E.B. Kaya

Fragmented QRS Complex Predicts the Arrhythmic Events in Patients with Arrhythmogenic Right Ventricular Cardiomyopathy/Dysplasia

Fragmented QRS (frQRS) complex, with various morphology, has been recently described as a diagnostic criterion of arrhythmogenic right ventricular cardiomyopathy/dysplasia (ARVC/D). However, there are little data regarding the prognostic role of frQRS in these patients. Therefore, we aimed to investigate the association of frQRS with arrhythmic events in patients with ARVC/D.

A Prospective DE-MRI Study Evaluating the Role of TGF-β1 in Left Atrial Fibrosis and Implications for Outcomes of Cryoballoon-Based Catheter Ablation: New Insights into Primary Fibrotic Atriocardiomyopathy

Transforming growth factor (TGF)‐β1 mediated atrial fibrosis plays a major role in the development of vulnerable atrial substrate for atrial fibrillation (AF). Although cryoablation effectively eliminates the triggers for AF, the impact of atrial substrate on the success of cryoablation remains unclear.

Percutaneous Closure of Coronary Artery Fistulae in Adults with Intermediate Term Follow‐Up Results

OBJECTIVE Percutaneous closure of coronary artery fistulae (CAF) has become an alternative method to surgery. But there are limited data about intermediate and long-term results. In this manuscript, we aimed to review our experience about the closure of CAF with several percutaneous methods in our center. METHODS Seven patients who admitted to our hospital, either symptomatic or having complications attributable to CAF, were analyzed. The immediate closure results and clinical follow-up were reviewed. RESULTS Five patients were male (71%) and mean age was 58.3 ± 13.3 years. Five of the CAF were draining into pulmonary artery and 2 of them were draining into the right atrium. Closure of CAF was performed with coil embolization in 5 patients, detachable balloon in 1 patient, and a combination of coil embolization and glue in the remaining 1 patient. In the early follow-up, 1 patient had atrial fibrillation and 1 patient had chest pain immediately after the closure procedure; other patients discharged from hospital uneventfully. Intermediate term follow-up results (32-83 months; median, 54 months) revealed that the procedure was clinically successful in all of the patients, despite the complaint of chest pain in 3 patients and minimal flow in 1 of these patients. CONCLUSION Percutaneous closure of CAF is feasible and safe in anatomically suitable vessels with good results at intermediate term follow-up.

OP-284 Serum Uric Acid Level is a Predictor of Recurrence Following Cryoballoon-Based Atrial Fibrillation Ablation

A B S T R A C T S any major complication. During a median follow-up of 18 months, 32 patients (78.1%) remained free of AF recurrence. Patients with AF recurrence showed higher pre-ablation plasma Pcoll-1-C levels than patients without AF recurrence (108.5 ng/mL vs 65.0 ng/mL, p1⁄40.001). Multivariate Cox regression analysis pointed out that the Pcoll-1-C level (p1⁄40.001) and early AF recurrence (p1⁄40.011) were the independent predictors of AF recurrence in late follow-up. Conclusion: Our findings suggest that the Pcoll-1-C level before PVI could be a crucial predictor of AF recurrence after cryoballoon based PVI.

Huge mediastinal mass surrounding the heart.

The clinical presentation of oncological malignancies may vary widely. Herein, we present a patient with a huge mediastinal mass surrounding the heart, which caused the right ventricle to collapse. The mass was diagnosed as T-cell lymphoblastic lymphoma. Treatment consisted of intrathecal prednisone, ARA-C, methotrexate, and the CHOP chemotherapy regimen. Transthoracic echocardiography revealed disappearance of the paracardiac mass in front of the right ventricle at the 2-month follow-up.ZusammenfassungMaligne Erkrankungen können auf ganz unterschiedliche Art klinisch auffällig werden. Wir stellen einen Patienten vor mit einer riesigen mediastinalen Läsion, die sich um das gesamte Herz herum ausdehnte und einen systolischen Kollaps des rechten Ventrikels verursachte. Histologisch erwies sich der Tumor als T-lymphoblastisches Lymphom. Behandelt wurde mit intrathekal gegebenem Prednison, ARA-C, Methotrexat und Chemotherapie (CHOP-Protokoll). Bei der Zwei-Monate-Follow-up-Untersuchung konnte die parakardiale Läsion vor dem rechten Ventrikel in der transthorakalen Echokardiographie nicht mehr nachgewiesen werden.

Severe limb pain suppresses chest pain in a patient with anterior myocardial infarction

Cardiac complications of chest trauma range from arrhythmias and valvular avulsions to myocardial contusion, rupture, and—rarely—myocardial infarction. Herein, we described a 44-year-old male patient who presented to the hospital after receiving a blow from a fist directly to the chest and fingertip amputation during a fight; anterior myocardial infarction without any chest pain was coincidentally detected. Our case illustrates the importance of electrocardiography in the initial evaluation of patients with chest trauma and suspected injury to the coronary arteries.ZusammenfassungKardiale Komplikationen eines Thoraxtraumas reichen von Rhythmusstörungen und Klappenabrissen bis zu Myokardkontusion, Ruptur und − selten − Myokardinfarkt. Wir berichten von einem 44-jährigen Patienten, der im Rahmen einer Schlägerei einen Faustschlag auf die Brust erhalten und ein Fingerendglied verloren hatte. Nebenbefundlich zeigte sich ein Vorderwandinfarkt ohne Schmerzsymptomatik. Unsere Kasuistik unterstreicht die Relevanz der Elektrokardiographie bei der initialen Evaluierung von Patienten mit Thoraxtrauma und Verdacht auf Beteiligung der Koronararterien.