International journal of cardiology
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Randomized Controlled Trial
Feasibility of a cardiologist-only approach to sedation for electrical cardioversion of atrial fibrillation: a randomized, open-blinded, prospective study.
Sedation with propofol should be administered by personnel trained in advanced airway management. To overcome this limitation, the use of short acting benzodiazepines by cardiologists spread widely, causing concerns about the safety of this procedure in the absence of anesthesiology assistance. The aim of the study was to compare feasibility of a cardiologist-only approach with an anesthesiologist-assisted sedation protocol during elective direct-current cardioversion (DCC) of persistent atrial fibrillation (AF). ⋯ Sedation with midazolam administered by cardiologist-only appears to be as safe as sedation with propofol and anesthesiologist assistance. Adverse events were few in both groups and easily handled by the cardiologist alone. A cardiologist-only approach to sedation provides less procedural delay, thus being easier to schedule and correlated with fewer costs.
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Multicenter Study
Hemoglobin and renal replacement therapy after cardiopulmonary bypass surgery: a predictive score from the Cardiac Surgery Registry of Puglia.
Acute Kidney Injury (AKI) after cardiac surgery is a complication influencing postoperative outcome. Preoperative hemoglobin is a predictor of postoperative AKI. We aimed to identify preoperative predictors of Renal Replacement Therapy (RRT) and to develop a new risk-scoring system including hemoglobin to better stratify the risk of events. ⋯ Our simple bedside prognostic score demonstrates good performance in predicting RRT. Hemoglobin plays an important role and future studies will clarify if preoperative anemia correction will lead to decreased RRT risk.
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Multicenter Study Comparative Study
Long-term comparison of cryoballoon and radiofrequency ablation of paroxysmal atrial fibrillation: a propensity score matched analysis.
Although radiofrequency (RF) and cryoballoon (CB) based technologies for pulmonary vein isolation (PVI) have both individually been demonstrated to be effective and safe for the treatment of paroxysmal AF, head-to-head comparisons are lacking. The purpose of this study was to compare the outcome of cryoballoon versus radiofrequency ablation in patients with paroxysmal atrial fibrillation undergoing pulmonary vein isolation. ⋯ A propensity score matched comparison between CB-PVI and RF-PVI using a 3D-mapping system for AF ablation showed similar long-term success rates.
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Despite the fact that recent evidence from meta-analysis of randomized trials indicates an increase in mortality, perioperative treatment with β-blockers is still widely advocated. We therefore performed a meta-analysis of cohort studies to evaluate the effects of perioperative β-blockers on mortality in patients undergoing non-cardiac surgery in the real world scenarios. ⋯ In the real world scenarios, for patients undergoing non-cardiac surgery, the routine use of β-blockers does not seem to reduce the risk of death. Moreover, those who are taking β-blockers on the day of surgery may have an increased risk of postoperative mortality. However, these results should be interpreted with caution because of the significant heterogeneity across the studies.
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Multicenter Study Comparative Study
One-year clinical outcomes of everolimus- versus sirolimus-eluting stents in patients with acute myocardial infarction.
In contrast to many studies comparing everolimus-eluting stent (EES) with paclitaxel-eluting stent (PES), data directly comparing EES with sirolimus-eluting stent (SES) are limited, especially in patients with acute myocardial infarction (AMI). ⋯ The present propensity score matched analysis performed in a large-scale, prospective, multicenter registry suggests that the second-generation drug-eluting stent EES has at least comparable or even better safety and efficacy profiles as compared with SES in the setting of AMI.