CJC Open最新文献

{"title":"Primary Atrial Leiomyosarcoma in a Patient with a Prior History of Uterine Leiomyoma and Ovarian Tumour","authors":"Solomon Tuonuur MD , Nasreen Shaikh MD , Radishma Kumar MD , Alireza Setarehaseman MD , Alessandra F. Nascimento MD , Hossein Akhondi MD , Abbas Mohammadi MD","doi":"10.1016/j.cjco.2025.03.008","DOIUrl":"10.1016/j.cjco.2025.03.008","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 671-674"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Evolution of Head-Upright Tilt-Table Testing in Toronto, Ontario, Canada: 2014-2024","authors":"Owais S. Mian MD ,&nbsp;Russell J. de Souza RD, ScD ,&nbsp;David M. Newman MD ,&nbsp;Sheldon M. Singh MD","doi":"10.1016/j.cjco.2025.02.010","DOIUrl":"10.1016/j.cjco.2025.02.010","url":null,"abstract":"<div><div>The real-world use of head-upright tilt-table tests (HUTTs) in North America is not known. This single-centre retrospective study in Toronto, Ontario, Canada reports on 1063 HUTTs conducted between 2014 and 2024. Use of the HUTT increased year over year, with a greater increase in HUTTs conducted as a result of a referral diagnosis of postural orthostatic tachycardia syndrome (POTS). Using specific diagnostic criteria for syncope and POTS, patients with either diagnosis who underwent testing, after January 2021 had an almost 50% reduction in the odds of a positive HUTT (syncope: odds ratio: 0.54, 95% confidence interval: 0.40-0.73 and postural orthostatic tachycardia syndrome: odds ratio: 0.51, 95% confidence interval: 0.28-0.95).</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 588-592"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936581","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Systemic Sclerosis Presenting as Arrythmogenic Cardiomyopathy: A Case Series","authors":"El-Hadji Diallo MD ,&nbsp;Julia Cadrin-Tourigny MD ,&nbsp;Sabrina Hoa MD, MSc ,&nbsp;Nadia Boulé Laghzali MD ,&nbsp;Brian J. Potter MD ,&nbsp;Océane Landon-Cardinal MD ,&nbsp;Jean-Marc Raymond MD","doi":"10.1016/j.cjco.2025.03.009","DOIUrl":"10.1016/j.cjco.2025.03.009","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 628-631"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936584","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Efficacy of Stereotactic Cardiac Radio-Ablation for Ventricular Tachycardia in Patients at High Risk of Mortality","authors":"Calum J. Redpath MBChB, MRCP, PhD ,&nbsp;Andrew M. Crean MRCP FRCR, MPH ,&nbsp;Pablo B. Nery MD ,&nbsp;Girish M. Nair MBBS, MSc, FRCPC ,&nbsp;Mehrdad Golian MD, MSc ,&nbsp;Simon Hansom BSc, MBBS, MRCP (UK) ,&nbsp;Connor Haberl MASc ,&nbsp;Robert deKemp PhD ,&nbsp;Phillip S. Cuculich MD ,&nbsp;Clifford G. Robinson MD ,&nbsp;Katie S. Lekx-Toniolo MCCPM, PhD ,&nbsp;David Tiberi MD, FRCPC ,&nbsp;Graham Cook MD, FRCPC","doi":"10.1016/j.cjco.2025.01.015","DOIUrl":"10.1016/j.cjco.2025.01.015","url":null,"abstract":"<div><h3>Background</h3><div>Patients who have recurrent ventricular tachycardia (VT) despite receiving antiarrhythmic drugs (AADs), implantable cardioverter defibrillator placement, and catheter ablation (CA) are at significant risk of morbidity and mortality.</div></div><div><h3>Methods</h3><div>We offered completely noninvasive cardiac radio-ablation (CRA) on a “compassionate use” basis for patients who were unable or unwilling to undergo CA for recurrent VT despite their having received treatment with AADs and placement of an implantable cardioverter defibrillator. All patients who were referred to the CRA program were entered into a prospective registry and followed indefinitely thereafter.