scholarly journals Safety of Permanent Pacemaker Implantation: A Prospective Study

2019 ◽  
Vol 8 (1) ◽  
pp. 35 ◽  
Author(s):  
Mª Reyes Carrión-Camacho ◽  
Ignacio Marín-León ◽  
José Manuel Molina-Doñoro ◽  
José Rafael González-López
Keyword(s):  
Antithrombotic Therapy ◽  
Pacemaker Implantation ◽  
Complication Rates ◽  
Minor Complication ◽  
Permanent Pacing ◽  
Short And Long Term ◽  
A Prospective Study ◽  
Technical Failures ◽  
Lead Dislodgement

Although pacemaker implantation is considered to be low risk, it is not exempt from complications and technical failures during the procedure, both in the short and long term, and the complications that such patients may present remain unknown. The aim has been to analyze the complication rates associated with permanent pacing and to identify if these differ between patients with or without previous antithrombotic therapy. We used a prospective, single center, observational study of 310 adult patients with indications of permanent pacing. They were hospitalized from 1 January to 31 December 2014 and followed up for 6 months after the pacemaker implant. The participants were distributed into two groups according to the antithrombotic therapy prior to the implant. The most frequent major complications were pneumothorax (3.87%) and lead dislodgement (8.39%), while superficial phlebitis (12.90%) and uncomplicated hematomas (22.58%) were presented as the most recurrent minor complications. Hematomas were the most frequent minor complication in the antithrombotic therapy cohort, and shoulder pain was reported as the most recurrent minor complication in the non-exposed group. Finding out about complications in pacemaker implants enables a complete view of the process, and hence the prioritization of actions aimed at improving safety and reducing associated risks.

A Case of 2:1 Atrio-Ventricular Block- Unravelled by Exercise Testing

2020 ◽  
Vol 02 ◽  
Author(s):  
Sharada Sivaram Kalavakolanu ◽  
Madan Mohan Balakrishnan ◽  
Deepesh Venkatarama
Keyword(s):  
Exercise Testing ◽  
Exercise Test ◽  
Heart Block ◽  
Complete Heart Block ◽  
Pacemaker Implantation ◽  
Ecg Monitoring ◽  
Permanent Pacing ◽  
Mill Test

: We present a case of 75-year-old lady with effort intolerance and baseline ECG showing 2:1 atrio-ventricular block, in whom it was unclear as to requirement of permanent pacing, even after long term ECG monitoring. She underwent a tread mill test during which her QRS became wide and developed complete heart block within 2 minutes of the test. Thus, a simple exercise test helped in confirming level of block to be infra nodal without need for invasive study. In patients with exertional symptoms, even in elderly, and in those where ECG masquerades as a benign entity, exercise testing is useful to differentiate benign cases of atrio-ventricular block from the more serious cases that mandate a pacemaker implantation.

scholarly journals Active Infective Native and Prosthetic Valve Endocarditis: Short- and Long-Term Outcomes of Patients after Surgical Treatment

2021 ◽  
Vol 10 (9) ◽  
pp. 1868
Author(s):  
Mohamed Salem ◽  
Christine Friedrich ◽  
Mohammed Saad ◽  
Derk Frank ◽  
Mostafa Salem ◽  
...  
Keyword(s):  
Surgical Treatment ◽  
Prosthetic Valve ◽  
Pacemaker Implantation ◽  
Prosthetic Valve Endocarditis ◽  
Neurological Deficits ◽  
Preoperative Embolization ◽  
Duration Of Surgery ◽  
Cerebral Embolization ◽  
Short And Long Term

