„Stent for Life“ Initiative of the European Association of Percutaneous Cardiovascular Interventions

Petr Widimský jménem „Stent for Life Steering Committee“,

Interv Akut Kardiol. 2010;9(1):7-8  

Catheter ablation of cavotricuspid isthmus in patients with permanent atrial flutter and dysfunction of left ventricle

David Břečka, Tomáš Minařík

Interv Akut Kardiol. 2010;9(1):9-11  

Introduction: Catheter ablation of cavotricuspid isthmus (CTI) has become the first line therapy in patients (pts) with typical atrial flutter. Methods: Retrospective analysis of patients (n = 61) with permanent typical atrial flutter and systolic dysfunction of left ventricle (left ventricular ejection fraction (LVEF) ≤ 50 %). All patients underwent catheter ablation of CTI and the effect of ablation on cardiac rhythm and LVEF after a minimum of 3 months follow-up was analysed with respect to the degree of LV systolic dysfunction and presence of structural heart disease. Results: Sinus rhythm (SR) was observed in 51 pts (83.6 %), with...

Prehospital mortality in patients with acute myocardial infarction

Zdeněk Monhart

Interv Akut Kardiol. 2010;9(1):12-14  

Prehospital mortality in patients with acute myocardial infarction significantly exceeds inhospital mortality and, in the recent decades, it has been decreasing at a markedly slower rate than inhospital mortality. According to the literature data available, it ranges from 20 to 30 percent, i. e. for one patient who dies in hospital, there are approximately another three who died prior to admission; moreover, prehospital deaths are predominant among younger patients with acute myocardial infarction.

Epicardial ablation of ventricular tachycardias

Josef Kautzner, Petr Peichl

Interv Akut Kardiol. 2010;9(1):16-19  

Catheter ablation of ventricular tachycardias (VTs) has undergone enormous development in the last decade. The advent of electroanatomic mapping has lead to improvement of efficacy of some focal arrhythmias and enabled the so-called substrate mapping of VTs in the presence of structural heart disease. Nevertheless, some VTs have critical part of the substrate localized epicardially. Epicardial mapping can be performed after pericardial puncture using epidural needle and introduction of a special sheath. Using this approach, entire surface of both ventricles can be mapped epicardially and catheter ablation performed, either by radiofrequency...

Alcohol septal ablation vs. surgical myectomy in the treatment of hypertrophic obstructive cardiomyopathy

Miloslav Brtko, Jan Vojáček, Josef Šťásek, Jan Vojáček, Pavel Polanský, Martin Tuna, Josef Bis, Jaroslav Dušek

Interv Akut Kardiol. 2010;9(1):20-26  

Hypertrophic cardiomyopathy is an autosomal dominant disease with prevalence of 0,2 % and with asymetric hypertrophy of left ventricle (> 15 mm). Obstructive form is clinically more significant and has worse prognosis. As a cause of this disease more than 200 mutations on more than 10 genes were diagnosed till now. Symptomatology and prognosis of hypertophic cardiomyopathy is heterogenous – from asymptomatic course to sudden death. Angina pectoris, effort dyspnoe or syncope are the most common symptoms. Mortality is estimated 1 % to 6 %. Obstructive form is characterized by resting or provoked gradient > 30 mm Hg. In patients with obstructive...

Unusual dislocation of atrial and left ventricular electrodes of a biventricular implantable defibrillator

Jolana Lipoldová, Miroslav Novák, Tomáš Vykypěl, Ivo Dvořák

Interv Akut Kardiol. 2010;9(1):32-36  

Authors present a case of 46-year old woman after biventricular implantable defibrillator (ICD) implantation. Remote monitoring system (Biotronik Home Monitoring) transferred intracardial electrogram of multiple episodes of supraventricular tachycardia, evaluated by the physician to be sinus tachycardia. Betablocker dosage was increased but without effect. Two and half months after implantation, Home Monitoring system alerts abnormal increase of left ventricle lead impedance. Intracardial electrogram of formerly mentioned episodes show intermittent loss of left ventricular sensing. The patient arrived to extra-follow-up 4 months after implantation...

Subacute postinfarction rupture of the left inferior ventricular wall

Petr Kačer, Jan Pirk, Jana Vodičková, Věra Adámková

Interv Akut Kardiol. 2010;9(1):38-40  

Postinfarction left ventricular free wall rupture is a serious complication of transmural myocardial infarction that directly leads to patient death. A case report of a patient with ischemic heart disease and subacute left ventricular inferior free wall rupture is presented.

Dabigatran etexilate - a new promising antithrombotic agent

Jan Bultas, Debora Karetová

Interv Akut Kardiol. 2010;9(1):27-31  

Dabigatran etexilate is a direct reversible thrombin inhibitor. Its advantages include effective anticoagulation without the need for monitoring, possibility to be administered orally once or twice daily and low risk of drug interactions. In clinical studies (Re-NOVATE, RE-MODEL or RE-COVER), it has proved effective in the prophylaxis and treatment of thromboembolic complications in the perioperative period and in the prevention of systemic embolization during atrial fibrillation (the RE-LY study). In the latter indication, in particular, dabigatran at a dose of 300 mg daily was more effective than warfarin (the occurrence of thromboembolic...

Cardiology Days 2009 of the Czech Society of Cardiology

Miloš Táborský

Interv Akut Kardiol. 2010;9(1):46  

ACTIVE A Study. Effect of Clopidogrel Added to Aspirin in Patients with Atrial Fibrillation

Ilja Kotík, Eva Krčová, Kateřina Kačírková, Miroslav Zavoral

Interv Akut Kardiol. 2010;9(1):41-43  

ACTIVE A (The Atrial Fibrillation Clopidogrel Trial with Irbersartan for Prevention of Vascular Events) compared the combination of aspirin plus clopidogrel with aspirin alone for the prevention of major vascular events in patiens with atrial fibrillation who had an increased risk of stroke and in whom therapy with a vitamin K antagonist was considered to be unsuitable. The addition of clopidogrel to aspirin reduced the rate of major vascular events from 7.6 % per year to 6.8 %. This was primarily due to a reduction in the rate of stroke. The rate of major hemorrhagic complications increased with the addition of clopidogrel, from 1.3 % to 2.0...

Quiz solution

Tomáš Janota

Interv Akut Kardiol. 2010;9(1):44