</div></div><div><h3>Results</h3><div>A total of 20 patients were referred for CRA, and 10 elected to undergo the treatment as outpatients. Ten patients declined CRA therapy, owing to fear of complications and/or logistic concerns relating to attending multiple hospital visits; they received escalated drug therapy. All patients who were referred to and were agreeable to CRA received CRA. No patients were excluded or were denied CRA by clinicians for any reason, and all patients were followed clinically. The VT burden decreased significantly, by &gt; 90% (both anti-tachycardia pacing and shocks), and 1 patient died of a cardiovascular cause at 1 year following a single CRA treatment of 25 Gy. One patient experienced steroid-responsive pneumonitis as an adverse event post-CRA (common terminology criteria for adverse events [CTCAE] grade 2). For the 10 patients who declined CRA, no appreciable reduction in VT occurred, despite their receipt of increasing dosages of AADs, and 5 patients died of cardiovascular causes within 1 year.</div></div><div><h3>Conclusions</h3><div>Noninvasive stereotactic CRA is well tolerated with good short-term efficacy for recurrent VT on a “compassionate use” basis. Prospective randomized controlled trials to determine the relative efficacy of CA vs CRA for VT are urgently required.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 545-554"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated with Same-Day Discharge After Catheter Ablation Procedures for Supraventricular Tachycardia in Ontario, Canada","authors":"Sheldon M. Singh MD ,&nbsp;Jiming Fang PhD ,&nbsp;Olivia Haldenby MSc ,&nbsp;Dennis T. Ko MD, MSc","doi":"10.1016/j.cjco.2025.03.001","DOIUrl":"10.1016/j.cjco.2025.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Variation exists in the practice of same-day discharge (SDD) after supraventricular tachycardia (SVT) catheter-ablation procedures. The aim of this study was to evaluate factors associated with SDD after SVT catheter-ablation procedures.</div></div><div><h3>Methods</h3><div>All Ontario residents aged &gt; 18 years undergoing a first-ever SVT ablation procedure between April 1, 2011 and May 31, 2020 were included. The rate of SDD at each hospital and the annual rate within Ontario were determined. A series of logistic regression models were created to determine the influence of clinical and procedural characteristics, and of the hospital performing the procedure, on the probability of SDD occurring. The median odds ratio was calculated to estimate the variation in the odds of similar patients receiving SDD at different hospitals.</div></div><div><h3>Results</h3><div>The cohort included 16,044 individuals (aged 55.9 ± 16.5 years; female: 45.9%). Transseptal catheterization was performed in 7.8% of the cohort. The rate of SDD increased from 61% in 2011 to 91% in 2020. Hospital rates of SDD ranged from 41% to 95%. The discrimination ability (measured by C-statistics) in predicting SDD was high, at 0.84, in the model that included the hospital, as opposed to 0.58 in the model that did not include the hospital. After adjusting for age, sex, patient comorbidities, the arrhythmia diagnosis, and procedural details, the median odds ratio attributed to the hospital performing the procedure was 3.82.</div></div><div><h3>Conclusions</h3><div>Variation in SDD after SVT ablation procedures is primarily related to hospital factors. Policymakers are encouraged to explore hospital-level barriers to adopting this approach.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 564-570"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rhythm vs Rate Control Strategies for Perioperative Atrial Fibrillation After Noncardiac Surgery: A Systematic Review and Meta-analysis","authors":"Michael Ke Wang MD ,&nbsp;Ghazal Razeghi BSc ,&nbsp;Geethan Baskaran BHSc ,&nbsp;Louis Park BHSc ,&nbsp;Steffen Blum MD, PhD ,&nbsp;Rachel Heo MD ,&nbsp;Tina Stegmann MD ,&nbsp;P.J. Devereaux MD, PhD ,&nbsp;William F. McIntyre MD, PhD ,&nbsp;Jeff S. Healey MD, MSc ,&nbsp;Michael Prystajecky MD, MSc ,&nbsp;Rémi LeBlanc MD ,&nbsp;Shannon M. Ruzycki MD ,&nbsp;Mohamed Panju MD ,&nbsp;Kiven Vuong BSc, MPH ,&nbsp;David Conen MD, MPH","doi":"10.1016/j.cjco.2025.01.018","DOIUrl":"10.1016/j.cjco.2025.01.018","url":null,"abstract":"<div><h3>Background</h3><div>For patients with perioperative atrial fibrillation (POAF) after noncardiac surgery, earlier conversion to sinus rhythm might improve outcomes. The efficacy of a rhythm vs rate control strategy for the acute management of POAF remains uncertain.