Journal of Cardiovascular Development and Disease最新文献

{"title":"Outcomes and Cost-Effectiveness of Transcatheter Versus Surgical Aortic Valve Replacement in Patients with and Without Coronary Artery Disease.","authors":"Horațiu Suciu, Ayman Elkahlout, Viorel Nicolae, Flavius Tomșa, Alexandru Stan, Hussam Al-Hussein, Paul-Adrian Călburean, Anda-Cristina Scurtu, David Emanuel Aniței, László Hadadi, Klara Brînzaniuc, Marius Mihai Harpa","doi":"10.3390/jcdd12060217","DOIUrl":"10.3390/jcdd12060217","url":null,"abstract":"<p><p><b>Background:</b> The aim of this study was to compare costs and clinical outcomes associated with transcatheter aortic valve implantation (TAVI) versus surgical aortic valve replacement (SAVR). A secondary analysis was performed in patients with coronary artery disease, and patients with TAVI and percutaneous coronary intervention (PCI) were compared with SAVR and coronary artery bypass grafting (CABG). <b>Methods:</b> All patients who underwent the TAVI or SAVR procedure for severe degenerative aortic stenosis between August 2013 and February 2025 at a tertiary cardiovascular center were selected for inclusion in the present study. Patients were excluded if there was no available follow-up or if there was a crossover between treatments (especially CABG undergoing TAVI or SAVR undergoing PCI within a 6-month timeframe). <b>Results:</b> A total of 2452 patients (1925 undergoing SAVR and 527 undergoing TAVI) were included. Of those, 400 underwent SAVR + CABG and 75 underwent TAVI + PCI. During a median follow-up of 2.88 (1.12-6.43) years, a total of 404 all-cause events occurred, corresponding to 4.18 deaths per 100 patient-years. TAVI was associated with higher hospitalization costs and fewer in-hospital deaths than SAVR. However, long-term survival was similar between TAVI and SAVR and between TAVI + PCI and SAVR + CABG. Interventional treatment was more cost-effective in patients with EuroSCORE > 10%, while surgical treatment was more cost-effective in patients with EuroSCORE < 10%. <b>Conclusions:</b> In patients who are at high surgical risk, TAVI is more cost-effective than SAVR, and TAVI + PCI is more cost-effective than SAVR + CABG. In patients who are not at high surgical risk, SAVR is more cost-effective than TAVI, and SAVR + CABG is more cost-effective than TAVI + PCI.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484457","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Biophysics and Clinical Effectiveness of Irreversible Electroporation for Catheter Ablation of Atrial Fibrillation.","authors":"Anna-Sophie Eberl, Gernot Plank, Martin Manninger, Ursula Rohrer, Laura Stix, Stefan Kurath-Koller, Andreas Zirlik, Daniel Scherr","doi":"10.3390/jcdd12060218","DOIUrl":"10.3390/jcdd12060218","url":null,"abstract":"<p><p>Understanding the biophysics of electroporation-the mechanism by which pulsed electric fields achieve tissue ablation-is essential for advancing this emerging technology. In this review, we summarize key publications from past years to provide an overview of current knowledge and future perspectives. We discuss the fundamental principles of PFA at the cellular, physical, and technical levels, along with its potential benefits and limitations. A deeper understanding of these biophysical mechanisms and the parameters required to create durable lesions may contribute to improved clinical outcomes and drive future innovation.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484393","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Management of TAVI Underexpansion with Self-Expanding Valves: A Practical Approach.","authors":"Rene Hameau, Marco B Ancona, Vittorio Romano, Luca Ferri, Barbara Bellini, Filippo Russo, Ciro Vella, Christos Papageorgiu, Francesca Napoli, Marco Licciardi, Gianluca Ricchetti, Andrea Tripoli, Rocco Sabarese, Lorenzo Zaccaria, Matteo Montorfano","doi":"10.3390/jcdd12060215","DOIUrl":"10.3390/jcdd12060215","url":null,"abstract":"<p><p>Underexpansion of a self-expanding transcatheter aortic valve (TAVI) is a critical issue that can negatively impact long-term outcomes, including paravalvular leak, valve thrombosis, and increased mortality. This paper provides a comprehensive review of the pathophysiology and consequences of such complications, including three primary mechanisms: (1) infolding, (2) incorrect site of crossing and (3) true underexpansion. It also discusses strategies to address these challenges, including pre-procedural planning and procedural techniques to ensure proper valve deployment and expansion. Mitigating these issues is essential to improving both immediate and long-term outcomes in TAVI patients.