CJC Open最新文献

{"title":"Atrial Fibrillation Inducibility After Ablation of Paroxysmal Supraventricular Tachycardia","authors":"Ahmed AlTurki MD, MHPE ,&nbsp;Bruno Toscani MD ,&nbsp;Alejandro Vidal MD,&nbsp;Sergio Diaz MD,&nbsp;Pedro Y. Lima MD, MSc,&nbsp;Daniel Garcia MD,&nbsp;Marcio Neumann MD,&nbsp;Lucas Faganello MD,&nbsp;Rodrigo Silva Barbosa MD, MSc,&nbsp;Martin L. Bernier MD,&nbsp;Jacqueline Joza MD, MSc,&nbsp;Vidal Essebag MD, PhD","doi":"10.1016/j.cjco.2025.03.027","DOIUrl":"10.1016/j.cjco.2025.03.027","url":null,"abstract":"<div><h3>Background</h3><div>Data on the inducibility of atrial fibrillation (AF) following supraventricular tachycardia (SVT) ablation in patients without prior history of AF are limited. This study aims to identify features associated with inducible AF and the subsequent development of clinical AF in patients who undergo SVT ablation.</div></div><div><h3>Methods</h3><div>This prospective study enrolled patients who underwent electrophysiology study and SVT ablation. AF inducibility testing post ablation utilized decremental atrial burst pacing, employing the same protocol that previously had been demonstrated to have clinical significance following pulmonary vein isolation. AF was assessed clinically as well as through 12-lead electrocardiogram recordings and ambulatory Holter recordings.</div></div><div><h3>Results</h3><div>A total of 152 patients who underwent an SVT ablation were evaluated. The median age was 53 years (range: 18-90); 87 patients were female (57.2%). Atrioventricular nodal reentrant tachycardia was diagnosed in 112 of the patients (73.6%), and 40 patients (26.3%) exhibited arrhythmias related to an accessory pathway. AF was induced in 31 patients (20.4%) during the induction protocol. Among patients with inducible AF, 79% spontaneously converted to sinus rhythm, and the rest were managed with cardioversion. During a median follow-up period of 514 ± 287 days, 6 patients (3.9%) developed clinical AF. Inducible AF at the time of the SVT procedure was associated with the development of clinical AF (odds ratio = 8.81, 95% confidence interval 1.53-50.63; <em>P</em> = 0.01).</div></div><div><h3>Conclusions</h3><div>A significant proportion of patients undergoing SVT ablation have inducible AF, but only a few have clinical AF in the first 2 years of follow-up. Inducible AF after SVT ablation predicts future AF.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 907-912"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587490","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":"Delayed Left Ventricular Rupture After Radiofrequency Catheter Ablation of Premature Ventricular Contractions Triggering Ventricular Fibrillation","authors":"Yuhei Kasai MD, FHRS ,&nbsp;Takayuki Kitai MD ,&nbsp;Junji Morita MD ,&nbsp;Ryo Horita MD ,&nbsp;Jungo Kasai PhD ,&nbsp;Tsutomu Fujita MD","doi":"10.1016/j.cjco.2025.04.013","DOIUrl":"10.1016/j.cjco.2025.04.013","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 952-954"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587380","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":"Dual Sinus Origins of the Left Coronary Artery From the Right and Left Coronary Sinus","authors":"Federico Oliveri MD ,&nbsp;Martijn Van Oort Msc ,&nbsp;Frank Van der Kley MD, PhD ,&nbsp;J. Wouter Jukema MD, PhD ,&nbsp;José Montero-Cabezas MD, PhD","doi":"10.1016/j.cjco.2025.04.015","DOIUrl":"10.1016/j.cjco.2025.04.015","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 967-968"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587384","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":"Intravascular Ultrasound-Guided Stenting for Iatrogenic Aortocoronary Dissection: The Art of “Needlework”","authors":"Quentin Liabot MD ,&nbsp;Jérémie Macia MD ,&nbsp;Stéphane Fournier MD, PhD ,&nbsp;Guillaume Testu de Balincourt MD ,&nbsp;Aurelia Zimmerli MD ,&nbsp;Marion Dupré MD ,&nbsp;Victor Weerts MD ,&nbsp;Olivier Muller MD, PhD ,&nbsp;Adil Salihu MD ,&nbsp;Louis Viallard MD ,&nbsp;David Meier MD","doi":"10.1016/j.cjco.2025.04.009","DOIUrl":"10.1016/j.cjco.2025.04.009","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 964-966"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587383","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":"“Is This Thing On?: Measuring Technology Self-Efficacy Influence on Cardiac Rehabilitation Patients’ Adoption of a Virtual Care Platform","authors":"Megan