Background: Heart failure (HF) is the most common cause of morbidity and mortality in developed countries. Here, we identify biologically relevant transcripts that are significantly altered in the early phase of myocardial infarction and are associated with the development of post-myocardial infarction HF. Methods: We collected peripheral blood samples from patients with ST-segment elevation myocardial infarction (STEMI): n = 111 and n = 41 patients from the study and validation groups, respectively. Control groups comprised patients with a stable coronary artery disease and without a history of myocardial infarction. Based on plasma NT-proBNP level and left ventricular ejection fraction parameters the STEMI patients were divided into HF and non-HF groups. Microarrays were used to analyze mRNA levels in peripheral blood mononuclear cells (PBMCs) isolated from the study group at four time points and control group. Microarray results were validated by RT-qPCR using whole blood RNA from the validation group. Results: Samples from the first three time points (admission, discharge, and 1 month after AMI) were compared with the samples from the same patients collected 6 months after AMI (stable phase) and with the control group. The greatest differences in transcriptional profiles were observed on admission and they gradually stabilized during the follow-up. We have also identified a set of genes the expression of which on the first day of STEMI differed significantly between patients who developed HF after 6 months of observation and those who did not. RNASE1, FMN1, and JDP2 were selected for further analysis and their early up-regulation was confirmed in HF patients from both the study and validation groups. Significant correlations were found between expression levels of these biomarkers and clinical parameters. The receiver operating characteristic (ROC) curves indicated a good prognostic value of the genes chosen. Conclusions: This study demonstrates an altered gene expression profile in PBMCs during acute myocardial infarction and through the follow-up. The identified gene expression changes at the early phase of STEMI that differentiated the patients who developed HF from those who did not could serve as a convenient tool contributing to the prognosis of heart failure.

DOI: 10.33963/KP.15289, Published online: April 08, 2020, Authors: Marcin Michalak, Grzegorz Opolski, Marcin Grabowski

Subcutaneous implantable cardioverter-defibrillators (S-ICD) and extravascular implantable cardioverter-defibrillators (EV-ICD) became in recent years a valuable alternative to transvenous ICDs (TV-ICD) and in specific populations may be the only possible solution. Lack of permanent pacing capability remains one of the main weaknesses of both new systems. Although it was shown that it is possible to merge single chamber pacemaker with S-ICD, most of the patients do not pass automated screening test [1, 2]. In this case report we present a patient with recurrent transvenous defibrillation lead damage and permanent pacing indications. On February 2025 a 75-year-old male with cardiac resynchronization therapydefibrillator with inactive anti-tachycardia therapy was transferred to our center after hemodynamically unstable ventricular tachycardia. In 2019 he underwent single chamber ICD implantation in primary prevention. One month later MitraClip XTR device (Abbott, US) was implanted both in mitral and tricuspid position due to severe symptomatic regurgitation. Two years after the procedure defibrillation lead damage due to its collision with MitraClip device was diagnosed. The lead was replaced and the system upgraded to cardiac resynchronization therapy-defibrillator due to the high percentage of right ventricular pacing in the presence of

Leadless pacemaker implantation via the right internal jugular vein (RIJV) is an emerging alternative to the traditional femoral approach, offering favorable anatomical access and potential procedural advantages. Our aim was to assess electrical performance, procedural efficiency and safety of Micra leadless pacemaker implantation via RIJV. Thirty-five consecutive patients who underwent Micra transcatheter pacing system (TPS) implantation via RIJV at 7 clinical centers in Poland between November 2024 and November 2025 were included in this registry. Procedural safety and efficacy were assessed, and in-hospital as well as short-term follow-up electrical parameters were analyzed. Implantation success was achieved in 100% of cases. There were no significant changes in R-wave sensing (8.41 [2.45] vs. 9.20 [3.43] vs. 9.34 [3.60] mV; P = 0.45) or pacing threshold (0.5 [0.38-0.57] vs. 0.5 [0.38-0.63] vs. 0.5 [0.38-0.69] V; P = 0.25) between procedure, predischarge, and 1-3-month follow-up. Impedance showed a decrease tendency across all time points (680 [620-745] vs. 630 [590-690] vs. 570 [535-607.5] Ω; P = 0.06). No mild or severe acute or in-hospital complications related to the procedure were observed. Micra TPS implantation via the RIJV is a highly effective and safe alternative to femoral access when performed in experienced cardiology centers.