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484453","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Efficacy and Safety of Outpatient Exercise Training for Patients with Chronic Thromboembolic Pulmonary Hypertension After Balloon Pulmonary Angioplasty.","authors":"Takayuki Masuda, Keitaro Akita, Ryota Sato, Takenori Ikoma, Yusuke Mizuno, Terumori Satoh, Masashi Takao, Kenichiro Suwa, Mikihiro Shimizu, Keiichi Odagiri, Katsuya Yamauchi, Yuichiro Maekawa","doi":"10.3390/jcdd12060216","DOIUrl":"10.3390/jcdd12060216","url":null,"abstract":"<p><strong>Background: </strong>To evaluate the efficacy and safety of outpatient exercise training in clinically stabilized patients with chronic thromboembolic pulmonary hypertension (CTEPH) after balloon pulmonary angioplasty (BPA).</p><p><strong>Methods: </strong>Twenty-four patients with CTEPH after BPA were enrolled in this prospective single-center study. Patients were assigned to the exercise and control groups. The exercise group comprised 12 patients who received 15 weeks of exercise training, with usual care. The control group received only the usual care, without exercise training. The exercise program included aerobic exercise thrice weekly and resistance exercise once or twice weekly. The assessments employed included a 6-min walk test, cardiopulmonary exercise testing, and an emPHasis-10 questionnaire.</p><p><strong>Results: </strong>In the exercise group, the 6-min walk distance was significantly longer (510.0 [467.5, 595.0] m vs. 425.0 [395.0, 465.0] m, <i>p</i> = 0.020), the time taken to walk 10 m was shorter (6.4 [5.9, 7.5] s vs. 8.9 [8.1, 9.1] s, <i>p</i> = 0.020), and the walking speed was faster (1.6 [1.3, 1.7] m/s vs. 1.1 [1.1, 1.2] m/s, <i>p</i> = 0.020) at 15 weeks compared with the results for the control group. The quality of life tended to improve at 15 weeks compared with that before the exercise training. However, hemodynamics did not change significantly before and after the exercise training, and no fatal arrhythmias or syncope were observed.</p><p><strong>Conclusions: </strong>Exercise training improved gait performance, without any adverse events, in patients with CTEPH after BPA. Therefore, exercise training as an adjunct to medical therapy may be a safe potential therapy for patients with CTEPH after BPA.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systematic Review on HRV Reference Values.","authors":"Maximillian Brozat, Irina Böckelmann, Stefan Sammito","doi":"10.3390/jcdd12060214","DOIUrl":"10.3390/jcdd12060214","url":null,"abstract":"<p><p>Heart rate variability (HRV) has been established as a measure for the variation in time intervals between successive cardiac actions as a marker of the autonomic nervous system. However, despite many efforts in this field, there are no reference values that are generally accepted. The objective of this systematic review is, therefore, to present an overview of the studies on HRV normal values published to date, with due consideration of any influencing factors. A systematic database query was carried out in PubMed, Scopus, Ovid Medline, and PsychInfo using the search string \"((hrv) or (heart rate variability)) and ((reference values) or (reference range) or (normal values))\". Of the 6640 studies yielded by the query, 58 were used for this systematic review. The STARD-HRV procedure was used to assess the quality of the studies. The studies considered date from 1989 to 2022. The number of subjects examined was between 20 and 84,772. The age of the subjects was between 1 day and 99 years. A total of 51 of the studies examined both male and female subjects. In total, 19 studies used long-term measurements, 22 studies used short-term measurements, and 17 studies used intermediate measuring periods. Many different