“Christ's years” and Czech interventional cardiology

Petr Kala

Interv Akut Kardiol. 2009;8(6):284  

Levels of myocardial damage markers in patients with hypertrophic cardiomyopathy

Radek Pudil, Miloš Tichý, Juraj Lenčo, Jan Miloš Horáček, Martina Ulrychová, Alena Fučíková, Jan Vojáček, Jiří Stulík, Vladimír Palička

Interv Akut Kardiol. 2009;8(6):286-290  

Aim of the study: To evaluate plasma levels of markers of structural myocardial damage in patients with hypertrophic cardiomyopathy (HCM). Methods: 21 pts with HCM was enrolled into the study. Echo and catheterization were performed before enrolment into the study. We analyzed plasma troponin I (cTnI), troponin T (TnT), creatine kinase MB concentration (CK-MB), glycogenphosphorylase BB (GPBB), heart fatty acid binding protein (hFABP) and myoglobin (myo) levels. Results: Compare to control group, plasma levels all evaluated parameters were significantly increased (cTnI: 0.92 ± 0.49 μg/l vs. 0.33 ± 0.06 μg/l, p < 0,001;...

Stress (Tako-tsubo) cardiomyopathy

Roman Surovčík, Rudolf Feuereisl, Petr Frídl, Karel Hlaváček, Pavel Jebavý, Jan Pavlovič

Interv Akut Kardiol. 2009;8(6):292-296  

Aim: The aim of our study was to determine the prevalence of the stress cardiomyopathy and to analyse clinical status, prognosis and results of echocardiographic stress tests with dobutamine. Methods: During six years (from January 2003 to December 2008) 2 143 patients with troponin positive ACS were examined in our cathlab (Kardiologie na Bulovce). We confirmed stress cardiomyopathy in 11 patients (10 females). We have determined prevalence, clinical profile, prognosis and performed with time-delay echocardiographic stress test with dobutamine. Results: Total prevalence was 0.5 %. The mean age of the population was 63.5 ± 12.5 years....

Arrhythmic storm - a life-threatening condition

Petr Peichl, Josef Kautzner

Interv Akut Kardiol. 2009;8(6):297-301  

Electric storm is defined as three or more episodes of ventricular tachyarrhythmias within 24 hours that require interruption. It’s incidence in patients with implanted cardioverter-defibrillator ranges between 10–20 % per one year. Electric storm occurs suddenly and mostly without indentifiable precipitating factor. The therapeutic approach is complex. From pharmacotherapy, sedation and combination of betablockers and amiodarone is recommended. In case of recurrent arrhythmias despite this treatment, catheter ablation and modification of arrhythmogenic substrate is indicated. If the electric storm is caused by polymorphic ventricular...

Insufficient effectiveness of antithrombotic therapy -

Jan Vojáček1, Hana Ševčíková1, Róbert Ševčík1, Josef Bis1, Jaroslav Dušek1, Josef Šťásek1, Miroslav Pecka2

Interv Akut Kardiol. 2009;8(6):302-306  

clinical associations and current opinions on its laboratory assessment Laboratory demonstration of insufficient platelet inhibition correlates with the clinical incidence of thrombotic complications. What is missing, however, is the evidence of how to proceed in patients with a laboratory demonstration of insufficient effectiveness of antiplatelet therapy, i. e. those with increased residual platelet aggregation. According to existing data, it is low (1–8 %) when acetylsalicylic acid alone is administered when assessing the specific inhibition of arachidonic acid cycle, but more common when assessing the non-specifically induced platelet...

Current trends in antiarrhythmic drug therapy of atrial fibrillation

Jan Bytešník

Interv Akut Kardiol. 2009;8(6):307-310  

Despite the increasing number and promising results of catheter ablations and cardiac surgeries to manage atrial fibrillation (AF), drug therapy currently remains the mainstay of treatment in various forms of AF. Two major strategies of this treatment are distinguished: heart rate control and heart rhythm control. To restore and maintain the sinus rhythm, three antiarrhythmic drugs – propafenone, sotalol, and flecainide – are mainly used in patients without structural cardiac disease; in those with cardiac damage, amiodarone is preferred. New antiarrhythmic drugs are being developed such as selective ones for atrial myocardium,...

