Hellenic Journal of Cardiology最新文献

{"title":"A scientific document for the remote monitoring of cardiac implantable electronic devices in Greece","authors":"Polychronis Dilaveris ,&nbsp;Christos-Konstantinos Antoniou ,&nbsp;Sotirios Xydonas ,&nbsp;Christina Chrysohoou ,&nbsp;Theodoros Apostolopoulos ,&nbsp;Panagiotis Stafylas ,&nbsp;George Kochiadakis ,&nbsp;Konstantinos A. Gatzoulis ,&nbsp;Pacing and Electrophysiology Working Group of the Hellenic Society of Cardiology","doi":"10.1016/j.hjc.2025.02.002","DOIUrl":"10.1016/j.hjc.2025.02.002","url":null,"abstract":"<div><div>It is estimated that the number of patients with a cardiac implantable electronic device (CIED) in Greece exceeds 120,000, and this population is expected to further rise by 5% annually. The importance of adequate monitoring and follow-up management of these devices is well-recognized. However, the increasing complexity and growing number of CIEDs makes their management a demanding medical service. Traditionally, interrogation and programming of CIEDS is performed using a portable programmer by qualified personnel, requiring patient physical presence. During the last decade, remote monitoring (RM) of CIEDs tends to become more and more popular given the advantages and improved outcomes in many groups of patients. Currently, RM represents the standard of care for CIED follow-up, and it is recommended by major cardiology societies worldwide, including the European Society of Cardiology. The objective of this statement is to summarize the current management of patients with CIED in Greece and the available evidence about clinical efficacy and safety of RM of CIEDs, present the most recent guideline recommendations, and, finally, propose actions to move toward the widespread adoption of RM of CIEDs in Greece.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 96-103"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143434396","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cryoablation versus hybrid radiofrequency with high- and very-high-power short-duration catheter ablation for the treatment of paroxysmal atrial fibrillation","authors":"Ourania Kariki,&nbsp;Panagiotis Mililis,&nbsp;Athanasios Saplaouras,&nbsp;Stylianos Dragasis,&nbsp;Ilias G. Patsiotis,&nbsp;Anastasios Chatziantoniou,&nbsp;Dimitrios Alexiou,&nbsp;Vasileios Cheilas,&nbsp;Konstantinos P. Letsas,&nbsp;Michael Efremidis","doi":"10.1016/j.hjc.2024.03.014","DOIUrl":"10.1016/j.hjc.2024.03.014","url":null,"abstract":"<div><h3>Background</h3><div>High-power short-duration (HPSD) and very-high-power short-duration (vHPSD-90 W/4 s) radiofrequency (RF) technology has reduced the procedure time of pulmonary vein isolation (PVI) using RF without compromising the efficacy of the technique. The current study compares the novel technology of HPSD/vHPSD with cryoablation (CRYO) in terms of efficacy, safety, and procedure time in a cohort of symptomatic patients with paroxysmal atrial fibrillation (pAF).</div></div><div><h3>Methods</h3><div>This is a prospective, non-randomized trial. Patients with pAF received either CRYO or HPSD/vHPSD RF PVI. The primary endpoint of the study was arrhythmia recurrence in a 12 month follow-up period. Secondary endpoints included procedure time, fluoroscopy time, and safety.</div></div><div><h3>Results</h3><div>104 patients were included (45 in HPSD/vHPSD and 59 in CRYO), with comparable characteristics between groups. The follow-up was 12.4 ± 0.5 months. There was no significant difference regarding arrhythmia recurrences during the early post-procedural period of the first 3 months (8.9% recurrences in HPSD/vHPSD versus 5.1% in CRYO-p 0.463) and in the mid-term follow-up of 12 months (17.8% recurrences in HPSD/vHPSD versus 10.2% in CRYO-p 0.385). Safety was excellent for both procedures. CRYO was a procedure of significantly shorter duration (64.64 ± 8.94 min versus 75.29 ± 18.30 min, p = 0.0001) at the expense of longer fluoroscopy time (HPSD/vHPSD 5.34 ± 1.83 versus 7.89 ± 3.70 min CRYO, p 0.001).</div></div><div><h3>Conclusions</h3><div>HPSD/vHPSD and CRYO in pAF were comparable regarding the arrhythmia recurrence rates in a 12-month follow-up with excellent safety. The hybrid approach of HPSD/vHPSD has accelerated RF-PVI compared to conventional RF, but CRYO remains a procedure of significantly shorter duration at the expense of longer fluoroscopy time.