Graat MPH ,&nbsp;Peter L. Prior PhD ,&nbsp;Tim Hartley MSc ,&nbsp;Karen Unsworth MSc ,&nbsp;Robert S. McKelvie MD, PhD, FRCPC ,&nbsp;Ashlay A. Huitema MD, FRCPC ,&nbsp;Mahima K. Bijji BSc ,&nbsp;Neville G. Suskin MBChB, MSc, FRCPC","doi":"10.1016/j.cjco.2025.02.003","DOIUrl":"10.1016/j.cjco.2025.02.003","url":null,"abstract":"<div><h3>Background</h3><div>The COVID-19 pandemic accelerated the adoption of virtual cardiac rehabilitation (vCR) delivery models. Understanding patient-level factors, such as technology self-efficacy (SE), is crucial for enhancing vCR adoption and ensuring its long-term sustainability. However, no validated tool exists to assess technology SE specifically for vCR. This paper outlines the initial phase of a quality-improvement project focused on developing a survey to assess technology SE among patients with access to videoconferencing (VC) technology in a vCR program.</div></div><div><h3>Methods</h3><div>A 30-item technology SE survey was developed by adapting items from validated instruments to prospectively assess technology SE in vCR and was tested for internal consistency.</div></div><div><h3>Results</h3><div>Of the 413 eligible patients, 99 completed the technology SE survey (24% response rate); 86 attended vCR using VC, and 13 did not use VC. The VC attendees were significantly younger than the non-VC attendees (aged 64.1 vs 72.5 years, <em>P</em> = 0.009). Although no significant differences were found in overall self-reported technology skills, novel technology use SE, or healthcare technology-related attitudes, VC attendees scored significantly higher on a measure of healthcare technology SE and demonstrated greater confidence in tasks such as opening a Web browser, clicking hyperlinks, downloading apps, and using novel technologies.</div></div><div><h3>Conclusions</h3><div>This quality-improvement initiative highlights disparities in technology SE that may impact participation in vCR programs. Addressing these gaps through targeted screening and interventions could enhance vCR accessibility and equity. Future research should focus on validating SE tools modified for vCR settings and exploring associated interventions to improve technology SE and patient vCR adoption.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 955-959"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587381","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 Multidisciplinary Aortopathy Clinic: The McGill Experience","authors":"Masaki Kodaira MD ,&nbsp;Kevin Lachapelle MD, FRSC(C), FACS ,&nbsp;Richard L. Leask PhD ,&nbsp;Kevin Bates MSc ,&nbsp;Yoni Grossman MD ,&nbsp;Carlos-Eduardo Guerrero-Chalela MD ,&nbsp;Lauren Kennedy MSc ,&nbsp;George Thanassoulis MD, MSc, FRCPC ,&nbsp;Oren K. Steinmetz MD, FRCS(C) ,&nbsp;Kent MacKenzie MD ,&nbsp;Josephine Pressacco MD, PhD ,&nbsp;James C. Engert PhD ,&nbsp;Judith Therrien MD, FRCPC","doi":"10.1016/j.cjco.2025.01.021","DOIUrl":"10.1016/j.cjco.2025.01.021","url":null,"abstract":"<div><h3>Background</h3><div>Guidelines recommend that patients with thoracic aortic disease (TAD) be seen in a multidisciplinary aortopathy clinic, because of their complex and high-risk profile. However, reports on such clinics are limited.</div></div><div><h3>Methods</h3><div>From September 2016 to May 2024, we evaluated 567 patients with TAD. They were seen by our multidisciplinary team, which is comprised of 1 cardiac surgeon, 2 vascular surgeons, 1 cardiologist, 1 cardiothoracic radiologist, a team of 4 engineering researchers, a dedicated member from the genetics department, and an administrative assistant. For patients who had computed tomography or magnetic resonance imaging performed outside our institution, image reanalysis was conducted by our cardiothoracic radiologist. Genetic testing was performed for patients with suspected hereditary TADs.</div></div><div><h3>Results</h3><div>Reanalysis of external computed tomography and/or magnetic resonance imaging by our radiologist altered clinical decision-making in 5 of 51 cases (9.8%). Genetic testing that examined 25 genes associated with Marfan syndrome and related aortopathies was conducted on 250 patients, revealing a positive TAD gene in 32 (12.8%), a variant of unknown significance in 99 (39.6%), and a negative result in 119 (47.6%). Forty patients (7%) had surgery within a median of 2.7 months (quartile 1–quartile 3: 1.1-4.9) from their initial clinic visit.