Usefulness of Sacubitril/Valsartan in reduction of atrial fibrillation burden in a patient with ICD delivering inappropriate therapies. A new possibility?

Abstract

Srdeční selhání je v současnosti onemocněním s obrovskými důsledky pro klinickou praxi i náklady na zdravotní péči. Léčba přístroji, jako jsou implantabilní kardioverter-defi brilátor (implantable cardioverter-defi brillator, ICD), se neustále vyvíjí a často dokáže zachránit život, v některých případech však pouze málo ovlivní symptomy. Optimální léčba často nedokáže zastavit progresi onemocnění; výsledkem je vznik arytmií (např. fi brilace síní), které by mohly být příčinou nežádoucích výbojů z ICD. Popisujeme případ pacienta s ICD, u něhož bylo provedeno kardiologické vyšetření na oddělení akutních příjmů pro opakované epizody dyspnoe a palpitací. V tomto případě byl zvolen konzervativní přístup s podáním kombinace sacubitril/valsartan spíše než použití jiných, invazivnějších metod, které by jinak bylo nutno v klinické praxi pro odstranění problému zkusit.

An "ordinary" case of COVID-19 pneumonia: when symptoms hide serious complications

“…15,16 Furthermore more evidence is currently needed in case of other concomitant cardiac conditions such as patent foramen ovale, cardiac devices, advanced heart failure or younger age. [17][18][19][20] Our case shows that it is possible to make an appropriate follow-up and therapy of patients even without extensive use of bedside echocardiography in COVID-19 patients. While its high availability and easiness made an ideal fi rst line diagnostic tool to date this point of view should be somewhat reevaluated.…”

Sino-atrial block due to Guillan-Barré syndrome: a rare case

“…He had history of CHF with reduced ejection fraction (EF) (25%, New York Heart Assocation [NYHA] class II) secondary to chronic coronary artery disease (age-indeterminate silent inferior acute myocardial infarction, stenting of anterior descendent in 2007 and critical occlusion of obtuse marginal branch and fi rst diagonal branch with no indication to treat). 5,6 In October 2019 he had a re-acutization of heart failure (HF) requiring hospitalization due to new--onset atrial fl utter. Sinus rhythm was restored with intravenous Amiodarone infusion and he was successively discharged without oral anticoagulation.…”

“…Cumulative incidence of wire-related thrombosis was estimated around 23% at 1 year from implant with the majority of events occurred within the fi rst three months after procedure without clinical sequelae. [1][2][3][4][5][6][7][8] Mostly events remain undiagnosed because clinically silent. Symptoms, which are generally related to deep vein thrombosis (DVT) in the electro-catheter (E-C) insertion site, occurs in only 1-3% of cases and sometimes appear lately, revealing a severe condition with congestive heart failure (CHF), shock and fi nally death.…”

The power and wisdom of prevention. Cardiovascular risk, new challenge, and approach to PLWH

“…Techniques such as ultrasound and computed tomographic angiography show a higher prevalence of hypogenic plaques and a higher incidence of CV events. [35][36][37] Using angiographic computed tomography, noncalcifi ed plaques are more com-lar Münster (PROCAM) score that was derived from a German cohort of industrial employees to predict the risk of CVD. 25 Nonetheless, the various risk prediction models also share some similarities with signifi cant overlap of predictive variables and derivation from high-income European countries or American cohorts.…”