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"84 ","pages":"Pages 75-80"},"PeriodicalIF":2.7,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute effectiveness and safety of the different mitral isthmus lines in the treatment of perimitral flutter with radiofrequency ablation.","authors":"Athanasios Ziakos, Julia Brilliant, Miltiadis Georgiadis, Kacem Zayakh, Angelis Sezenias, Harald Greiss, Armin Sause, Melchior Seyfarth","doi":"10.1016/j.hjc.2025.05.001","DOIUrl":"10.1016/j.hjc.2025.05.001","url":null,"abstract":"<p><strong>Objective: </strong>Ablating perimitral flutter (PMF) is challenging mainly because of epicardial structures such as the Bachmann bundle, the coronary sinus (CS) system, and the ligament of Marshall. There is still no consensus on which ablation strategy is the most effective. This study evaluates the acute effectiveness and safety of 3 different mitral isthmus (MI) ablation line types in treating PMF with radiofrequency ablation.</p><p><strong>Methods: </strong>This retrospective analysis reviewed 102 cases of definitively diagnosed PMF from 5131 electrophysiological procedures performed between January 2018 and April 2024 in our center. The 3 MI line types implemented were the anteroseptal line (ASML) from the mitral valve annulus to the right superior pulmonary vein, the anterior line (AML) from the mitral valve annulus to the left superior pulmonary vein, and the lateral (or posterior) line (LML) from the lateral mitral valve annulus to the left inferior pulmonary vein. In addition to endocardial ablation, when necessary, CS ablation and ethanol ablation of the vein of Marshall (VOM-ETOH) were used.</p><p><strong>Results: </strong>The LML had the highest block success rate (23/29 cases, 79.3%), followed by AML (41/64 cases, 64%) and ASML (19/33 cases, 57.6%). The overall acute block rate reached 81.4%, due to the combined use of multiple MI lines. In 16 cases (55.2% of LML), epicardial ablation in the CS system was performed. Use of VOM-ETOH with lateral lines increased success rates to 87.5%. Complications were rare, with one cardiac tamponade and one vascular complication.</p><p><strong>Conclusion: </strong>The LML demonstrated a trend toward superior acute effectiveness compared with AMLs and ASMLs for PMF, especially with adjunctive epicardial ablation techniques, without safety concerns. Accurate verification of bidirectional block and non-inducibility is critical.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Humanistic values of the physician in the era of artificial intelligence.","authors":"Konstantinos Dean Boudoulas, Konstantinos Marmagkiolis, Filippos Triposkiadis, Harisios Boudoulas","doi":"10.1016/j.hjc.2025.04.005","DOIUrl":"10.1016/j.hjc.2025.04.005","url":null,"abstract":"<p><p>Artificial intelligence (AI) has recently been introduced into clinical practice with the potential to revolutionize medicine. AI will provide the physician with unlimited power, which is almost impossible to foresee at present. In addition, AI can be used for the development of pharmacologic agents and antibodies with unprecedented accuracy and speed. AI will assist the physician in defining individuals at high risk for developing a certain disease and, in turn, provide appropriate care to delay or prevent the disease. Using vast information related to a certain disease, the physician will be able to apply individualized care in contrast to the current approach based on guidelines where \"one size fits all.\" With prevention and individualized care, the cost of health care will decrease, human suffering will diminish, and overall mortality will decline. However, in this endless evolution of medicine, the role of the physician remains constant, which is to maintain the health of a human being. In addition to diagnosis and management, the physician should apply common sense, courage, and compassion when dealing with the difficulties of human life that may escape machines. Humanistic values, among others, are basic for the caring physician. Thus, the humanistic approach to the patient and the divine vocation of the physician should never be forgotten and should be based on a solid ethical foundation. The greatest challenge for physicians and medical leadership in the 21st century will not be living with and adapting to changing technology, but determining the proper balance between clinical wisdom and evolving technology.