HRV parameters were analyzed, most often traditional time-domain and frequency-domain ones. Nine studies described the subjects as \"healthy\" without giving more detailed explanations. There are no generally accepted HRV normal values (yet). Some large studies provide values that may be used for orientation purposes. However, further studies are required to collect HRV normal values. It was not possible to merge the results of the studies in terms of a meta-analysis; this would also not be practical since, among other reasons, the consideration of confounders as well as recording and measuring modalities sometimes vary to a large extent and impede the comparability of the studies. Generally, HRV seems to be influenced by various mechanisms and external factors that are still not fully understood. An exploration of these factors will ultimately allow HRV normal values to be obtained in a manner that is generally accepted.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484487","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gender-Specific Differences in Diastolic Dysfunction and HFpEF: Pathophysiology, Diagnosis, and Therapeutic Strategies.","authors":"Francesca Coppi, Gianluca Pagnoni, Francesca Grossule, Ashraf Nassar, Arianna Maini, Giuseppe Masaracchia, Francesco Sbarra, Elisa Battigaglia, Enrico Maggio, Daniela Aschieri, Federica Moscucci, Marcello Pinti, Anna Vittoria Mattioli, Francesco Fedele, Susanna Sciomer","doi":"10.3390/jcdd12060213","DOIUrl":"10.3390/jcdd12060213","url":null,"abstract":"<p><p><b><b>:</b></b> Heart failure with preserved ejection fraction (HFpEF) accounts for approximately 50% of heart failure cases and is primarily characterized by impaired diastolic function, leading to increased ventricular filling pressures and symptoms like dyspnea and reduced exercise tolerance. Significant gender-specific differences are observed, with women, particularly post-menopausal, experiencing higher prevalence and distinct clinical profiles compared to men. Diastolic dysfunction in HFpEF involves altered cellular mechanisms such as reduced SERCA2a expression, impacting calcium handling and myocardial relaxation. Diagnostic strategies mainly employ echocardiography, including Doppler imaging, tissue Doppler imaging, and strain imaging, to assess ventricular relaxation and stiffness. However, early identification remains challenging, necessitating advanced tools like cardiac magnetic resonance and exercise stress testing for accurate diagnosis, especially in women who often present with subtle symptoms. Treatment options for HFpEF have traditionally been limited, but recent trials, notably EMPEROR-PRESERVED and DELIVER, demonstrated significant cardiovascular benefits using sodium-glucose cotransporter-2 (SGLT2) inhibitors. Additionally, glucagon-like peptide-1 receptor agonists (GLP-1 RAs) have shown promising results, particularly in obese patients. Despite these advances, gender differences in therapeutic response necessitate further research for personalized management strategies. Understanding sex-specific pathophysiological mechanisms and optimizing diagnostic criteria remain essential to improving prognosis and quality of life in HFpEF patients.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12194537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lifestyle and Pharmacological Interventions to Prevent Anthracycline-Related Cardiotoxicity in Cancer Patients.","authors":"Luigi Spadafora, Francesca Maria Di Muro, Chiara Intonti, Ludovica Massa, Mauro Monelli, Roberto Franco Enrico Pedretti, Edvige Palazzo Adriano, Pasquale Guarini, Gaia Cantiello, Marco Bernardi, Federico Russo, Stefano Cacciatore, Pierre Sabouret, Michele Golino, Giuseppe Biondi Zoccai, Francesca Romana Zimatore, Laura Adelaide Dalla Vecchia","doi":"10.3390/jcdd12060212","DOIUrl":"10.3390/jcdd12060212","url":null,"abstract":"<p><p>Anthracyclines remain a cornerstone of cancer therapy but are associated with a significant risk of cardiotoxicity, which can lead to overt heart failure. The risk is modulated by cumulative dose, pre-existing cardiovascular disease, and patient-specific factors. As cancer survival improves, the long-term cardiovascular consequences