Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Sep 2007
The role of left atrial muscular bundles in catheter ablation of atrial fibrillation.
We sought to investigate the imaging of the left atrial (LA) muscular bundle and the relationship between the bundle and inducibility of tachyarrhythmia after pulmonary vein isolation (PVI). ⋯ Left atrial muscular bundles may provide a conduction block line and barrier, which is important for the formation of LA flutter/AF after PVI. The noninducibility of LA flutter/AF achieved after additional linear ablation may contribute to a better outcome in RF ablation of paroxysmal atrial fibrillation.
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J. Am. Coll. Cardiol. · Sep 2007
ReviewReperfusion strategies in acute ST-segment elevation myocardial infarction: a comprehensive review of contemporary management options.
There are an estimated 500,000 ST-segment elevation myocardial infarction (STEMI) events in the U. S. annually. Despite improvements in care, up to one-third of patients presenting with STEMI within 12 h of symptom onset still receive no reperfusion therapy acutely. ⋯ Careful attention to these variables is critical to ensuring safe and rapid reperfusion, particularly in the prehospital setting. The emerging modality of pharmacoinvasive therapy, although controversial, seeks to combine the benefits of mechanical and pharmacologic reperfusion. Results from ongoing clinical trials will provide guidance regarding the utility of this strategy.
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J. Am. Coll. Cardiol. · Aug 2007
Multicenter Study Clinical TrialChronic mechanical circulatory support for inotrope-dependent heart failure patients who are not transplant candidates: results of the INTrEPID Trial.
This study evaluated the impact of left ventricular assist device (LVAD) support on survival and quality of life in inotrope-dependent heart failure patients ineligible for cardiac transplantation. ⋯ Inotrope-dependent heart failure patients who are ineligible for transplantation have a high short-term mortality rate and derive a significant survival advantage from "destination" mechanical circulatory support.
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J. Am. Coll. Cardiol. · Aug 2007
Long-term predictors of descending aorta aneurysmal change in patients with aortic dissection.
We sought to demonstrate the long-term natural course of descending aorta dilation after acute aortic dissection (AD) and identify early predictors for late aneurysmal change. ⋯ The UT is the major site of late aneurysmal dilation. A large UT false lumen diameter on the initial CT portends late aneurysm and adverse outcome warranting early intervention.