Catheter closure of type II atrial septal defect and telemetry monitoring of heart rhythm

Petr Kala, Martin Poloczek, Tomáš Brychta, Jiřina Ječmínková, Irena Kolářová, Veronika Bulková, Václav Chaloupka

Interv Akut Kardiol. 2009;8(6):311-313  

Catheter closure of the interatrial septal defect is relatively simple, safe and highly effective method of treatment with a low risk of acute complications. What is not well known at present is the monitoring and occurrence of the cardiac arrhytmias during the followup. Telemetry seems to provide a promising option for ECG monitoring of the patients as described in this case in whom the first atrial fibrillation was diagnosed after a successful and uncomplicated catheter closure.

Acute anterior STEMI with prolonged successful cardiopulmonary resuscitation

Abdul Al Mawiri, Jan Vojáček, Jiří Nový

Interv Akut Kardiol. 2009;8(6):314-315  

A case of young patient after protracted cardiopulmonary resuscitation due to acute myocardial infarction as a first manifestation of ischemic heart disease. After successful resuscitation, primary coronary intervention of the infarct-related artery and management of subsequence hospitalisation patient was dismissed in good condition. infarct-related artery.

Rupture of an abdominal aortic aneurysm

Jana Čepelová, Miroslav Černohous, Ivan Jeřábek, Miroslav Zavoral

Interv Akut Kardiol. 2009;8(6):316-318  

A case of an old man, a smoker, with untreated hypertension, with a diagnosis of ruptured abdominal aortic aneurysm is presented. A 79 years old man had been examinated in an emergency for a sudden colic pain in a hipster area, an emesis and a progress of a shock. Diagnosis of ruptured abdominal aortic aneurysm was confirmed by ultrasonic and subsequently by computer tomography. Succesfull surgical operation was perform. Patient‘s condition was observated in an ambulatory care next year without complications.

Tips and tricks of transradial approach. How to remove kinked catheter in brachial artery ?

Miroslav Brtko, Šárka Holá, Peter Priester

Interv Akut Kardiol. 2009;8(6):320-321  

Extraction of kinked diagnostic catheter during transradial approach for coronary angiography is described in this case report. Using this method a damage of access artery and a surgical revision were avoided.

Beta blockers in the treatment of acute heart failure

Tomáš Janota

Interv Akut Kardiol. 2009;8(6):322-324  

Beta blockers boast a number of advantageous effects. Substantial is a deceleration of heart rate, leading to the decrease in metabolic demands of the myocardium, improvement of left ventricle filling, as well as improvement in the subendocardial blood flow. They also decrease arterial blood pressure, have antiarrhythmic effects and in long term use in chronic heart failure lead to an increase in left ventricle ejection fraction. Beta blockers can also improve myocardial function in acute heart failure. It is nowadays a standard practice to continue chronic beta blocker medication in acute exacerbation of chronic heart failure when possible....

The initial outcomes of STICH Trial (Surgical Treatment of Ischemic Heart Failure Trial)

Růžena Jandová, Ivan Málek, Jan Pirk

Interv Akut Kardiol. 2009;8(6):328-331  

Surgical ventricular reconstruction (SVR) is a procedure designed to reduce left ventricular (LV) volume in patients with heart failure caused by coronary artery disease. The aim of the study was the question whether SVR added to coronary-artery bypass grafting (CABG) would decrease the rate of death or hospitalization for cardiac causes, as compared with CABG alone. 1,000 patients with (LV) ejection fraction ≤ 35 %, coronary artery disease amenable to CABG, and dominant anterior LV dysfunction suitable to SVR were randomized to CABG alone (n = 499) or CABG + SVR (n = 501). The median follow-up was 48 months. SVR reduced end-systolic...

Studies from the HOTLINES section at ESC Congress in Barcelona (29. 8.- 2. 9. 2009)

Josef Kautzner, Peter Hlivák

Interv Akut Kardiol. 2009;8(6):332-333  

Invasive cardiology in Czech Paradise 2009

Jaroslav Dušek

Interv Akut Kardiol. 2009;8(6):334  

ACTIVE I and upstream therapy

Jindřich Špinar, Růžena Lábrová

Interv Akut Kardiol. 2009;8(6):325-327  

Atrial fibrillation is the most common sustained arrhythmia. It is associated with increased morbidity and mortality and decreased quality of life. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers reduce morbidity and mortality in patients with heart failure, vascular disease, and hypertension. The renin-angiotensin-aldosterone system (RAAS) is involved in the pathophysiology of atrial fibrillation, and that RAAS blockade improves outcomes in atrial fibrillation merits plausibility. There are now mounting data to suggest that modulation of the renin-angiotensin-aldosterone system might have an important role in the...