of anthracycline exposure have become a growing concern, underscoring the need for effective preventive strategies. This narrative review examines lifestyle and pharmacological interventions aimed at mitigating anthracycline-induced cardiotoxicity. Evidence suggests that structured exercise programs and antioxidant-rich diets may enhance cardiovascular resilience, while beta-blockers, renin-angiotensin system inhibitors, and dexrazoxane remain central pharmacological options. Emerging therapies, including sodium-glucose co-transporter 2 inhibitors and sacubitril/valsartan, show promise but require further investigation. A comprehensive approach that integrates lifestyle modifications with pharmacological strategies within a multidisciplinary cardio-oncology framework may provide optimal protection, improving long-term cardiovascular outcomes in cancer patients receiving anthracyclines.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193841/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484452","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Driveline Relocation and Vacuum-Assisted Closure for Ventricular Assist Device Driveline Infections.","authors":"Mehmet Cahit Saricaoglu, Melisa Kandemir, Elif M Saricaoglu, Ali Fuat Karacuha, Ezel Kadiroglu, Mustafa Farah Abdullahi, Mustafa Bahadir Inan, Alpay Azap, Ahmet Ruchan Akar","doi":"10.3390/jcdd12060211","DOIUrl":"10.3390/jcdd12060211","url":null,"abstract":"<p><strong>Background: </strong>Durable mechanical circulatory support (DMCS) infections remain a serious challenge. Ventricular assist device (VAD)-specific driveline infections (DLIs) are the most common type; however, no consensus exists on their surgical management. We aimed to define the incidence, risk factors, and microbiology of DLIs and discuss the surgical treatment modalities.</p><p><strong>Methods: </strong>We retrospectively reviewed 90 patients who underwent a left or biventricular ventricular assist device (LVAD or BiVAD) implantation with either a HeartMate 2 (Abbott), HeartWare HVAD (Medtronic), or HeartMate 3 (Abbott) in a single center between 1 March 2011 and 30 May 2023.</p><p><strong>Results: </strong>DLIs were detected in 20 (21.5%) patients during the follow-up. The mean duration of VAD support was 561.1 ± 833.2 days (1-4124 days), while it was 1277.9 ± 621.6 days in the DLI group. An extended duration of VAD support was associated with higher incidence rates of late-onset DLIs (<i>p</i> < 0.05). A younger age and lower plasma albumin levels were independent predictive factors for the risk of a DLI, with a hazard ratio of 9.77 (95%CI: 1.3-74.5) and 10.55 (95%CI: 1.40-79.35), respectively. The removal of the biofilm with velour and DL relocation through the rectus muscle combined with vacuum-assisted strategies (VAC) were performed in nine patients. One patient developed a recurrent infection, and another patient with a deep DLI subsequently received a heart transplant. No patient underwent a device exchange for an intractable DLI.</p><p><strong>Conclusions: </strong>Our results suggest that DLIs are common infectious complications after VAD implantation, which endanger patient autonomy, and impair their quality of life and overall survival. A DL relocation through the rectus muscles and VAC strategies have a role in controlling DLIs.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparative Diagnostic Efficacy of HeartLogic and TriageHF Algorithms in Remote Monitoring of Heart Failure: A Cohort Study.","authors":"David Ledesma Oloriz, Daniel García Iglesias, Rodrigo Ariel di Massa Pezzutti, Fernando López Iglesias, José Manuel Rubín López","doi":"10.3390/jcdd12060209","DOIUrl":"10.3390/jcdd12060209","url":null,"abstract":"<p><strong>Introduction: </strong>Implantable defibrillator devices (ICDs) can be used for remote monitoring of different variables, including some related to Heart Failure (HF). Two different algorithms (TriageHF and HeartLogic) arise by combining some of these variables to generate an estimation of HF decompensation risk in the following days. Until now, no other trial has evaluated both algorithms in a head-to-head comparison. The primary objective is to compare diagnostic accuracy of both algorithms in a similar cohort of patients.