Echokardiografie v diagnostice akutního srdečního selhání

Radek Pudil

Interv Akut Kardiol. 2020;19(4):201-202 | DOI: 10.36290/kar.2020.049  

ECG in patients after out-of-hospital cardiac arrest

Jiří Karásek, Klára Boušková, Robert Pospíšil, Jiří Seiner, Matěj Strýček, Rostislav Polášek

Interv Akut Kardiol. 2020;19(4):203-206 | DOI: 10.36290/kar.2020.044  

Introduction: ECG is a simple method accessible in prehospital care and is commonly used in the management of out-of-hospital cardiac arrest (OHCA). Previous studies were focused mainly on ST elevation. The informative value of ECG after restitution of spontaneous circulation (ROSC) may be influenced by hemodynamic instability, acid-base changes, and hyposaturation after resuscitation. Aim: To establish the incidence of different pathologies on ECG after ROSC, to determine its sensitivity and specificity for acute coronary syndromes (ACS), and to compare their validity immediately after ROSC and after hospital admission. Methods: An observational retrospective...

Five-year experience with an ECMO programme at a regional heart centre without cardiac surgery on site

Jiří Karásek, Rostislav Polášek, David Horák, Jiří Seiner, Vladimír Hraboš, Jan Horák, Pavel Tomašov, Kateřina Krejbichová, Ivana Zýková, Pavel Sedlák, Dušan Morman, Petr Ošťádal

Interv Akut Kardiol. 2020;19(4):208-212 | DOI: 10.36290/kar.2020.045  

Introduction: Extracorporeal membrane oxygenation (ECMO) is a method of extracorporeal circulation which is increasingly used in patients with cardiogenic shock or refractory cardiac arrest. The care is almost exclusively provided in hospitals with cardiac surgery on site. Methods: A prospective registry of all patients treated with ECMO from April 2015 to March 2020 regardless of the reason for implantation was performed. We assessed the technical success, duration of treatment, complication rate, and in-hospital mortality. Results: From April 2015 to March 2020, we performed 38 ECMO implementations (31 veno-arterial and 1 veno-venous as well as 6...

What to expect from direct oral anticoagulant monitoring

Miroslav Penka, Jan Novotný

Interv Akut Kardiol. 2020;19(4):215-221 | DOI: 10.36290/kar.2020.033  

In our quest for an ideal antithrombotic drug with therapeutic efficacy and a good safety profile with a possibility of parenteral administration, rapid onset of action, no need for routine laboratory checks, few or no drug-drug and drug-food interactions, and economic availability, we have arrived at direct oral anticoagulants (DOACs) which get us a step closer to meet these requirements. Although not necessary, laboratory monitoring of the effect of DOACs can be appropriate in the setting of bleeding, overdose, treatment failure, before acute interventional procedures and operations, in renal insufficiency, in drug interactions, in the case of extreme...

Ultrasound guided anesthetic stellate ganglion block in treatment of ventricular storm

Otakar Jiravský, Radim Špaček, Jan Chovančík, Miroslav Hudec, Libor Škňouřil, Martin Fiala

Interv Akut Kardiol. 2020;19(4):222-226 | DOI: 10.36290/kar.2020.034  

Malignant ventricular storm is a life-threatening condition. The increasing use of implantable cardioverter-defibrillators has significantly improved the related mortality. On the other hand, the increasing number of implanted devices has led to a growing number of patients with ventricular arrhythmias treated with shocks. Altering the activity of the sympathetic system with ultrasound-guided stellate ganglion blockade may target the crucial initiating as well as sustaining mechanisms of ventricular tachyarrhythmia.

Sirolimus-eluting balloon catheters

Leoš Pleva, Pavel Kukla

Interv Akut Kardiol. 2020;19(4):229-231 | DOI: 10.36290/kar.2020.046  

Drug-eluting balloon catheters allow local delivery of an effective antiproliferative agent which reduces neointimal hyperplasia into the vessel wall. Due to its easy binding to the surface of the balloon catheter and rapid penetration into tissues, paclitaxel is mainly used as the active substance. However, sirolimus-eluting balloon catheters, similarly to sirolimus-eluting stents, could be more effective than paclitaxel.

Administration of cangrelor after coronary intervention immediately following minimally invasive cardiac surgery procedure

Martin Mates, Štěpán Černý, Karel Kopřiva

Interv Akut Kardiol. 2020;19(4):236-237 | DOI: 10.36290/kar.2020.050  

The case report describes the administration of cangrelor to a female patient who underwent percutaneous coronary intervention with stent implantation immediately following a minimally invasive cardiac surgery procedure (mitral and tricuspid valvuloplasty). The reasons for administering a parenteral antiplatelet agent were bleeding concerns and impossibility of oral intake.

Covered Stent Embolization: a case of acute coronary intervention with a series of multiple complications

Firas R. AL-Obaidi, Mohammed H. AL-Ali, Tahsin AL-Kinani, Mohammed AL-Myahi

Interv Akut Kardiol. 2020;19(4):232-235 | DOI: 10.36290/kar.2020.036  

Complications during acute coronary intervention are rare and life-threatening. We present a case of a patient with acute coronary syndrome admitted for percutaneous coronary intervention to the left anterior descending artery. The straightforward procedure was challenged by multiple complications of coronary artery perforation, cardiac tamponade, stent loss, and ventricular fibrillation. The management was complicated by covered stent embolization into the left circumflex artery without a wire inside. We were able to retrieve the lost covered stent by re-accessing the lumen with a coronary guidewire followed by advancing a balloon distal to the stent...

Zpráva z TCT 2020

Jan F. Vojáček

Interv Akut Kardiol. 2020;19(4):245-246 | DOI: 10.36290/kar.2020.052  

EMPEROR-Reduced trial: empagliflozin in patients with heart failure and low ejection fraction

Jindřich Špinar, Lenka Špinarová, Jiří Vítovec

Interv Akut Kardiol. 2020;19(4):238-241 | DOI: 10.36290/kar.2020.051  

Background: In patients with heart failure with and without diabetes, inhibitors of sodium-glucose cotransporter 2 (SGLT2) reduce the risk of serious heart failure events. More evidence is needed regarding the effects of SGLT2 inhibitors in patients across the broad spectrum of heart failure, including those with markedly reduced ejection fraction and higher natriuretic peptide levels. Methods: In this phase III, placebo-controlled trial, we randomly assigned 3,730 patients with New York Heart Association class II, III, or IV heart fail-ure and an ejection fraction of 40 % or less to receive either empagliflozin (10 mg once daily) or placebo, in addition...

MUDr. Petr Janský šedesátníkem

Tomáš Janota

Interv Akut Kardiol. 2020;19(4):243