Background: Active infective endocarditis (IE) is a serious disease associated with high mortality. The current study represents our experience over 18 years with surgical treatment for active infective native and prosthetic valve endocarditis (INVE, IPVE). Method: Analysis of 413 patients (171 with IPVE vs. 242 with INVE) who underwent cardiac surgery due to IE between 2002 and 2020. Results: Patients with IPVE were significantly older (64.9 ± 13.2 years vs. 58.3 ± 15.5 years; p < 0.001) with higher EuroSCORE II (21.2 (12.7; 41.8) vs. 6.9 (3.0; 17.0); p < 0.001)) and coronary heart disease (50.6% vs. 38.0%; p < 0.011). Preoperative embolization was significantly higher within INVE (35.5% vs. 16.4%; p < 0.001) with high incidence of cerebral embolization (18.6% vs. 7.6%; p = 0.001) and underwent emergency curative surgery than the IPVE group (19.6% vs. 10.6%; p < 0.001). However, patients with IPVE were significantly represented with intracardiac abscess (44.4% vs.15.7%; p < 0.001). Intraoperatively, the duration of surgery was expectedly significantly higher in the IPVE group (356 min vs. 244 min.; p = 0.001) as well as transfusion of blood (4 units (0–27) vs. 2 units (0–14); p < 0.001). Post-operatively, the incidence of bleeding was markedly higher within the IPVE group (700 mL (438; 1163) vs. 500 mL (250; 1075); p = 0.005). IPVE required significantly more permanent pacemakers (17.6% vs. 7.5%: p = 0.002). The 30-day mortality was higher in the IPVE group (24.6% vs. 13.2%; p < 0.003). Conclusion: Patients with INVE suffered from a higher incidence of cerebral embolization and neurological deficits than patients with IPVE. Surgical treatment in INVE is performed mostly as an emergency indication. However, patients with IPVE were represented commonly with intracardiac abscess, and had a higher indication of pacemaker implantation. The short- and long-term mortality rate among those patients was still high.

A Prospective Study of Short- and Long-Term Cosmetic Outcome after Reduction Mammaplasty from Three Different Perspectives

2012 ◽  
Vol 130 (2) ◽  
pp. 273-281 ◽  
Author(s):  
Line Bro Breiting ◽  
Trine Foged Henriksen ◽  
Louise Vennegaard Kalialis ◽  
Christina Gramkow ◽  
Anette Pernille Høyer
Keyword(s):  
Prospective Study ◽  
Reduction Mammaplasty ◽  
Cosmetic Outcome ◽  
Short And Long Term ◽  
A Prospective Study

scholarly journals Genital tuberculosis and infertility

2017 ◽  
Vol 6 (8) ◽  
pp. 3514 ◽  
Author(s):  
Prajakta Shende ◽  
Shalini Mahana Valecha ◽  
Manisha Gandhewar ◽  
Diwija Dhingra
Keyword(s):  
Treatment Options ◽  
Long Term Effects ◽  
Genital Tuberculosis ◽  
Clinical Criteria ◽  
High Incidence ◽  
Short And Long Term ◽  
Tb Pcr ◽  
A Prospective Study ◽  
Strong Suspicion

Background: An analytical study to diagnose genital tuberculosis, using various modalities, it`s treatment options and fertility outcomes in infertile labour class women.Methods: A prospective study, where 120 women, presented to hospital due to infertility were subjected to hystero-laparoscopy over 36 months. Endometrium sent for TB-PCR and HPR. Those diagnosed with GTB were given Anti-Tubercular Drugs as per standard regimes and their fertility outcome was studied.Results: Out of 120 women, 32(27%) were diagnosed with GTB using accepted clinical criteria, TB-PCR and endometrial HPR. 30 of these 32 were diagnosed by HLscopic picture (94%) alone, 18 by positive endometrial TB-PCR (58%) and another 3 by HPR (10%). Among 32 women treated, 9(28%) conceived after treatment.Conclusions: High incidence of GTB amongst the labour class warrants strong suspicion and early diagnosis using hystero-laparoscopy and prompt treatment to minimize the short and long-term effects of GTB on fertility.

scholarly journals The Subcutaneous ICD: A Review of the UNTOUCHED and PRAETORIAN Trials

2021 ◽  
Vol 10 (2) ◽  
pp. 108-112
Author(s):  
Ahmadreza Karimianpour ◽  
Leah John ◽  
Michael R Gold
Keyword(s):  
Structural Heart Disease ◽  
Complication Rates ◽  
General Applicability ◽  
Subcutaneous Icd ◽  
T Wave ◽  
Treatment And Prevention ◽  
High Risk Populations ◽  
Short And Long Term ◽  
Myopotential Oversensing

The ICD is an important part of the treatment and prevention of sudden cardiac death in many high-risk populations. Traditional transvenous ICDs (TV-ICDs) are associated with certain short- and long- term risks. The subcutaneous ICD (S-ICD) was developed in order to avoid these risks and complications. However, this system is associated with its own set of limitations and complications. First, patient selection is important, as S-ICDs do not provide pacing therapy currently. Second, pre-procedural screening is important to minimise T wave and myopotential oversensing. Finally, until recently, the S-ICD was primarily used in younger patients with fewer co-morbidities and less structural heart disease, limiting the general applicability of the device. S-ICDs achieve excellent rates of arrhythmia conversion and have demonstrated noninferiority to TV-ICDs in terms of complication rates in real-world studies. The objective of this review is to discuss the latest literature, including the UNTOUCHED and PRAETORIAN trials, and to address the risk of inappropriate shocks.

