Objective To examine the possible use of magnetocardiography in the diagnosis of fetal arrhythmias.Design Investigation of routinely examined pregnant women, as well as women referred because of Participants Sixty-three women between the 13th and 42nd week of pregnancy.Methods Recording of 189 fetal magnetocardiograms, of which 173 traces (92%) demonstrated sufficient fetal signal strength to permit evaluation. After digital subtraction of the maternal artefact, all fetal complexes were identified and the recording was examined for arrhythmic events.Results Short bradycardic episodes, not associated with any pathological condition, were found in 26% of all recordings, usually in mid-pregnancy. In 12 cases, isolated extrasystoles of no clinical importance could be identified. There were nine traces which revealed multiple arrhythmias including ventricular and supraventricular ectopic beats, bigeminy and trigeminy, sino-atrial block and atrio-ventricular conduction disturbances. Furthermore, two cases with tachycardia were found.Conclusion Magnetocardiography offers a simple noninvasive method for examination of the fetal cardiac electrophysiological signal. It may thus be useful in the identification and classification of clinically relevant arrhythmia and aid in decisions concerning treatment.arrhythmias or other reasons.
Contrary to ECG, unshielded MCG reveals significant differences between normals and symptomatic patients with and without relevant stenoses using current density reconstruction during repolarization at rest. This method might be a suitable noninvasive tool for the management of patients with chest pain.
Background:The Myocardial Infarction Network Essen was initiated in order to establish a standardized procedure with immediate reopening of the infarcted vessel for patients with ST-elevation myocardial infarction (STEMI) in the city of Essen, Germany. The present study aims to evaluate gender-related differences in presentation of disease and clinical outcome. Hypothesis: Gender is associated with differences in presentation and outcome of STEMI. Methods: All patients with STEMI were included without exception. Parameters such as risk profile, mortality, and relevant time intervals were documented. The follow-up period was 1 year. Results: For this study, 1365 patients (72.1% male) were recruited. Women were significantly older, with higher prevalence of diabetes (28.1% vs 20.3%, P = 0.004) and hypertension (76.5% vs 64.8%, P < 0.0005). Analysis of time intervals between symptoms to actions showed no significant differences. However, women tended to wait longer before calling for medical assistance (358 vs 331 min, P = 0.091). In-hospital mortality was comparable with respect to gender, whereas women had higher 1-year mortality (18.6% vs 13.2%). Age and diabetes were associated with a higher mortality. Adjusted for age, gender is no longer an independent risk factor. In the follow-up period, significantly more women were readmitted to the hospital without a difference in the frequency of reangiography, surgery, or target-vessel revascularization. Conclusions: The present data display a successful implementation of a standardized procedure in patients with STEMI. Although differences between genders are not as obvious as expected, efforts should be taken to perform a gender-specific risk analysis as well as to promote education about proper behavior in case of new onset of angina. IntroductionAlthough gender-related differences in treatment and prognosis of acute myocardial infarction (MI) have been documented for more than a decade, the results are still conflicting. Some investigations have described a generally consistent pattern of less-intensive treatment in acute MI
Acute and subacute ischemia of the legs in acute and subacute femoropopliteal bypass occlusion is a dramatic situation that endangers the survival of the limbs, depending on the severity of the ischemia. Different therapy options like percutaneous mechanical thrombectomy procedures, which include rotational thrombectomy, have become available in recent years, in addition to local lysis and surgical thrombectomy. Surgical thrombectomy using the Fogarty catheter technique, in particular, shows an increased incidence of perioperative complications but only small technical success rates in randomized trials. On the other hand, local lysis is associated with increased costs due to resource-consuming measures, such as intensive monitoring and repeat angiographies, in addition to bleeding complications. In the past, further development of the Straub Rotarex® system as an endovascular therapy option has demonstrated good success leading to amputation-free survival in multiple studies. At the same time, a low rate of complications with use has been documented. Most examinations have been conducted in the thigh. To date, there are little investigational data on its use in acutely and subacutely occluded femoropopliteal bypasses. In this paper, the current study-based significance of the Rotarex system for this indication is analyzed based on the existing literature and the authors’ own experiences with 22 patients.
Acute and subacute ischemia of the legs in acute and subacute femoropopliteal bypass occlusion is a dramatic situation that endangers the survival of the limbs, depending on the severity of the ischemia. Different therapy options like percutaneous mechanical thrombectomy procedures, which include rotational thrombectomy, have become available in recent years in addition to local lysis and surgical thrombectomy. Rotational thrombectomy with the Straub Rotarex(®) System as an endovascular therapy option has demonstrated promising results leading to amputation-free survival in multiple studies. We recently provided data of 22 patients with acute femoropopliteal bypass occlusion where we examined the feasibility of the Rotarex(®) System in this indication. A technical success rate of 82% was demonstrated. During a follow-up period of 6 months, no reinterventions in these patients had to be performed. We now provide patency rates in 21 patients of our study group after a follow-up period of 12 months. The average ABI after 12 months was 0.80 ± 0.1. One patient showed a hemodynamic restenosis in a Nitinolstent distal to the femoropopliteal bypass which was implanted in the index procedure. No reocclusion of the femoropopliteal bypasses occurred in all patients.
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