</div></div><div><h3>Methods</h3><div>We searched databases for randomized controlled trials (RCTs) and observational studies that included patients with POAF after noncardiac surgery and reported outcomes for patients acutely treated with a rhythm control strategy vs either a rate control or no treatment strategy. Studies were pooled using random effects models.</div></div><div><h3>Results</h3><div>Of the observational studies, a rhythm control strategy was associated with higher conversion rates to sinus rhythm compared with a rate control or no treatment strategy (risk ratio [RR], 1.93; 95% confidence interval [CI], 1.25-2.97; 9 studies; N = 591). Compared with a rate control or no treatment strategy, a rhythm control strategy was not associated with differences in length of hospital stay (mean difference, -1.67 days; 95% CI, -7.10 to 3.76; 2 studies), length of intensive care stay (mean difference, -1.90 days; 95% CI, -7.62 to 3.82; 1 study), or all-cause mortality (RR, 1.12; 95% CI, 0.62-2.00; 5 studies). In an RCT that compared amiodarone vs magnesium, the RR was 0.56 for conversion to sinus rhythm (95% CI, 0.31-1.03; N = 34).</div></div><div><h3>Conclusions</h3><div>A rhythm control strategy was associated with greater success rates for conversion to sinus rhythm compared with a rate control or no treatment strategy. However, the observational studies were of low quality and only 1 small RCT was identified, and few data were available for other outcomes.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 579-587"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Equity Gaps in the Diagnosis and Treatment of Occlusion Myocardial Infarction","authors":"Varunaavee Sivashanmugathas BSc ,&nbsp;Mazen El-Baba MD, MSc ,&nbsp;Marcella K. Jones MD ,&nbsp;Alex Kiss PhD ,&nbsp;H. Pendell Meyers MD ,&nbsp;Stephen W. Smith MD ,&nbsp;Lucas B. Chartier MD, CM, MPH, MBA ,&nbsp;Jesse T.T. McLaren MD","doi":"10.1016/j.cjco.2025.01.016","DOIUrl":"10.1016/j.cjco.2025.01.016","url":null,"abstract":"<div><h3>Background</h3><div>Patients with occlusion myocardial infarction (OMI) who meet the ST-elevation myocardial infarction (STEMI) criteria experience inequitable delays in care, because of sociodemographic factors, such as age and sex. OMI patients who do not meet STEMI criteria and are admitted to the hospital as non-STEMI patients, experience further delays. However, whether equity gaps exist in OMI care remains unknown.</div></div><div><h3>Methods</h3><div>A retrospective chart review included patients with acute coronary syndrome admitted to the hospital through 2 academic emergency departments, in the period from January 1, 2021 to December 31, 2022. Patients were categorized as having one of the following: OMI (acute culprit with Thrombolysis In Myocardial Infarction [TIMI] 0-2 flow, or acute culprit with TIMI 3 flow, and a troponin I level &gt; 10,000 ng/L; or if they had no angiogram, a troponin I level &gt; 10,000 ng/L plus new regional wall-motion abnormality on echocardiogram); non-OMI (MI that did not meet the OMI threshold); or MI ruled out.</div></div><div><h3>Results</h3><div>Among 662 charts, 260 were OMI patients, 296 were non-OMI patients, and 106 were patients with MI ruled out. Of the 260 OMI patients, 116 were admitted to the hospital as STEMI patients (true-positive), and 144 (55.4%) were admitted as non-STEMI patients (false-negative). In bivariate analyses, true-positive STEMI patients with atypical symptoms had a longer door-to-electrocardiogram (ECG) time (<em>P</em> &lt; 0.0001) and a longer ECG-to-catheterization time (<em>P</em> &lt; 0.001). False-negative STEMI patients had a longer door-to-ECG time for atypical symptoms (<em>P</em> &lt; 0.0001), a longer ECG-to-catheterization time for atypical symptoms (<em>P</em> = 0.003), and were aged ≥75 years (<em>P</em> = 0.006).