Twenty-five years since the first cardioverter-defibrillator implantation in Czechoslovakia and further development of this therapy in Czech Republic

Jan Bytešník

Interv Akut Kardiol. 2009;8(5):224-227  

Spectrum of the idiopathic ventricular tachycardias in specialized center

Markéta Koželuhová, Petr Peichl, Peter Hlivák, Robert Čihák, Dan Wichterle, Vladislav Vančura, Jan Bytešník, Josef Kautzner

Interv Akut Kardiol. 2009;8(5):228-232  

Idiopathic ventricular tachycardias (VTs) appear in patients with no structural heart disease. The aim of our study was to describe allotment of individual forms of idiopathic VTs in the cohort of the patients reported for treatment to the specialized center and describe the possibilities of catheter ablation. Methods: The study included 77 patients with idiopathic VT or ventricular ectopic beats (40 males, 37 females; age 49.5 ± 15.6 years, ejection fraction of left ventricle 57.4 ± 3.8 %). Catheter ablation was performed under the guidance of activation sequence mapping, electroanatomic mapping and intracardial echocardiography. Results:...

Can biphasic rectilinear external cardioversion of atrial fibrillation be compared to biphasic intracardiac cardioversion ?

Pavel Marcián, prof. MUDr. Jan Lukl CSc, Jana Zapletalová

Interv Akut Kardiol. 2009;8(5):234-241  

Purpose of Study: According to some papers, the effectiveness of intracardiac electrical cardioversion approaches 100 % and is generally considered to be a „gold standard“ in the effectiveness of electrical cardioversion of atrial fibrillation to sinus rhythm. Findings from experimental papers and experience from the practice suggest that the effectiveness of intracardiac biphasic cardioversion is closely approached by that of some external biphasic defibrillators. Our aim was to try to determine whether in our cohort of patients with persistent atrial fibrillation presenting for external biphasic rectilinear electrical cardioversion,...

Genetic predisposition and risk of sudden cardiac death due to malignant arrythmias

Kamil Sedláček, Jaroslav Hubáček, Josef Kautzner

Interv Akut Kardiol. 2009;8(5):242-246  

Despite significant advances in primary and secondary prevention of sudden cardiac death, risk stratification in individual patients is of a limited value. In clinical practice, it remains restricted mainly to assessment of left ventricular ejection fraction which is the most robust parameter among all. Advances in the field of genomic medicine open new opportunities to apply knowledge obtained through studies of Mendelian diseases such as short or long QT syndrome for risk prediction of malignant arrhythmias in general population. Currently, population studies are ongoing that aim at identification of genetic markers associated with increased...

End stage mitral insufficiency. Surgical view of mitral insufficiency due to left ventricular dilatation and remodeling

Aleš Mokráček

Interv Akut Kardiol. 2009;8(5):248-250  

The aim of the paper is to highlight certain aspects of cardiac surgery in patients with functional mitral insufficiency caused by left ventricular dilatation and remodeling with the exception of cardiac transplantation. The current situation in this field is presented with an emphasis on practical medicine. In the United States alone, 5 million patients with cardiac failure are expected to live and 500,000 new cases appear annually. Transplantation and experimental surgery is of enormous significance and potential; however, only a small portion of these patients can be managed in this manner. The majority, particularly elderly patients, are not...

Patient selection and investigation prior to transcatheter aortic valve implantation

Martin Mates, Jan Kováč

Interv Akut Kardiol. 2009;8(5):251-254  

Transcatheter aortic valve implantation has become a new method available in management of patients with severe aortic stenosis contraindicated for conventional cardiac surgery. Patient selection and assessment of specific morphological criteria obtained by echocardiography and angiography required for certain type of prosthesis are essential parts of pre-operative assessment and are critical for successful intervention.

