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The purpose of this meta‐analysis was to evaluate the impact of image integration technique on clinical and procedural outcomes in patients undergoing radiofrequency catheter ablation of atrial fibrillation with a three‐dimensional electroanatomic mapping system. Randomized controlled trials were identified through a systematic literature search of PubMed and CENTRAL databases from inception to April 2020. The primary outcome was arrhythmia recurrence during the follow‐up period. The secondary outcomes were the difference in total procedural time and fluoroscopy time. Four studies with a total of 749 patients were included. The pooled result showed no statistically significant difference between the groups with respect to arrhythmia recurrence (RR, 0.75; 95% CI, 0.47‐1.21), fluoroscopy time (MD, −6 minutes; 95% CI, −23.4 to 11.3), and total procedural time (MD, 1.1 minutes; 95% CI, −31.8 to 34.1). Image integration to guide radiofrequency catheter ablation for patients with atrial fibrillation does not improve clinical and procedural outcomes. Meta‐analysis of four randomized controlled trials showed that integration of preprocedural CT or MRI images with real‐time electroanatomic maps to guide pulmonary vein isolation does not improve clinical and procedural outcomes.

Background. Platelet to lymphocyte ratio (PLR) has been demonstrated as a risk and prognostic marker in many of cardiovascular diseases. A relationship between PLR and severity of carotid stenosis has been shown. The aim of our study was to investigate the relationship between PLR and all cause mortality in patients with carotid arterial disease.

ObjectiveSerum procalcitonin levels are associated with congestive heart failure, but are not established biomarkers of the disease. We evaluated the predictive value of serum procalcitonin levels for diagnosing heart failure and assessing its severity.Methods and resultsThis retrospective, case-control study involved 59 subjects (mean age 59.7 ± 10.1 years; 38 males), including 21 outpatients and 19 inpatients with heart failure and left ventricular ejection fractions < 45%, and 19 healthy controls. Serum procalcitonin levels were measured and compared among the 3 groups. Procalcitonin levels were signifi cantly higher among inpatients (median [interquartile range], 1.45 [0.25–5.80] ng/mL) than among the outpatients (0.35 [0.001–1.70] ng/mL; P< 0.001) or controls (0.05 [0.02–0.08] ng/mL; P< 0.001). Using a procalcitonin cut-off level of 0.09 ng/mL, 35 (87.5%) of the 40 inpatients and outpatients were procalcitonin-positive; all control individuals were procalcitonin-negative. Serum procalcitonin levels differentiated between heart failure patients and healthy controls (sensitivity, 88.9% [95% confi dence interval, 75.9–96.2%]; specifi city, 100% [82.2–100.0%]; positive predictive value, 100% [91.1–100.0%]; negative predictive value, 79.2% [57.8–92.8%]). Procalcitonin levels were > 0.53 ng/mL in 4/21 (19%) outpatients and in 16/19 (84.2%) inpatients. The sensitivity and specifi city of serum procalcitonin levels for diff erentiating between inpatients and outpatients were 84.2% and 81.0%, respectively (positive predictive value 80% [95% confi dence interval, 67.6–92.4%] and 85.0% [73.9–96.1%], respectively).ConclusionSerum procalcitonin levels, showing high sensitivity and specifi city for diagnosing and assessing the severity of heart failure in this small study, might be considered potential heart failure biomarkers.

Radiographic contrast agents can cause acute decrease in renal functions. It is thought that anti-oxidant acetylcysteine can prevent contrast nephropathy. Fifty patients planned to undergo elective diagnostic coronary angiography with serum creatinine values above 1.3 mg/dL were included in the study. Acetylcysteine was given orally at a dose of 600 mg twice daily, on the day before and on the day of administration of contrast agent in the acetylcysteine group (n = 25). Acetylcysteine was not given to the control group (n = 25). Saline (0.9%) was given intravenously at a rate of 1 mL/kg/h for 12 hours before and 12 hours after administration of contrast agent. Contrast nephropathy was detected in 3 of 25 patients (12%) in the acetylcysteine group and 2 of 25 patients (8%) in the control group (P> 0.05). Contrast nephropathy was developed in 2 of 4 patients (50%) with baseline serum creatinine concentrations above 2.5 mg/dL, whereas it was developed in only 3 of 46 patients (6.5%) with baseline serum creatinine concentrations below 2.5 mg/dL (P= 0.04). It was detected that in patients planned to undergo elective diagnostic coronary angiography with renal dysfunction, oral acetylcysteine and hydration before the procedure was not more effective than hydration alone in the prevention of contrast nephropathy. High baseline serum creatinine values were detected as a risk factor for development of contrast nephropathy.

Background:Atrial fibrillation (AF) is a common complication of acute myocardial infarction (AMI) with a reported incidence of 7–18%. Recently, P‐wave signal‐averaged electrocardiogram (P‐SAECG) has been used to assess the risk of paroxysmal AF attacks in some diseases. The aim of this study was to determine prospectively whether patients with AMI at risk for paroxysmal AF would be identified by P‐SAECG and other clinical variables.

Pseudoaneurysm of the left ventricle (LV) is one of the mechanic complications of myocardial infarction. This rare complication mostly stems from inferior wall of the LV. The wall of pseudoaneurysm contains pericardium and/or scar tissue but not myocardium. Transthorasic echocardiography is commonly used in clinical practice and is usually sufficient to make a diagnosis of LV pseudoaneurysm. It is important to differentiate pseudoaneurysm from true LV aneurysm. Pseudoaneursym does not contain myocardial tissue whereas true LV aneurysm does. Pseudoaneurysm also has narrow neck unlike true LV aneurysm. Urgent surgical approach is indicated because of fatal rupture. Here we report a case report of pseudoaneurysm manisfesting with acute dyspnea.

Single coronary artery anomaly associated with coronary fistula is a rare entity. Transcatheter coil embolization is the treatment of choice for coronary artery fistulas. In this case report, we describe a patient with both single coronary artery anomaly and coronary fistula who was successfully treated with coil embolization.