The American journal of cardiology
-
Data on the diagnostic accuracy of multislice computed tomographic coronary angiography (CTA) have been mostly derived from patients with a high pretest likelihood of coronary artery disease. Systematic comparisons with invasive angiography in patients with an intermediate pretest likelihood are scarce. The purpose of the present study was to determine the diagnostic accuracy of CTA in patients without known coronary artery disease with an intermediate pretest likelihood. ⋯ In conclusion, the results from the present study have confirmed that CTA has excellent diagnostic accuracy in the target population of patients with an intermediate pretest likelihood. The high negative predictive value allowed us to rule out significant stenosis in a large proportion of patients. CTA can, therefore, be used as a highly effective gatekeeper for invasive coronary angiography.
-
More patients who are receiving therapy with a left ventricular assist device (LVAD) also have an implantable cardioverter-defibrillator (ICD). The aim of the present study was to describe the outcomes and device interactions of simultaneous therapy with an ICD and a LVAD. We evaluated 76 patients with class IV heart failure (age 52 + or - 12 years, left ventricular ejection fraction 0.13 + or - 0.05%, 88% men, 61% nonischemic cardiomyopathy) with both an ICD and a LVAD. ⋯ No ICD therapies occurred because of device-related interactions. In conclusion, simultaneous ICD and LVAD therapy in patients with severe congestive heart failure is safe and clinically feasible. Interactions between the devices are uncommon and appear limited to specific models of ICDs.