Stereotactic radiotherapy in treating ventricular tachycardias: reality or fiction?

Josef Kautzner, Marek Šramko

Interv Akut Kardiol. 2019;18(4):189-191  

Impact of cardiac surgery on short- and longterm mortality among patients with left-sided Staphylococcus aureus infective endocarditis

Michal Pazdernik, Peter Wohlfahrt, Josef Kautzner, Jiří Kettner, Jan Sochman, Josef Stasek, Miroslav Solar, Radek Pelouch, Jan Vojacek

Interv Akut Kardiol. 2019;18(4):193-199  

Purpose: Staphylococcus aureus (SA), which is the leading cause of infective endocarditis (IE), has increased in prevalence over recent years. Contemporary data on the long-term benefits of cardiac surgery among patients with SA and non-SA IE are sparse. Methods: The aim of the present study was to compare short-term and long-term mortality risk among surgical and non-surgical patients with SA and non-SA IE. We carried out a retrospective survey of consecutive left-sided IE adult patients, admitted over a 15-year period to the University Hospital Hradec Kralove, Charles University, Czech Republic (between 1998 and 2006), and to the Institute...

Cardioversion

Jiří Kettner

Interv Akut Kardiol. 2019;18(4):201-208  

Cardioversion is a procedure aimed at prompt abolition of arrhythmia and restoration of sinus rhythm. This most frequently involves atrial fibrillation (AF). The article describes the history and nature of cardioversion, the most common indications, practical implementation of the procedure, possible complications, and anticoagulant therapy in relation to cardioversion with an emphasis on novel direct anticoagulants.

Current options of vulnerable plaque imaging

Karel Kopřiva, Tomáš Kovárník, Martin Mates

Interv Akut Kardiol. 2019;18(4):211-217  

In an effort to improve the prevention of acute coronary syndrome, one of the key priorities in cardiology is the development of methods capable of identifying individuals with a high risk of presence of vulnerable plaques. These plaques possess typical morphological characteristics that can be identified in vivo by using imaging techniques. The aim of detecting these vulnerable plaques is to determine a higher risk of developing acute coronary syndrome both at patient level and in relation to a particular coronary lesion. The authors present a review of invasive and non-invasive imaging modalities currently used in detecting vulnerable plaques, and...

Cardiomyopathy induced by frequent premature ventricular complexes

Petr Pařízek

Interv Akut Kardiol. 2019;18(4):218-222  

Premature ventricular complex-induced cardiomyopathy is a potentially reversible condition in which left ventricular dilatationand/or dysfunction is induced by the occurence of frequent premature ventricular complexes (PVCs). The elimination of PVCs byantiarrhythmic drugs or radiofrequency ablation may improve or restore normal left ventricular function.

Long-term results following atrial septal defect surgery

Daniela Žáková, Tomáš Zatočil, Olga Pokorná, Petr Malík, Jiří Ničovský, Jiří Ondrášek, Jan Černý, Petr Němec

Interv Akut Kardiol. 2019;18(4):224-229  

Atrial septal defect is the most common congenital heart disease of adults with a good outcome. Early repair of significant atrialshunt leads to regression of symptoms and prevents right ventricular dysfunction and tricuspid regurgitation. Patients benefitfrom closure at any age. Residual lesions are not frequent and depend on the age at closure. Device closure is the first option toclose an atrial septal defect if it is suitable for cathether intervention. Minimally invasive surgery has been an increasing trend ofclosure in recent years in defects not to be managed with device closure.

The under-recognized value of an electrocardiogram

Helder Santos, Inês Almeida, Hugo Miranda, Mariana Santos, Samuel Almeida, Lurdes Almeida,, Catarina Sousa, Joana Chin, Catarina Sá, Luís Santos, João Tavares

Interv Akut Kardiol. 2019;18(4):230-231  

In ST elevation myocardial infarction, an emergent coronary revascularization is recommended. Although, despite the recommendations not all the patients receive a standard therapy, due the presence of electrocardiogram (EKG) patterns that do not mimic a ST elevation. A 64-year-old male, smoker, was admitted for acute retroesternal pain, radiating to the jaw, associated with nausea and diaphoresis. EKG without a clear ST elevation but revealed a De Winter pattern. Transthoracic echocardiography showed hypokinesis in the mid and apical segments of the anterior wall, with preserved left ventricular ejection fraction. A coronary angiogram revealed a left...

DECLARE study confirms cardiovascular effect of dapagliflozín

Jindřich Špinar, Lenka Špinarová

Interv Akut Kardiol. 2019;18(4):232-234  

DECLARE is an international clinical trial with dapagliflozin and was published the last year. The study included 17 160 patients with diabetes mellitus type 2, who were randomised on placebo or dapagliflozin 10mg/daily. Mean age was 63.8 ± 6.8 years, mean duration of diabetes 11.8 ± 7.8 years, mean glycated haemoglobin 8.3 ± 1.2 %. 6 971 (40.6 %) were patients with confirmed cardiovascular disease (CVD). 10 189 (59.4 %) were patients with multiple risc factors (MRF), 1 316 (7.7 %) had low ejection fraction. In the primary safety outcome analysis dapagliflozin met the prespecified criterion for noninferiority to placebo with respect...

The MARINER Study

Lenka Špinarová, Jindřich Špinar, Jiří Vítovec

Interv Akut Kardiol. 2019;18(4):236-237  

The Mariner study aimed to ascertain whether prolonged administration of rivaroxaban for a period of several weeks had any importance for thromboprophylaxis. The aim was to show efficacy as well as safety of prolonged prophylactic administration of rivaroxaban in a population at risk. The primary endpoint was a composite of deep vein thrombosis and nonfatal pulmonary embolism or death from thromboembolic disease. The primary safety endpoint was major bleeding. Rivaroxaban, when administered preventively for 45 days, failed to significantly reduce the composite endpoint of venous fatal or nonfatal thromboembolism compared with placebo. The rate of major...

ISAR REACT 5: acute concern or storm in a teacup?

Ivo Varvařovský

Interv Akut Kardiol. 2019;18(4):239-242  

Aggressive antiplatelet therapy is the cornerstone for acute coronary syndrome treatment. Acute phase therapy is based on thedual antiplatelet treatment (DAPT) with highly effective inhibitors of the platelet receptor P2Y12. The ISAR-REACT 5 trial directlycompare ticagrelor and prasugrel in two different antiplatelet strategies. The result of both efficacy and safety are contrary tocurrent knowledge and needs to be carefully validated.