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Background: Mitral annular flutter (MAF) is the most common left atrial macro‐reentrant arrhythmia following catheter ablation of atrial fibrillation (AF). The best ablation approach for this arrhythmia remains unclear. Methods: This single‐center, retrospective study sought to compare the acute and long‐term outcomes of patients with MAF treated with an anterior mitral line (AML) versus a mitral isthmus line (MIL). Acute ablation success, complication rates, and long‐term arrhythmia recurrence were compared between the two groups. Results: Between 2015 and 2021, a total of 81 patients underwent ablation of MAF (58 with an AML and 23 with a MIL). Acute procedural success defined as bidirectional block was achieved in 88% of the AML and 91% of the MIL patients respectively (p = 1.0). One year freedom from atrial arrhythmias was 49.5% versus 77.5% and at 4 years was 24% versus 59.6% for AML versus MIL, respectively (hazard ratio [HR]: 0.38, confidence interval [CI]: 0.17–0.82, p =.009). Fewer patients in the MIL group had recurrent atrial flutter when compared to the AML group (HR: 0.32, CI: 0.12–0.83, p =.009). The incidence of recurrent AF, on the other side, was not different between both groups (21.7% vs. 18.9%; p =.76). There were no serious adverse events in either group. Conclusion: In this retrospective study of patients with MAF, a MIL compared to AML was associated with a long‐term reduction in recurrent atrial arrhythmias driven by a reduction in macroreentrant atrial flutters. [ABSTRACT FROM AUTHOR]

Introduction and objectives: The aim of this study was to investigate the association of serum albumin (SA) level with long‐term prognosis in patients with acute pulmonary embolism (PE). Materials and methods: We retrospectively enrolled 269 patients with acute PE. The SA level was obtained within 12‐24 hours following admission. The primary endpoints were the incidence of short‐ and long‐term mortality in acute PE patients. The mean duration of the study follow‐up was 21 ± 19 months. Results: During the follow‐up period, short‐ and long‐term mortality rates were higher in patients who had low SA level compared to those who did not have. In multivariate Cox regression analysis, the SA level was found to be independently associated with long‐term mortality (HR: 0.47, 95%CI: 0.28‐0.78, P = 0.004). In receiver operating characteristics analysis, the SA level of ≤3.17 predicted long‐term mortality with a sensitivity of 77.5% and a specificity of 79.5% (area under the curve 0.82, 95%CI: 0.76‐0.87, P < 0.001). In addition, when the SA plus simplified pulmonary embolism severity index (sPESI) risk score compared to the sPESI risk score alone, it produced a net reclassification improvement of 0.22 with P < 0.001, that is a 22% improved classification. Conclusion: To the best of our knowledge, this is the first study to demonstrate that the low SA level is a strong and independent predictor for long‐term mortality in patients with acute PE. [ABSTRACT FROM AUTHOR]

Left ventricular diastolic dysfunction (LVDD) is commonly seen in hypertensive patients, and it is associated with increased morbidity and mortality. Hence, the detection of LVDD with a simple, inexpensive, and easy-to-obtain method can contribute to improving patient prognosis. Therefore, we aimed to evaluate whether there was any association between the electrocardiographic P wave peak time (PWPT) and invasively measured left ventricular end-diastolic pressure (LVEDP) in hypertensive patients who had undergone coronary angiography following preliminary diagnosis of coronary artery disease. A total of 78 patients were included in this cross-sectional study. The PWPT was defined as the time from the beginning of the P wave to its peak, and it was calculated from the leads DII and VI . In all patients, LVEDP was measured in steady state. The PWPT in lead DII was significantly longer in patients with high LVEDP; however, there was no significant difference between groups in terms of PWPT in the lead VI . In multivariable analysis, PWPT in lead DII was found to be independent predictor of increased LVEDP (OR: 1.257, 95% CI: 1.094-1.445; P = 0.001). In receiver operating characteristic curve analysis, the optimal cut-off value of PWPT in the lead DII for prediction of elevated LVEDP was 64.8 ms, with a sensitivity of 68.7% and a specificity of 91.3% (area under curve: 0.882, 95% CI: 0.789-0.944, P < 0.001). In conclusion, this study result suggested that prolonged PWPT in the lead DII may be an independent predictor of increased LVEDP among hypertensive patients. [ABSTRACT FROM AUTHOR]

Abstract: Background: The ratio of serum C‐reactive protein (CRP) to albumin has been proven to be a more accurate indicator than albumin and CRP levels alone in determining the prognosis of patients with cancer and critical illness. The aim of this study was to determine whether the CRP/albumin ratio (CAR) can be linked to imperfect reperfusion that can worsen the prognosis of ST‐elevation myocardial infarction (STEMI) in patients treated with primary percutaneous coronary intervention (pPCI). Materials and methods: A total of 1217 consecutive STEMI patients who achieved epicardial vessel patency with pPCI were recruited to this study. Results: The study population was divided into 2 groups: reflow (n = 874) and no‐reflow (NR) (n = 343) groups. The white blood cell count (WBC), neutrophil‐to‐lymphocyte ratio (NLR) and CAR (0.03 [0.01‐0.04] vs 0.06 [0.03‐0.12] (P < .001) were significantly higher in the NR group than in the reflow group, and these factors were found to be independent predictors of NR development. The best cut‐off value of CAR predicting NR was 0.59 with a sensitivity of 54.7% and specificity of 86.7. The predictive power of CAR surpassed that of CRP, albumin, WBC count and NLR in the receiver operator curve (ROC) curve comparison. Conclusion: No‐reflow can be predicted by systemic inflammation markers including WBC count, NLR and CAR measured from the blood sample obtained on admission. CAR has a higher clinical value than CRP, albumin level, WBC count and NLR in NR prediction. [ABSTRACT FROM AUTHOR]

Entrainment is an important tool for the diagnosis and location of reentry. The usefulness of this maneuver requires that, prior to cessation of ventricular pacing, the atrial rate accelerates to the ventricular pacing rate. Moreover, it is important to verify the continuation of the tachycardia following cessation of entrainment. The recognizing the last entrained atrial beat is utmost important to avoid erroneous A–A–V labeling. [ABSTRACT FROM AUTHOR]