</p>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144060780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In memoriam: George L. Bakris (1952–2024)","authors":"Konstantinos Tsioufis ,&nbsp;Pantelis Sarafidis ,&nbsp;Rigas Kalaitzidis ,&nbsp;George Stergiou ,&nbsp;Costas Thomopoulos ,&nbsp;Kyriakos Dimitriadis ,&nbsp;Athanasios Manolis ,&nbsp;John Boletis ,&nbsp;Fotis Tatakis ,&nbsp;Gerasimos Filippatos ,&nbsp;Vasilios Papademetriou ,&nbsp;Michalis Doumas ,&nbsp;Hellenic Cardiorenal and Hypertension Community","doi":"10.1016/j.hjc.2024.11.001","DOIUrl":"10.1016/j.hjc.2024.11.001","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 96-98"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142683794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mind the gap: the silent divide of digital health (Il)literacy","authors":"Charalambos Vlachopoulos ,&nbsp;Constantinos Bakogiannis","doi":"10.1016/j.hjc.2025.05.002","DOIUrl":"10.1016/j.hjc.2025.05.002","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 1-2"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144090675","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sex-based differences in ischemic cardiovascular and bleeding outcomes following implantation of drug-eluting stent in patients at high bleeding risk","authors":"Chao-Feng Lin ,&nbsp;Chia-Ling Tsai ,&nbsp;Ya-Hui Chang ,&nbsp;Dai-Yi Lin ,&nbsp;Li-Nien Chien","doi":"10.1016/j.hjc.2024.01.001","DOIUrl":"10.1016/j.hjc.2024.01.001","url":null,"abstract":"<div><h3>Background</h3><div>Patients with high bleeding risk (HBR) may exhibit uncertain adherence to dual antiplatelet therapy (DAPT) following drug-eluting stent (DES) implantation. The current population-based cohort study aimed to investigate the sex-based differences in adverse outcomes among the HBR population by analyzing the National Health Insurance Research Database in Taiwan.</div></div><div><h3>Methods</h3><div>Patients who had HBR features defined by the Academic Research Consortium (ARC) and received DES implantation between January 1, 2007, and December 31, 2017, were enrolled. Propensity score matching was adopted to select 3,981 pairs with similar clinical cardiovascular risks but different sexes. A competing risk model was performed to evaluate the risk of adverse ischemic events (cardiac death, nonfatal myocardial infarction, and ischemic stroke) and any bleeding events in both sexes. Noncardiac death was considered a competing risk.</div></div><div><h3>Results</h3><div>Within a 5-year follow-up, the incidence rates (per 1,000 person-year (95% confidence interval (CI)) of composite ischemic events and any bleeding events in males were respectively 44.09 (40.25–48.30) and 42.55 (38.79–46.68), while those in females were respectively 40.18 (36.51–44.23) and 42.35 (38.57–46.51). After adjustment for clinical variables, male patients had a marginally increased risk in the composite ischemic events (adjusted subdistribution hazard ratio (SHR) = 1.15 (1.00–1.31), <em>p</em> = 0.045) and a similar risk of any bleeding events (adjusted SHR = 1.00 (0.88–1.15), <em>p</em> = 0.946) compared with female patients.</div></div><div><h3>Conclusions</h3><div>Of the HBR population, males had an increased risk of ischemic outcomes but a similar risk of bleeding compared with females following DES implantation.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 10-19"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139461611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of long-term prognoses of percutaneous coronary intervention via distal transradial and conventional transradial access for acute coronary syndrome","authors":"Lingxia Xu ,&nbsp;Wei Lu ,&nbsp;Ganwei Shi ,&nbsp;Wenhua Li ,&nbsp;Jianqiang Xiao ,&nbsp;Anni Yang ,&nbsp;Feng Li ,&nbsp;Gaojun Cai","doi":"10.1016/j.hjc.2024.03.001","DOIUrl":"10.1016/j.hjc.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><div>Distal transradial access (dTRA) has recently emerged as a new vascular access alternative for coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). However, published data on long-term mortality and major adverse cardiac events after PCI via dTRA are inconclusive. The aim of this study was to compare the long-term prognoses of PCI via dTRA and conventional transradial access (cTRA) for acute coronary syndrome (ACS) after 1–3 years of follow-up.