of synthetic cannabinoid (Bonzai) abuse presented with chest discomfort, dyspnea, and lower extremity edema. Investigations revealed reduced left ventricular ejection fraction, elevated inflammatory markers, low electrocardiogram voltages, and atrial fibrillation. Diagnosis: Chest spiral computerized tomography scan and chest X-ray demonstrated pericardial calcification. Cardiac magnetic resonance imaging and right heart catheterization were done to confirm the possibility of constrictive pericarditis. Based on the patient's addiction history and exclusion of rheumatologic and infectious causes, it was supposed that constrictive pericarditis and cardiomyopathy may be accompanied by synthetic cannabinoid use. Interventions: The patient received standard medical therapy, including loop diuretics for cardiomyopathy and constrictive pericarditis. Catheter ablation was recommended for his rhythm control, and he was planned for close monitoring of clinical and echocardiographic response and evaluation of the need for surgical pericardiectomy in the future. Outcomes: After 6 months follow-up, echocardiographic exam revealed no significant improvement in ventricular function. However, due to the high surgical risk, the patient's poor compliance, and the continuation of drug abuse, he was not a good candidate for surgery according to our heart team's decision. Lessons: Synthetic cannabinoids can trigger constrictive pericarditis, and clinicians should consider them when evaluating patients with compatible symptoms and exposure history. Further research on the cardiovascular effects of synthetic cannabinoids is needed and public education on potential harms is warranted. [ABSTRACT FROM AUTHOR]

Background: Recent studies investigating the effects of fish oil on shocks administered by ICDs in patients with ventricular tachycardias produced inconclusive results. This systematic review aims to evaluate the effectiveness of omega-3 polyunsaturated fatty acids in lowering the risk of life-threatening VTs among individuals with implantable cardioverter-defibrillators., Methods: We searched five databases, including Central, PubMed, EMBASE, Web of Science, and Scopus, for studies evaluating the efficacy of omega-3 polyunsaturated fatty acids (PUFAs) for the prevention of ICD events for VT or VF, published up to December 1, 2023., Results: Four trials were finally included in the study. The pooled risk ratios for mortality and ICD events were 0.87 (95% CI:0.58-1.32) and 0.75 (95% CI:0.48-1.18), respectively., Conclusion: No significant effect was discovered to support the antiarrhythmic properties or survival advantages of n-3 polyunsaturated fatty acids (PUFA) in individuals with implanted implantable cardioverter-defibrillators (ICD)., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Author(s).)