In-Stent Thrombosis and Stenosis After Neck-Remodeling Device-Assisted Coil Embolization of Intracranial Aneurysms

Neurosurgery ◽  
2010 ◽  
Vol 67 (6) ◽  
pp. 1523-1533 ◽  
Author(s):  
Hilal Kanaan ◽  
Brian Jankowitz ◽  
Aitziber Aleu ◽  
Dean Kostov ◽  
Ridwan Lin ◽  
...  
Keyword(s):  
Coil Embolization ◽  
Intracranial Aneurysms ◽  
Anterior Communicating Artery ◽  
Complication Rates ◽  
Stent Patency ◽  
Unruptured Aneurysms ◽  
Short And Long Term ◽  
Stent Complications

Abstract BACKGROUND: Intrinsic thrombosis and stenosis are complications associated with the use of neck-remodeling devices in the treatment of intracranial aneurysms. OBJECTIVE: To examine the technical and anatomic factors that predict short- and long-term stent patency. METHODS: We undertook a retrospective review of 161 patients who underwent coil embolization of 168 ruptured and unruptured aneurysms assisted by the use of a neck-remodeling device. One hundred twenty-seven patients had catheter-based angiographic follow-up to evaluate 133 stent-coil constructs (mean, 15.4 months; median, 12.7 months). The technique of microcatheter jailing was used in a majority of patients; nonstandard stent configurations were also used. RESULTS: Clinical follow-up for all patients who had catheter-based angiograms demonstrated that among 133 stent constructs, a total of 9 (6.8%) had an in-stent event: 6 acute or subacute thrombosis (4.5%) and 3 delayed stenosis or occlusion (2.3%). Seven of these constructs were associated with a symptomatic event (5.3%). A significantly higher rate of in-stent events was seen with the use of constructs to treat anterior communicating artery aneurysms. When all patients are considered, including those who did not receive catheter-based follow-up imaging, 2 of 168 procedures (1.2%) resulted in the death of a patient, and procedural morbidity was 14.9%. CONCLUSION: From these results and those in the published literature, in-stent complication rates are low in carefully selected patients. The use of dual antiplatelet therapy, sensitivity assays, and glycoprotein IIb/IIIa inhibitors may decrease the rate of acute and chronic in-stent complications.

Short- and long-term changes of quality of life in patients with acromegaly: Results from a prospective study

2010 ◽  
Vol 33 (1) ◽  
pp. 20-25 ◽  
Author(s):  
C. Sardella ◽  
M. Lombardi ◽  
G. Rossi ◽  
C. Cosci ◽  
S. Brogioni ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Prospective Study ◽  
Long Term Changes ◽  
Short And Long Term ◽  
A Prospective Study

scholarly journals The role of premorbid psychological attributes in short- and long-term adjustment after cardiac disease. A prospective study in the elderly in The Netherlands

2005 ◽  
Vol 60 (5) ◽  
pp. 1035-1045 ◽  
Author(s):  
Cornelia H.M. van Jaarsveld ◽  
Adelita V. Ranchor ◽  
Robbert Sanderman ◽  
Johan Ormel ◽  
Gertrudis I.J.M. Kempen
Keyword(s):  
The Netherlands ◽  
Prospective Study ◽  
Cardiac Disease ◽  
The Elderly ◽  
Psychological Attributes ◽  
Short And Long Term ◽  
A Prospective Study

scholarly journals Cones and sleeves present good survival and clinical outcome in revision total knee arthroplasty: a meta-analysis

2021 ◽  
Author(s):  
Laura Theresa Fischer ◽  
Markus Heinecke ◽  
Eric Röhner ◽  
Peter Schlattmann ◽  
Georg Matziolis
Keyword(s):  
Aseptic Loosening ◽  
Meta Analysis ◽  
Fixation Method ◽  
Good Survival ◽  
Complication Rates ◽  
Long Term Follow Up ◽  
Total Knee ◽  
Short And Long Term