</div></div><div><h3>Methods</h3><div>Patients who were diagnosed with ACS and underwent PCI between January 1, 2020 and December 31, 2021, were retrospectively enrolled. The patients were divided into two groups at a 1:1 ratio, subjected to propensity score matching (PSM), and then followed for 1–3 years after PCI. Cox proportional hazards regression was used to evaluate the relationship between the two access sites and clinical outcomes.</div></div><div><h3>Results</h3><div>Among the 550 patients in the dTRA and cTRA groups, 11 (4.0%) and 19 (6.9%) died during the observation period, respectively. dTRA and cTRA had similar risks of all-cause mortality [hazard ratio (HR) = 0.688; 95% CI = 0.323–1.463; <em>P</em> = 0.331] and major adverse cardiac events (MACEs, HR = 0.806, 95% CI = 0.515–1.263; <em>P</em> = 0.347) after PCI. The risk of cardiovascular mortality (HR = 0.330, 95% CI = 0.107–1.105; <em>P</em> = 0.053), TLR-MACEs (HR = 0.587, 95% CI = 0.339–1.109; <em>P</em> = 0.058), and unplanned revascularization (HR = 0.860, 95% CI = 0.483–1.529; <em>P</em> = 0.606) were not significantly different between the two groups.</div></div><div><h3>Conclusions</h3><div>PCI via dTRA has the same long-term prognoses as PCI via cTRA in ACS patients, and the compression time and bleeding rate are lower than those in patients undergoing PCI via cTRA.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 28-37"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Modifiers of the Association between E/e' Ratio and Survival among Patients with No Apparent Structural or Functional Cardiac Abnormality","authors":"Yishay Wasserstrum ,&nbsp;Rami Gilead ,&nbsp;Sagit Ben-Zekry ,&nbsp;Efrat Mazor-Dray ,&nbsp;Anan Younis ,&nbsp;Amit Segev ,&nbsp;Elad Maor ,&nbsp;Rafael Kuperstein","doi":"10.1016/j.hjc.2024.01.005","DOIUrl":"10.1016/j.hjc.2024.01.005","url":null,"abstract":"<div><h3>Background</h3><div>The ratio between early mitral flow wave to early diastolic mitral annulus velocity (E/e’ ratio) varies according to age and sex and is associated with mortality in heart failure. We sought to describe the association between E/e’ and mortality in patients with no apparent structural or functional cardiac abnormality and explore possible modifiers of this association.</div></div><div><h3>Methods</h3><div>A retrospective study of 104,315 patients who underwent echocardiographic evaluation during 2009-2021 in the largest tertiary center in Israel. Patients with cancer, ventricular dysfunction, significant valvular or structural heart disease, or evidence of pulmonary hypertension were excluded.</div></div><div><h3>Results</h3><div>The final analysis included 32,836 patients with a median age of 56 (43-66) years, and 13,547 (41%) were female. The median E/e’ was 8.3 (6.8-10.3), and 9,306 (28%) had an E/e’ &gt;10. During a median follow-up of 5.7 (3.3-8.5) years, 2,396 (7.3%) individuals died. E/e’ &gt;10 was associated with mortality (adjusted hazard ratio [HR] 1.16, 95% confidence interval [CI] 1.07-1.27, p&lt;0.001). The mortality risk associated with E/e’ &gt;10 was significantly higher in those aged ≤70 (HR 1.26, 95% CI 1.12-1.42, p&lt;0.001), males (HR 1.34, 95% CI 1.19-1.49, p&lt;0.001), a normal left ventricular mass (HR 1.13, 95% CI 1.02-1.24, p = 0.017), and pulmonary artery pressure &lt;30 mmHg (HR 1.18, 95% CI 1.06-1.30, p = 0.003).</div></div><div><h3>Conclusion</h3><div>An elevated E/e’ is associated with mortality, specifically in younger individuals, males, and those with a normal left ventricular mass and lower pulmonary artery pressure. This suggests that an elevated E/e’ might be a marker of subclinical risk in these subgroups. Further studies are needed to identify whether an elevated E/e' is useful in shared decision-making regarding the management of cardiovascular risk factors.</div></div>","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 20-27"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139551739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transcatheter closure of a postoperative iatrogenic pseudoaneurysm in a patient with congenital heart disease","authors":"Ioannis Kasouridis ,&nbsp;Oleksandr Danylenko ,&nbsp;Wei Li ,&nbsp;Aleksander Kempny","doi":"10.1016/j.hjc.2024.05.016","DOIUrl":"10.1016/j.hjc.2024.05.016","url":null,"abstract":"","PeriodicalId":55062,"journal":{"name":"Hellenic Journal of Cardiology","volume":"83 ","pages":"Pages 99-101"},"PeriodicalIF":2.7,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141187226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}