</div></div><div><h3>Conclusions</h3><div>Our 8-year experience at the aortopathy clinic of McGill University demonstrates that a multidisciplinary approach to TAD can deliver complete, precise, and timely care to this complex patient population.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 921-927"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587375","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":"Adjustment of Antiplatelet Therapy in Patients With Myocardial Infarction Treated Without Revascularization: A Retrospective Cohort Study","authors":"Nicolas Dostie ,&nbsp;Arman Sarshoghi ,&nbsp;Alexis Doucet ,&nbsp;Robert Avram MD, MSc ,&nbsp;Jean-François Tanguay MD ,&nbsp;Guillaume Marquis-Gravel MD, MSc","doi":"10.1016/j.cjco.2025.04.012","DOIUrl":"10.1016/j.cjco.2025.04.012","url":null,"abstract":"<div><h3>Background</h3><div>Although a substantial proportion of patients with myocardial infarction (MI) are treated without revascularization, no randomized controlled trial has evaluated the optimal antiplatelet strategy in this vulnerable population and practice patterns may be heterogeneous. This study aims to describe postdischarge antiplatelet therapy (APT) practice patterns in medically managed patients with MI.</div></div><div><h3>Methods</h3><div>A retrospective cohort study was conducted at the Montreal Heart Institute (July 31, 2020–July 31, 2023). Patients aged ≥18 years hospitalized for MI and discharged without revascularization were included, and discharge antiplatelet patterns were documented.</div></div><div><h3>Results</h3><div>A total of 365 patients were included, comprising 156 women (42.7%) (median age: 71.4 years [interquartile range: 61-83]). Reasons for being treated without revascularization include MI without obstructive coronary artery disease (n=139; 38%), no angiography performed (n=118; 32%), severe disease not amenable to revascularization (n=71; 20%), small branch disease (n=21; 6%), and spontaneous coronary dissection (n=16; 4%). At discharge, 41.9% (n=153) received dual APT (DAPT), 38.4% (n=140) received single APT, and 19.7% (n=72) received no antiplatelet agent. The most common DAPT regimen prescribed was clopidogrel–acetylsalicylic acid (aspirin) (34.0%; n=124), and the most frequently prescribed antiplatelet monotherapy was aspirin (25.8%; n=94). Among patients treated with DAPT, duration of prescription was 12 months in 91.5% of cases. Postdischarge antiplatelet strategy varied depending on the underlying MI etiology.</div></div><div><h3>Conclusion</h3><div>Postdischarge antiplatelet strategies prescribed in patients with an MI treated without revascularization are heterogeneous, whereas the preferred strategy is DAPT for 12 months. This variability reflects current clinical equipoise in this understudied population.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 913-920"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587374","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":"Cost Analysis for Minimally Invasive Mitral Valve Surgery: A Single-Centre Canadian Study","authors":"Toshiro W.S. Sembo MD, JD ,&nbsp;Ali Fatehi Hassanabad MD, MSc ,&nbsp;Kailey Stevens MSc ,&nbsp;Amy N. Brown MD, MSc, MPH ,&nbsp;Ken Parhar MD, MSc ,&nbsp;Corey Adams MD, MSc ,&nbsp;William D.T. Kent MD, MSc","doi":"10.1016/j.cjco.2025.04.072","DOIUrl":"10.1016/j.cjco.2025.04.072","url":null,"abstract":"<div><h3>Background</h3><div>Stakeholders within a publicly funded healthcare system have a duty to consider costs and economics, to utilize finite resources in the most effective manner. We aimed to quantify the postoperative costs associated with mitral valve repair (MVR) at the Foothills Medical Centre in Calgary, Canada.</div></div><div><h3>Methods</h3><div>A retrospective review of patients who underwent MVR from January 2020 to November 2023 was performed. For patients undergoing minimally invasive mitral valve surgery (MIMVS), a postoperative rapid recovery (RR) protocol was introduced. Postoperative costs were analyzed for 3 comparator groups: MIMVS with RR (MIMVS-RR), MIMVS without RR, , and median sternotomy.