Abstract Purpose The fixation of revision total knee arthroplasties (rTKA) tends to be difficult, leading to a reduction in implant survival. One option for achieving a more stable anchorage is to use metaphyseal cones and sleeves. The objective of the present paper is to provide a current comparative meta-analysis on survival and clinical results of cones vs. sleeves, with a differentiation between the short- and long-term outcome. Methods A search of the literature was conducted systematically to include original papers from 2010 to June 2021. The following parameters were taken into account: revision for aseptic loosening, revision for any reason, periprosthetic joint infections (PJI), KSS as well as KSFS. Studies with a mean follow-up of at least 60 months were defined to be long-term follow-up studies (LT). All other studies were included in the short-term (ST) study analysis. A pooled incidence was used as a summary statistic using a random intercept logistic regression model. Results The present meta-analysis included 43 publications with 3008 rTKA. Of these, 23 publications with 1911 cases were allocated to the sleeve group (SG) and 20 papers with 1097 cases to the cone group (CG). CG showed overall numerically higher complication rates in short- and long-term follow-up, compared with SG. Aseptic loosening occurred at a rate of 0.4% in SG (LT) and 4.1% in CG (LT) (p = 0.09). Periprosthetic joint infection (PJI) was more frequent in the cone group (7% in ST and 11.7% in LT) than in the sleeve group (3.4% in ST and 4.9% in LT, p = 0.02 both). The total revision rate was 5.5% in SG (LT) and 14.4% in CG (LT) (p = 0.12). The clinical scores were also comparable between the two groups. Hinged prothesis were used more frequent in the cone group (ST p < 0.001; LT p = 0.10), whereas CC type protheses were used more frequently in the sleeve group (ST p < 0.001; LT p < 0.11). Conclusions This meta-analysis takes into account the longest follow-up periods covered to date. Both cones and sleeves represent a reliable fixation method in the case of severe bone loss in rTKA, although the higher rate of PJI after cone fixation remains a source of concern. A metaphyseal fixation of hinged implants should be taken into account. Level of evidence II (meta-analysis).

Retrospective analysis of intracranial aneurysms after flow diverter treatment including color-coded imaging (syngo iFlow) as a predictor of aneurysm occlusion

2021 ◽  
pp. 159101992110240
Author(s):  
Andreas Simgen ◽  
Christine Mayer ◽  
Michael Kettner ◽  
Ruben Mühl-Benninghaus ◽  
Wolfgang Reith ◽  
...  
Keyword(s):  
Cerebral Aneurysms ◽  
Flow Diverter ◽  
Complication Rates ◽  
Long Term Follow Up ◽  
Aneurysm Growth ◽  
Short And Long Term ◽  
Aneurysm Occlusion ◽  
Unruptured Cerebral Aneurysms

Purpose Flow Diverters (FD) have immensely extended the treatment of cerebral aneurysms in the past years. Complete aneurysm occlusion is a process that often takes a certain amount of time and is usually difficult to predict. Our aim was to investigate different syngo iFlow parameters in order to predict aneurysm occlusion. Methods Between 2014 and 2018 patients with unruptured cerebral aneurysms treated with a FD were reviewed. Aneurysm occlusion and complication rates have been assessed. In addition, various quantitative criteria were assessed using syngo iFlow before, after the intervention, and after short and long-term digital subtraction angiography (DSA). Results A total of 66 patients hosting 66 cerebral aneurysms were included in this study. 87.9% (n = 58) aneurysms in the anterior and 12.1% (n = 8) in the posterior circulation were treated. Adequate aneurysm occlusion at long-term follow-up (19.05 ± 15.1 months) was achieved in 90.9% (n = 60). Adequately occluded aneurysm revealed a significantly greater peak intensity delay (PI-D, p = 0.008) and intensity decrease ratio (ID-R, p < 0.001) compared to insufficiently occluded aneurysms. Increased intra-aneurysmal contrast agent intensity (>100%) after FD implantation resulted in an ID-R < 1, which was associated with aneurysm growth during follow-up DSA. Retreatment with another FD due to foreshortening and/or aneurysm growth was performed in 10.6% (n = 7). Overall morbidity and mortality rates were 1.5% (n = 1) and 0%. Conclusion The applied syngo iFlow parameters were found to be useful in predicting adequate aneurysm occlusion and foresee aneurysm growth, which might indicate the implantation of another FD.

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