Left ventricular assist devices (LVADs) are widely used as end-stage therapy in patients with advanced heart failure, whereas implantation increases the risks of development of sustained ventricular tachycardia at the later postimplantation stage. Therefore, this study aimed to evaluate the clinical efficacy of orally administered amiodarone and propranolol in 3 patients with ventricular tachycardia (VT) after LVAD implantation who were resistant to initial anti-antiarrhythmic drugs. This retrospective cohort study consisted of the initial evaluation of the clinical data of 14 adult patients who underwent implantation of LVAD between January 2019 and March 2021. A total of 3 patients with resistant VT were finally included. In all cases, the patients were initially administered amiodarone in the different doses intravenously to stabilize the critical condition, whereas its oral form along with that of propranolol was used as maintenance therapy in the first 2 cases. In the third case, amiodarone was withdrawn because of the risk of development of hyperthyroidism, while oral propranolol was used in the treatment. The assessment in the 16-month follow-up period after discharge did not show presence of non-sustained and sustained VT in all 3 cases. In the ventricular arrhythmia-free group, the total mortality rate within the follow-up period was 11.1 ± 7.78 months in the 3 patients. We suggest that maintenance oral therapy of propranolol and amiodarone can significantly decrease the risks of complications in patients with VT after implantation of ventricular assist device in the long term.

Objective: The coronary artery calcium score (CACS) is used as a screening tool to identify the presence/absence of subclinical atherosclerosis in asymptomatic individuals. We evaluated the risk categories and medical therapy of asymptomatic individuals with subclinical atherosclerosis (CACS > 0) and applied the atherosclerotic cardiovascular disease (ASCVD) score and Framingham risk score (FRS) to assess those at a high risk of subclinical atherosclerosis (CACS ≥ 400). Methods: We retrospectively enrolled 218 asymptomatic individuals (65.6% women, and mean age 67.5 ± 10.3 years) who had their CACS evaluated at the cardiovascular department of our hospital between 2016 and 2020. Results: Among the 218 participants, 24.3% were classified as low-risk according to the FRS, and 19.3% had no subclinical atherosclerosis. However, only 12.8% and 27.5% of the study population were taking statins and aspirin, respectively. Furthermore, although more than half of the individuals without subclinical atherosclerosis were in the intermediate- and high-risk groups according to the risk scores, there were no considerable differences in the rates of taking aspirin and statins between the groups. When patients in the very-high-risk group according to the CACS and low-intermediate-risk patients were compared, there was no considerable difference in the rates of risk subgroups and taking statins, whereas high-risk patients took statistically significantly more aspirin. Conclusions: In primary prevention screening, CACS can be used as a reliable marker of subclinical ASCVD and help physicians optimize and improve adherence to medical therapy, including aspirin and statins, particularly for high-risk individuals.

Background/Objectives: Anthracyclines carry considerable cardiotoxicity risk, and atrial fibrillation (AF) during cancer treatment adversely affects morbidity and mortality. We compared the incidence of clinically documented AF and explored its early clinical correlates between anthracycline-containing and non-anthracycline adjuvant regimens in triple-negative breast cancer (TNBC). Methods: This single-centre retrospective cohort included consecutive women with stage II TNBC treated with breast-conserving surgery and adjuvant doxorubicin–cyclophosphamide followed by docetaxel (AC-T) or docetaxel–cyclophosphamide (TC) between 2018 and 2023. ECG and echocardiography were performed at baseline, month one, and month six. Clinically documented AF was defined as AF documented on a scheduled or symptom-triggered 12-lead ECG or as AF lasting ≥30 s on symptom-triggered 72 h Holter monitoring. Patients with structural or coronary heart disease, complete bundle branch block, or non-sinus rhythm were excluded. Results: Among 140 women (mean age, 64 ± 12 years; 64 AC-T), 17 (12.1%) developed clinically documented AF within six months. AF was more frequent with AC-T (18.8% vs. 6.6%; absolute risk difference, 12.2% [95% CI, 1.1–23.3%]; risk ratio, 2.85 [1.07–7.58]; log-rank p = 0.030), and the association persisted after inverse probability of treatment weighting (OR, 3.28 [1.05–10.24]). At one month, PR prolongation > 20 ms was associated with incident AF (OR, 5.16 [1.79–14.89]), whereas conventional echocardiographic changes did not differ between regimens. Conclusions: The AC-T regimen was associated with more clinically documented incident AF than TC. Early PR prolongation, occurring without detectable changes in conventional echocardiographic parameters, may be an informative early electrical signal of AF risk, although prospective validation is required.

Bu kitabın hazırlanmasındaki temel amaç, pulmoner tromboembolinin patofizyolojik temellerini, güncel klinik risk değerlendirme yaklaşımlarını ve elektrokardiyografik bulgularını bütüncül bir çerçevede sunmak; özellikle fragmente QRS'nin olası prognostik katkısını mevcut bilimsel kanıtlar ışığında değerlendirmektir. Bu doğrultuda, araştırma sonuçlarının yanı sıra çalışmaların metodolojik sınırlılıklarına ve henüz yanıtlanmamış bilimsel sorulara da yer verilmiştir. Bilimsel bilginin değeri, yalnızca ortaya koyduğu sonuçlarda değil, yeni sorulara ve araştırmalara açtığı yolda da saklıdır.

Background: Chronic coronary syndrome (CCS) remains a major cause of morbidity and mortality worldwide, and real-world data on outpatient management are limited. Methods: In total, 697 patients with previously diagnosed CCS who visited outpatient cardiology clinics at 25 centers in Turkey between June 2023 and December 2023 were prospectively enrolled and followed up for 12 weeks. Demographic and clinical characteristics, diagnostic and therapeutic strategies, a modified questionnaire derived from the Seattle Angina Questionnaire (modified SAQ-based questionnaire), and clinical outcomes were recorded. Results: The most common diagnostic modalities were exercise stress testing (31.6%) and coronary angiography (38.2%). Medical therapy (58.5%) was preferred over interventional treatment (41.5%). Among patients who were not receiving the respective medication at baseline, beta-blockers (61.8%), statins (46.5%), and ranolazine (40.4%) were the most commonly newly initiated medications. Patients in the intervention group were younger, were more frequently current smokers, had greater nitrate use, and had lower ejection fraction than those in the medical treatment group. Patient-reported responses to the modified SAQ-based questionnaire shifted toward less functional limitation, lower angina burden, and better perceived quality of life over the 12-week follow-up. Conclusions: Medical therapy was the predominant management strategy for CCS in Turkey. The observed diagnostic and therapeutic patterns reflect real-world management of patients with established CCS, with substantial use of invasive coronary angiography and high baseline utilization of guideline-directed medical therapies.