</div></div><div><h3>Results</h3><div>Care in the cardiovascular intensive care unit (CVICU) is 2.83 times more expensive than care on the cardiac surgery ward. Length of stay (LOS) in the CVICU was identified to be the primary driver of postoperative costs. The CVICU LOS and total LOS for sternotomy patients was longer than those of MIMVS patients. This difference translated to increased postoperative costs for sternotomy compared to MIMVS on a per-patient basis. The postoperative costs associated with sternotomy are 1.42 times higher than those for MIMVS-RR. When modelled with 200 patients, MIMVS-RR represents a postoperative cost-savings of $3.657 million CAD, compared to sternotomy.</div></div><div><h3>Conclusions</h3><div>Following MVR, a minimally invasive approach demonstrates cost-savings, compared to a sternotomy. Reduced CVICU LOS was the primary driver of cost-savings for MIMVS. Further analysis and investigations are required to fully quantify the true economic benefits of MIMVS-RR at our centre.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 871-878"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587517","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":"Impact of Coronary Intervention on In-Hospital Mortality in Octogenarians and Nonagenarians, Compared to Elderly Patients Aged < 80 Years with Acute Coronary Syndromes","authors":"Jayant Ravindran BSc Med, MBBS, MMed ,&nbsp;David Brieger MBBS, PhD ,&nbsp;Karice Hyun PhD ,&nbsp;Vincent Chow MBBS, PhD ,&nbsp;Andy Yong MBBS, PhD ,&nbsp;Leonard Kritharides MBBS, PhD ,&nbsp;Austin Chin Chwan Ng MBBS, BSc Med, MMed","doi":"10.1016/j.cjco.2025.04.006","DOIUrl":"10.1016/j.cjco.2025.04.006","url":null,"abstract":"<div><h3>Background</h3><div>Given that the Australian population is aging, with older patients presenting with acute coronary syndrome (ACS), its management over the past 20 years is likely to have changed.</div></div><div><h3>Methods</h3><div>Retrospective observational study from the New South Wales statewide Admission Patient Data Collection database of those aged ≥ 65 years hospitalized for ACS between January 2002 and December 2021. Patients were stratified into 3 age groups: 65-79 years, 80-89 years, ≥ 90 years). Temporal trends of ACS, coronary angiogram (CA), and percutaneous coronary intervention (PCI) and in-hospital mortality were evaluated. Multivariable analysis was used to adjust for baseline profiles and year of admission in mortality analysis.</div></div><div><h3>Results</h3><div>The study cohort comprised 118,608 patients (56.7% aged 65-79 years [n = 67,211]; 34.1% aged 80-89 years [n = 40,452]; 9.2% aged ≥ 90 years [n = 10,945]). Those aged 65-79 years, compared to older groups, had proportionally more male patients, with higher rates of ischemic heart disease, diabetes, smoking history, prior PCI and/or surgical bypass revascularization, and obesity. Heart failure, chronic pulmonary and renal disease, and dementia were more common in the older age groups. Proportionally, ST-elevation myocardial infarction decreased over time, whereas non-ST-elevation myocardial infarction rates increased. Although fewer CAs were performed in the older age groups, PCI rates in those who had CA were higher in those aged ≥ 80 years. Multivariable analysis showed that in-hospital mortality fell 49% in the group admitted in 2017 or later, vs in 2006 or earlier; for the younger, vs the older age groups, mortality fell by 55.4%, 52.5%, and 44.6%, respectively. The group aged ≥ 90 years had 3.1-fold higher adjusted odds of in-hospital death, compared to the group aged 65-79 years.</div></div><div><h3>Conclusions</h3><div>Over the past 2 decades, with increasing rates of coronary intervention, rates of in-hospital mortality in the elderly decreased, but older patients continue to have poorer outcomes following ACS.</div></div>","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 897-906"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587513","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":"Transapical Closure of Re-entry Tear in Aortic Dissection With the Off-Label Use of a Gore Cardioform Septal Occluder Using 3D-Printed Simulation","authors":"Christoph Huber MD ,&nbsp;Louis Vaisière ,&nbsp;Hajo Müller MD ,&nbsp;Christoph Ellenberger MD ,&nbsp;Mustafa Cikirikcioglu MD, PhD ,&nbsp;Jean Paul Vallée MD, PhD ,&nbsp;Stephane Noble MD","doi":"10.1016/j.cjco.2025.04.010","DOIUrl":"10.1016/j.cjco.2025.04.010","url":null,"abstract":"","PeriodicalId":36924,"journal":{"name":"CJC Open","volume":"7 7","pages":"Pages 928-931"},"PeriodicalIF":2.5,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144587376","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}