Peripartum cardiomyopathy - case report and concise review

Tomáš Belza, Pavel Švancar, Rostislav Polášek, Dušan Morman

Interv Akut Kardiol. 2009;8(5):255-258  

Peripartum cardiomyopathy (PPCM) is a rare, but life threatening disease, which affects women in the last month of pregnancy or in the first five months after delivery (1). Our case report describes a case of patient, who was admitted for shortness of breath and rapidly worsening shock closely after Caesarean section. The termination of pregnancy was indicated acutely for the signs of fetal hypoxia due to accidentally detected incesant supraventricular tachycardia of the mother. As the cause of the shock was diagnosed heart failure due to peripartum cardiomyopathy. The treatment was symptomatic by diuretics, inotropes, amiodarone, later on betablocker...

Intramural haematoma of left coronary artery

Martin Pavolko, Petr Vojtíšek, Aleš Herman, Ivo Varvařovský

Interv Akut Kardiol. 2009;8(5):260-263  

In our case report we would like to present a rare instance of myocardial infarction of the anterior wall with primary ventricular fibrillation and cardiogenic shock in a young woman who had no risk factors for ischemic heart disease. The cause was stenosis of the left anterior descending artery produced by an intramural haematoma, which was due to spontaneous coronary artery dissection. Diagnosis was verified by intravascular ultrasound. The lasting presence of stenosis 17 days after the troubles were first documented was the argument for surgical revascularization. In this report we shall try to illustrate epidemiological and diagnostic specifics...

More or less a disease of three coronary arteries and what next ?

Petr Kala

Interv Akut Kardiol. 2009;8(5):264  

Coronary artery disease despite its modern treatmen belongs to the main causes of mortality of the czech population. The optimal treatment strategy should be based not just on the coronary disease morphology but also and especially on its functional significance. Coronary angiography often does not provide enough information and the investigation should be followed by the functional testing, at least in the borderline lesions (40 – 70 %). To perform the myocardial fractional flow reserve measurement just in the cathlab is besides the non-invasive testing a very practical tool offered to the interventional cardiologist. This principle of this...

Pulmonary hypertension in chronic heart failure and options of affecting it

Martin Šurda, Hikmet Al-Hiti, Vojtěch Melenovský, Jiří Kettner, Josef Kautzner

Interv Akut Kardiol. 2009;8(5):265-268  

Various degree of secondary pulmonary hypertension can be found in a significant number of patients with advanced heart failure. It has been considered as an important predictor of morbidity and mortality. Currently, a variety of specific therapies is available for treatment of idiopathic arterial hypertension – endothelin receptor blockers, phosphodiesterase 5 inhibitors and prostanoids. These drugs influence favourably symptoms, haemodynamic parameters and prognosis. Some of them are promissing also for treatment of secondary pulmonary hypertension. The aim of this review is to summarize current possibilities of management of pulmonary...

AURORA study. Rosuvastatin and Cardiovascular Events in Patients Undergoing Hemodialysis

Jiří Vítovec, Jindřich Špinar

Interv Akut Kardiol. 2009;8(5):269-270  

The AURORA study included 2,776 patients who had been in a regular dialysis programme for at least 3 months. Following randomization, the patients received rosuvastatin at a dose of 10 mg/day or placebo. The combined primary endpoint was cardiovascular death, nonfatal myocardial infarction, or stroke. The study failed to demonstrate an effect of treatment with rosuvastatin on reducing cardiovascular events in dialysis patients.

The PLATO study - the birth of an ideal antiplatelet therapy ?

Ivo Varvařovský

Interv Akut Kardiol. 2009;8(5):271-272  

Ticagrelor, direct reversible inhibitor P2Y12 platelet receptor, significantly reduced the rate of death from vascular causes, myocardial infarction and stroke in patients with acute coronary syndromes. First in the history of clinical trials, dual antiplatelet therapy reduced the all-cause mortality. This treatment success was reached without an increase in the rate of overall major bleeding, but with an increase in the rate of non-procedure-related bleeding in patients treated with ticagrelor.

Quiz

Tomáš Janota

Interv Akut Kardiol. 2009;8(5):273-274