</p><p><strong>Material and methods: </strong>Descriptive monocentric cohort study of a series of 64 patients who have been implanted with a Medtronic or Boston Scientific ICD with the TriageHF or Heart Logic algorithm available during the period between January 2020 and June 2022, with a total of 27 patients in the HeartLogic group and 37 patients in the TriageHF group.</p><p><strong>Results: </strong>During the period of the study there were a total of 1142 alarms analyzed. There were no differences in the basal characteristics of both groups. We reported a risk alarm-patient ratio of 1.31 ± 1.89 in the HeartLogic group and of 3.32 ± 3.08 in the TriageHF group (<i>p</i> < 0.01). In the TriageHF group, we reported a lower specificity with (0.76), with higher sensitivity (0.97) and PPV (0.18), and similar NPV (1). Survival analysis shows no statistical differences between both algorithms in the 30 days following the alert.</p><p><strong>Conclusions: </strong>TriageHF algorithm had higher sensibility and PPV, leading to a higher number of alerts/patients, while HeartLogic algorithm had a better specificity. These differences should be considered to optimize patient follow-ups in home monitoring.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193614/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sudden Cardiac Death Due to Ventricular Arrhythmia in Acute Coronary Occlusion: Potential Roles of the Sinoatrial Nodal Artery and Conus Artery.","authors":"Justine Bhar-Amato, Aurojit Roy, Benjamin Lambert, Sofia Kassou, Stephen P Hoole, Sharad Agarwal","doi":"10.3390/jcdd12060210","DOIUrl":"10.3390/jcdd12060210","url":null,"abstract":"<p><strong>Background: </strong>Despite advances in the management of coronary disease, the incidence of sudden cardiac death (SCD) in the context of coronary artery disease (CAD) remains significant and unpredictable. We investigated the patient and angiographic characteristics, and predictors of long-term outcomes, of patients presenting with cardiac arrest in the context of acute coronary occlusion, to elucidate possible mechanisms of ventricular arrhythmia.</p><p><strong>Methods: </strong>A total of 127 consecutive patients presenting to a tertiary cardiac centre with pulseless ventricular tachycardia or ventricular fibrillation during acute myocardial infarction (AMI) were compared to 100 patients with uncomplicated AMI (Cohort A). We also compared a separate group comprising 20 patients with acute RCA occlusion complicated by cardiac arrest and 24 patients with uncomplicated inferior STEMI (Cohort B).</p><p><strong>Results: </strong>In Cohort A, there was a higher incidence of proximal lesions in the arrest group (55% vs. 41%, <i>p</i> < 0.05). There was an almost equivalent incidence of both LAD and non-LAD (RCA/Cx) infarcts presenting with cardiac arrest. In the non-LAD arrest patients, sinoatrial nodal artery (SANa) involvement was seen in 77%, compared with 33% in non-arrest patients (<i>p</i> < 0.005). In Cohort B, involvement of the SANa or conus artery (CA) was found in 74% of arrest versus 21% of non-arrest patients (<i>p</i> < 0.005). Cohort A patients were followed up for 3.8 to 8.7 years, and at the end of this period, 22% of arrest patients and 16% of non-arrest patients were deceased. Mortality <30 days was highest in the arrest group (43% vs. 7%, <i>p</i> < 0.05). Beyond 30 days, there were no differences in all-cause mortality between arrest and non-arrest patients. There were more cardiac causes of death in the arrest group (54% vs. 20%, <i>p</i> < 0.05).</p><p><strong>Conclusions: </strong>VT/VF arrest due to acute coronary occlusion was more common in those with proximal disease and there was an increased incidence of SANa and/or CA involvement in non-LAD infarcts. Short-term mortality was higher in patients with cardiac arrest post-AMI, but beyond 30 days there was no significant difference.</p>","PeriodicalId":15197,"journal":{"name":"Journal of Cardiovascular Development and Disease","volume":"12 6","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12193499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484486","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}