</div></div><div><h3>Conclusions</h3><div>True-positive STEMI patients had delayed ECGs and catheterization for those presenting with atypical symptoms. More than half of those with OMI were admitted as non-STEMI patients, with further reperfusion delays for older patients and those presenting with atypical symptoms. Shifting to the OMI paradigm highlights reperfusion delays and equity gaps in the management of ACS.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 632-640"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety and Feasibility of Over 10 years and 1000 Exercise Hours of Cardiac Rehabilitation in a Patient with a Left Ventricular Assist Device","authors":"Javier Loureiro Diaz MSc ,&nbsp;Prasobh Jacob MSc ,&nbsp;Praveen Jayaprabha Surendran MPT ,&nbsp;Omar Ibrahim MD","doi":"10.1016/j.cjco.2025.03.006","DOIUrl":"10.1016/j.cjco.2025.03.006","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 667-670"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and Validation of Models to Predict Major Adverse Cardiovascular Events in Chronic Kidney Disease","authors":"Navdeep Tangri MD, PhD ,&nbsp;Thomas W. Ferguson MSc ,&nbsp;Ryan J. Bamforth MSc ,&nbsp;Manish M. Sood MD, MSc ,&nbsp;Pietro Ravani MD, PhD ,&nbsp;Alix Clarke Stat MSc ,&nbsp;Alessandro Bosi MSc ,&nbsp;Juan J. Carrero Pharm PhD","doi":"10.1016/j.cjco.2025.02.016","DOIUrl":"10.1016/j.cjco.2025.02.016","url":null,"abstract":"<div><h3>Background</h3><div>Accurate cardiovascular (CV) risk prediction tools may heighten awareness and monitoring, improve the use of evidence-based therapies and help inform shared decision making for patients with chronic kidney disease (CKD). The purpose of this study was to develop and externally validate a risk prediction model for incident and recurrent CV events across all stages of CKD using commonly available demographics and laboratory data.</div></div><div><h3>Methods</h3><div>A series of models were developed using administrative and laboratory data (n=36,317) from Manitoba, Canada, between April 1, 2006, and December 31, 2018, with external validation in health system’s data from Alberta, Canada (n=95,191), and Stockholm, Sweden (n=83,000). Adults with incident CKD stages G1-G4 were followed for the occurrence of major adverse cardiovascular events (MACE) (myocardial infraction, stroke, and CV death), and MACE including hospitalization for heart failure (MACE+). Discrimination and calibration were evaluated using the area under the receiver operating characteristic curve (AUC), Brier scores, and plots of observed vs predicted risk, and the models were compared to an existing model from the Chronic Renal Insufficiency Cohort (CRIC).</div></div><div><h3>Results</h3><div>In the Alberta cohort, the AUCs for predicting MACE and MACE+ were 0.77 (0.77-0.77) and 0.80 (0.79-0.80), respectively. In the Stockholm cohort, the model achieved an AUC of 0.87 (0.86-0.87) for predicting MACE and 0.88 (0.88-0.88) for MACE+. Overall performance was improved relative to CRIC.</div></div><div><h3>Conclusions</h3><div>A model including commonly available administrative data and laboratory results can predict the risk of MACE and MACE+ outcomes among individuals with CKD.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 686-694"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mobile Setup for Atrial Fibrillation Catheter Ablation","authors":"William K. Chan MD, FRCPC, DRCPSC,&nbsp;Umjeet S. Jolly MD, FRCPC, DRCPSC","doi":"10.1016/j.cjco.2025.02.015","DOIUrl":"10.1016/j.cjco.2025.02.015","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 5","pages":"Pages 593-594"},"PeriodicalIF":2.5,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143936582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}