Polskie Archiwum Medycyny Wewnętrznej
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Pol. Arch. Med. Wewn. · Sep 2023
Randomized Controlled TrialMobile app and digital system for patients after Myocardial Infarction (afterAMI): early results from a randomized trial.
Cardiac rehabilitation (CR) is a complex program aimed at better control of cardiovascular risk factors. It can be supported by mobile applications. Despite promising results from previous studies on telemedicine tools, there is a paucity of evidence when it comes to prospective randomized trials. ⋯ This study serves as an example of a telemedicine tool being implemented into everyday practice. The augmented rehabilitation program resulted in better control of cholesterol level. Longer follow‑up is required to establish prognosis in this population.
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Pol. Arch. Med. Wewn. · Sep 2023
ReviewPharmacological cardioversion of atrial fibrillation: practical considerations.
The choice between rhythm and rate control strategy represents one of the most intriguing dilemmas in the management of atrial fibrillation (AF). Although the advantage of rhythm over rate control in terms of outcome has not been unequivocally proven, the initial management of patients with symptomatic episodes of AF frequently involves early cardioversion. As electrical cardioversion (EC) is challenging in terms of fasting status and involvement of an anesthesiologic team, pharmacological cardioversion (PC) is usually selected as the first step toward rhythm conversion. ⋯ The presence of SHD consistent with any left ventricular hypertrophy, heart failure, myocardial ischemia, or valvular heart disease limits the choice of AAD to amiodarone. Given the risk of ventricular proarrhythmia of AAD, safety should always prevail over the enticing possibility of rhythm conversion. The present review aims to provide a comprehensible summary of proper qualification for PC, selection of suitable AAD, and state‑of‑the‑art periprocedural management of patients with recent‑onset AF.