Journal of cardiovascular medicine
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J Cardiovasc Med (Hagerstown) · Dec 2012
A new approach for catheter ablation of atrial tachycardia following atrial fibrillation ablation.
The origin and mechanisms of focal and macro-re-entrant atrial tachycardia occurring after ablation of paroxysmal or persistent atrial fibrillation are difficult to determine and are often the cause of distress for both patients and electrophysiologists. The purpose of this study was to describe a novel practical approach which would be helpful in planning the treatment of atrial tachycardia in patients who had received prior atrial fibrillation ablation. We used an algorithm which aims to facilitate mapping and ablation strategies, using both conventional electrophysiological tools and a three-dimensional electroanatomic approach. ⋯ The increased acquisition speed by AFocusII DL facilitated the reconstruction of the geometric chamber, and the generation of an isochronal activation map reduced processing time and fluoroscopy time per patient, together with the radiation exposure and patient radiation dose. A novel algorithm combining both conventional electrophysiology and a three-dimensional electroanatomic approach for rapid diagnosis, accurate mapping and ablation of iatrogenic atrial tachycardias showed high reproducibility and a satisfactory overall success rate.
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J Cardiovasc Med (Hagerstown) · Dec 2012
Comparative StudyOne-year clinical outcome in patients with acute coronary syndrome treated with concomitant use of clopidogrel and proton pump inhibitors: results from a regional cohort study.
We sought to compare the 1-year risk of re-hospitalization for acute coronary syndrome (ACS) between patients taking clopidogrel with proton pump inhibitors (PPIs) vs. clopidogrel without PPIs. ⋯ This study suggests the hypothesis that a concomitant use of clopidogrel and PPIs in patients with ACS, at low risk for gastrointestinal bleeding, having mostly undergone coronary revascularization, is associated with an approximately 30% higher risk of nonfatal hospitalization for ACS.
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J Cardiovasc Med (Hagerstown) · Dec 2012
Case ReportsThe heart in an airbag: spontaneous pneumopericardium in a young lady.
Pneumopericardium is a rare but potentially life-threatening clinical condition that must be considered in the differential diagnosis of chest pain. It is usually associated with chest trauma, infections, invasive procedures or mechanical ventilation. ⋯ The diagnosis was made by posteroanterior chest radiography and confirmed with computed tomography. Contrast swallow test failed to detect oesophagopericardial fistulae and the patient was managed conservatively without further complication.