Úvodní slovo

prof. MUDr. Jan Vojáček, DrSc., FESC, FACC

Interv Akut Kardiol. 2020;19(2):79  

Kardioneuroablace - inovace bez legraceCardioneuroablation - a true innovation

Dan Wichterle

Interv Akut Kardiol. 2020;19(2):85-86 | DOI: 10.36290/kar.2020.022  

Distal radial approach in coronary catheterizations and interventions

Ivo Bernat, David Horák, Štěpán Jirouš, Jan Pešek, Jiří Koza, David Slezák, Richard Rokyta

Interv Akut Kardiol. 2020;19(2):88-90 | DOI: 10.36290/kar.2020.023  

Standard radial approach from the right or left wrist has become a dominant arterial approach for coronary catheterizations and interventions with IA recommendation in 2018 Guidelines for myocardial revascularization of European Society of Cardiology. Since that time several articles has been published about distal radial approach. This article describes our first experience with this new approach.

Cardioneuroablation as a new modality of invasive treatment of functional bradyarrhythmias: initial experience

Alan Bulava, Jiří Haniš, Klára Stašková, Iva Šafaříková, Veronika Kotolová, David Sitek

Interv Akut Kardiol. 2020;19(2):91-96 | DOI: 10.36290/kar.2020.024  

Introduction: Cardioinhibitory mechanisms are very common and usually benign cause of syncope. A frequent recurrence of syncopal spells significantly reduces the quality of life and may result in serious injuries. Both pharmacological therapy and non-pharmacological measures are often ineffective. Goal: To show our initial experience with an interventional treatment aimed at reducing the parasympathetic tone using radiofrequency catheter ablation (also known as cardioneuroablation, CNA). Methods and Results: Initial 20 patients (mean age 42 ± 13 years, 10 men, 10 women) were included in the trial. The mean duration of asystolic pauses was 11.4...

Importance of modern antidiabetic drugs for the cardiologist and diabetologist

Alena Šmahelová

Interv Akut Kardiol. 2020;19(2):97-100 | DOI: 10.36290/kar.2020.025  

SGLT2 inhibitors - gliflozins - are a novel group of antidiabetic drugs whose action is independent of insulin secretion from pancreatic beta cells. In addition to affecting hyperglycaemia without a risk of hypoglycaemia, they contribute to reducing weight and hypertension. Large randomized clinical trials of these antidiabetic drugs have not only confirmed their cardiorenal safety, but also have shown other major benefits. In type 2 diabetic patients who more often present with cardiorenal syndrome, atherosclerotic cardiovascular disease, renal involvement, and increased risk of heart failure (also seen in non-diabetics), these drugs have a protective...

Proton pump inhibitors as part of comedication with antithrombotic drugs: are their indications justified?

Jan Bultas

Interv Akut Kardiol. 2020;19(2):101-108 | DOI: 10.36290/kar.2020.026  

The administration of proton pump inhibitors (PPIs) along with antithrombotic therapy indicated to reduce gastrointestinal bleeding is common practice. Evidence of reduced bleeding risk with this strategy is only available at the level of observational studies, with a reduction by approximately one-third being significant. However, with a relatively low rate of gastrointestinal bleeding, the absolute risk reduction is small, somewhere near 0.3 %. The observed value of NNT (number needed to treat) is around 250, i.e. for every 250 patients treated with PPIs, one bleeding episode (typically not a critical one) is prevented. On the other hand, there has...

Pulmonary embolism - what is new in the 2019 European Society of Cardiology guidelines

Richard Rokyta, Martin Hutyra, Pavel Jansa

Interv Akut Kardiol. 2020;19(2):109-116 | DOI: 10.36290/kar.2020.027  

In 2019, the European Society of Cardiology published new guidelines for the management of acute pulmonary embolism. This article summarizes the new/revised concepts and recommendations. Details as well as classes of recommendations and levels of evidence are listed in the original text of the guidelines (1).

Coronary stent thrombosis: the problem still persists

František Holm

Interv Akut Kardiol. 2020;19(2):117-121 | DOI: 10.36290/kar.2020.028  

Coronary stent thrombosis is a feared complication with a relatively high mortality rate. Despite advances in stent type and design and the introduction of novel, more effective antiplatelet drugs, the problem still persists. The paper deals with the pathophysiology of thrombosis, taking into account the patient's clinical condition, lesion characteristics, procedural technical factors, and adjuvant pharmacotherapy. A case report is presented of early stent thrombosis with a fatal outcome.

Fixed combination of atorvastatin and ezetimibe in the dyslipidemia treatment

Hana Rosolová

Interv Akut Kardiol. 2020;19(2):122-124 | DOI: 10.36290/kar.2020.029  

Primary and secondary prevention of atherosclerotic cardiovascular diseases (ASCVD) stays to be one of the Czech health care priorities. The ABC of ASCVD prevention is healthy life style and LDL-cholesterol (ch), the most causal risk factor among all, reduction. To reach the new ambicious LDL-ch aims is impossible by only statin monotherapy. Combination of statin and ezetimibe has got the highest class of recommendation. That fixed combination is very effective, well tolerated and improves therapy adherence. It is eligible for all patients with very high or high global cardiovascular risk. The advantages of atorvastatin and ezetimibe fixed combination...

Koronární intervence stenózy ve větvení levé věnčité tepny za použití "provisional stenting" -význam invazivního funkčního hodnocení a intrakoronárního zobrazení pro techniku zavedení stentu

Luís Graça Santos, Marco Costa, Luís Paiva, Lino Gonçalves

Interv Akut Kardiol. 2020;19(2):127-128 | DOI: 10.36290/kar.2020.004  

Popisujeme pozoruhodný případ pacienta se stenózou ve větvení kmene levé věnčité tepny, postihující jak odstup ramus circumflexus, tak první marginální větve, která byla úspěšně léčena provizorním zavedením jednoho stentu. Intrakoronární zobrazení a invazivní funkční hodnocení bylo použito k posouzení anatomické a funkční složitosti tohoto případu, pro vlastní techniku zavedení stentu a ke zhodnocení konečného výsledku.

Zpráva z 15. setkání EBC 18.-19. října 2019 v Barceloně

Jan F. Vojáček

Interv Akut Kardiol. 2020;19(2):137-138 | DOI: 10.36290/kar.2020.032  

Results of ISCHEMIA trial were presented at AHA meeting in Philadelphia in November 2019

Jan F. Vojáček

Interv Akut Kardiol. 2020;19(2):134-135 | DOI: 10.36290/kar.2020.031  

The results of the ISCHEMIA study were presented at the American Heart Association Congress in Philadelphia 2019. The four-year incidence of primary endpoint (cardiovascular death, myocardial infarction, hospitalization for unstable angina, heart failure or resuscitated cardiac arrest) was in 15.5% of patients on conservative treatment and 13.3% of patients with invasive strategy and did not differ statistically in both groups.

Simulation training in invasive and interventional cardiology

Radka Smitalová, David Pospíšil, Barbora Farkasová, Jan Kaňovský, Petr Kala

Interv Akut Kardiol. 2020;19(2):130-133 | DOI: 10.36290/kar.2020.030  

This document summarizes the knowledge based on virtual reality simulations used as a learning and training instrument in interventional cardiology. The authors focus on historical development, current possibilities, forms, advantages, disadvantages, and limitations of various simulation modalities. The studies published so far have shown that simulators are useful tools for the assessment and training of operator skills. However, a comparison of these studies is difficult because of their diversity. There are not enough studies quantifying the benefits of simulation training in real clinical practice or comparing the results of simulation training...