Background and Objectives: Revascularization has been proven to be superior to medication for symptom improvement in patients with peripheral arterial disease (PAD). There are well known gender differences in therapeutic strategies for PAD. The influence of gender on post-angioplasty prognosis is not fully understood though. The present study aims to identify potential peculiarities between men and women undergoing peripheral angioplasty, as well as factors responsible for those differences. Material and methods: 104 consecutive subjects (50 women and 54 men) who underwent percutaneous angioplasty (PTA) between January and October 2019 for symptomatic PAD were included. Demographics, PAD history, cardiovascular risk factors, comorbidities, the associated coronary or cerebrovascular diseases, biological parameters, drug-treatment and PTA type and technique were taken into account. The follow-up period was 2 years, during which major adverse limb events (MALE) were documented. Results: The mean age was 67 ± 10 years. Women were 4 years older than the men (69 ± 10 years vs. 65 ± 9.2 years—p = 0.04). Smoking was more prevalent in men (p = 0.0004), while other cardiovascular risk factors did not differ significantly. The mean follow-up of the two groups was 21 ± 2.4 months. Women had infra-inguinal involvement more frequently (78%), while men exhibited mixed disease, with supra + infra-inguinal (37%) or solely supra-inguinal (20.3%) involvement (p = 0.0012). Rates of MALE were similar in the two groups (p = 0.914). Gender did not influence the incidence of PAD-related adverse events. The only parameter that proved to have a significant influence on the occurrence of MALE was the ankle–brachial index (ABI). A value below 0.5 was found to be an independent predictor for MALE (p = 0.001). Conclusions: There was no significant difference in the incidence rates of MALE between the two genders over a 2-year follow-up period post-PTA. Regardless of sex, an ankle–brachial index value below 0.5 was the sole independent predictor for limb-related adverse events.

Introduction Cardiac masses are at the attention of health specialists since the development of echocardiography. Even though imaging is an excellent tool for diagnosis, the clinical presentation, risk factors, and hemodynamic status of the patients are important in establishing the diagnosis and subsequent management. The purpose of this presentation is to assess the difficulty of diagnosis in the case of an intracardiac mass and its therapeutic management. Case report A 29-year-old female with paresthesia in the left arm and a systolic tricuspid murmur underwent echocardiography, which revealed a mass of 35/20 mm in the right atrium. Due to the high embolic risk, the patient was referred to the cardiac surgery department and underwent surgical removal of the cardiac mass, which presented the macroscopical aspect of a myxoma. However, the histopathological examination revealed a right atrial thrombus. Conclusion Right heart thrombi represent a challenging diagnosis that involves a multidisciplinary team for the diagnosis and treatment of the patient.

Funding Acknowledgements Type of funding sources: None. Background Atrial fibrillation (AF) represents the most common cardiac arrhythmia in adults worldwide. Catheter ablation (CA) of AF provides higher efficacy with comparable safety as antiarrhythmic drug therapy. Recently, high-power short-duration (HPSD) approach has emerged as an alternative to standard-power standard-duration settings, showing reduction in ablation times and increasing patient tolerability, with similar outcomes in terms of safety and efficacy. Although the advantages of general anesthesia (GA) are well established for standard-power standard-duration settings, there are currently no studies comparing GA to mild conscious sedation (MCS) for HPSD approach CA for AF. The aim of this study was to show whether GA improves procedural outcomes compared to MCS in AF CA using HPSD approach. Methods We included patients with paroxysmal or persistent AF who underwent HPSD CA using a contact-force sensing catheter (50W, ablation index 450 on the anterior wall and 320 on the posterior wall) either under GA or MCS. Procedural characteristics and success rates were compared between the two groups, as well as mid-term outcomes. Procedural safety was evaluated by intra- and post-procedural complications. Procedural efficiency was evaluated by total procedural time, number of radiofrequency applications, fluoroscopy time and dose. Acute success was defined as confirmation of entrance block in all pulmonary veins and mid-term success as freedom of AF at 6-months follow-up visits and re-do procedures. Results A total number of 131 patients were included in the study, 47 which underwent HPSD CA for AF under GA (group 1, mean age 60.2±10.2), and 84 under MCS (group 2, mean age 58.6±10.6). CA was performed for paroxysmal AF in 34 patients in group 1 (72.3 %) and 68 patients in group 2 (80.9 %), and for persistent AF in the remaining patients. We found lower mean total procedure time in the GA group (105.7±26.4 vs. 164.4± 41.9 min, p<0.0001), as well as lower radiation exposure (1310.0±1083.2 vs. 3060.5± 2254.8 μGy, p<0.0001 and 4.9± 2.8 vs 9.4± 7.5 min, p<0.0001) and lower number of radiofrequency applications (70.4± 20.4 vs. 106.0± 30.2, p<0.01). At the 6-months follow-up AF recurrence rate was lower in GA group (21.2% vs. 33.3%), however without reaching statistical significance (p=0.14). There was one moderate pericardial effusion in the MCS group which remitted with pharmacological treatment. Conclusion This is the first study comparing GA to MCS for AF CA using HPSD approach. Our findings demonstrate that GA improves procedural efficiency and suggest lower AF mid-term recurrence when HPSD AF CA is performed under GA, compared to MCS.

Background: Atrial fibrillation is more common in men, but in the presence of ischemic heart disease, this arrhythmia is more frequent in women. However, like in coronary heart disease, women with atrial fibrillation are suboptimally treated. Methods: To identify particularities of ablation, in women with atrial fibrillation and ischemic heart disease. Results: 29 women and 26 men, with documented ischemic heart disease and atrial fibrillation, who underwent catheter ablation, were admitted in the study. No significant differences were registered regarding the heart rate control treatment. Electrical cardioversion was significantly higher in men, while pharmacological cardioversion was predominantly recommended in women. The ablation was performed later in women, after 2.55 ± 1.84 years versus 1.80 ± 1.05 in men (p = 0.05). The time elapsed until the ablation was performed was statistically correlated with atypical symptomatology and with the number of antiarrhythmics used prior to the ablation. There were no significant differences for the relapse of atrial fibrillation at 3 months. Quality of life at 3 months after ablation was increased in both groups. Conclusion: Catheter ablation is performed much later in women, and the causes responsible for this delay would be more atypical symptoms and a greater number of antiarrhythmics tried before the ablation.