Coateshoff0747

823). Radiation duration was similar between the two groups (p = 0.217). There were 49 (10%) patients with complications after catheter ablation. There were no differences between complication rates and TSP type (p = 0.555). Similarly, recurrence rates were comparable between both TSP groups (p = 0.788). CONCLUSION There was no clear benefit of single or double TSP in AF ablation.BACKGROUND The impact of left ventricular reverse remodeling (LVRR) on the prognosis of Chagas cardiomyopathy is unknown. The aim of this study was to determine whether the presence of LVRR can predict mortality in these patients. METHODS From January 2000 to December 2010, the medical charts of 159 patients were reviewed. LVRR was defined as an increase of left ventricular ejection fraction (LVEF) and a decrease of left ventricular end-diastolic diameter (LVDD) by two-dimensional echocardiography. No patient underwent cardiac resynchronization therapy or required mechanical ventricular assistance. RESULTS At baseline, median (25th-75th) LVDD was 64 mm (59-70), and median LVEF was 33.2% (26.4-40.1). LVRR was detected in 24.5% of patients in a 40-month (26-64) median follow-up. In the LVRR group, LVDD decreased from 64mm (59-68) to 60 mm (56-65; p 0.05 for all comparisons). The Cox proportional hazard model analysis identified only cardiogenic shock (hazard ratio [HR] 2.41; 95% confidence interval [CI] 1.51-3.85; p less then 0.001) and serum sodium level (hazard ratio, 0.91; 95% CI 0.86-0.96; p less then 0.001) as independent predictors of all-cause mortality. CONCLUSIONS Left ventricular reverse remodeling occurs in one quarter of patients with Chagas cardiomyopathy and have no impact on the outcome of patients with this condition.BACKGROUND Regional citrate anticoagulation (RCA) is the recommended standard for continuous renal replacement therapy (CRRT). This study assesses its efficacy in patients admitted to critical care following cardiovascular surgery and the influence of standard antithrombotic agents routinely used in this specific group. METHODS Consecutive cardiovascular surgery patients treated with post-dilution hemofiltration with RCA were included in this prospective observational study. The primary outcome of the study was CRRT circuit life-span adjusted for reasons other than clotting. The secondary outcome evaluated the influence of standard antithrombotic agents (acetylsalicylic acid [ASA], low molecular weight heparin [LMWH] or fondaparinux as thromboprophylaxis or treatment dose with or without ASA) on filter life. RESULTS Fifty-two patients underwent 193 sessions of CVVH, after exclusion of 15 sessions where unfractionated heparin was administered. The median filter life span was 58 hours. Filter life span was significantly longer in patients receiving therapeutic dose of LMWH or fondaparinux (79 h [2-110]), in comparison to patients treated with prophylactic dose of LMWH or fondaparinux (51 h [7-117], p less then 0.001), and patients without antithrombotic prophylaxis (42 h [2-91], p less then 0.0001). 12 bleeding episodes were observed; 8 occurred in patients receiving treatment dose anticoagulation, 3 in patients receiving prophylactic dose anticoagulation and 1 in a patient with no antithrombotic prophylaxis. CONCLUSIONS A post dilution hemofiltration with RCA provides prolonged filter life span when adjusted for reasons other than clotting. Patients receiving treatment dose anticoagulation had a significantly longer filter life span than those who were on prophylactic doses or ASA alone.BACKGROUND Numerous worldwide clinical trials have proven the indisputably negative influence of morphine on the pharmacokinetics and pharmacodynamics of P2Y₁₂ receptor inhibitors in patients presenting with acute coronary syndromes. The aim of this trial was to evaluate whether oral co-administration of an anti-opioid agent, naloxone, can be considered a successful approach to overcome 'the morphine effect'. METHODS Consecutive unstable angina patients receiving ticagrelor and morphine with or without orally administered naloxone underwent assessment of platelet reactivity using Multiplate analyzer as well as evaluation of the pharmacokinetic profile of ticagrelor and its active metabolite, AR-C124910XX, at nine pre-defined time points within the first 6 hours following oral intake of the ticagrelor loading dose. RESULTS The trial shows no significant differences regarding the pharmacokinetics of ticagrelor between both study arms throughout the study period. AR-C124910XX plasma concentration was significantly higher 120 min after the ticagrelor loading dose administration (p = 0.0417). However, the evaluation of pharmacodynamics did not show any statistically significant differences between the study arms. CONCLUSIONS To conclude, this trial shows that naloxone co-administration in ticagrelor-treated acute coronary syndrome patients on concomitant treatment with morphine shows no definite superiority in terms of ticagrelor pharmacokinetic and pharmacodynamic profile.BACKGROUND We aim to study the association between QRS duration and mortality in our Asian heart failure cohort with HFpEF and HFrEF. METHODS Consecutive patients admitted with heart failure from Jan 2008 to Dec 2009 were included. Preserved ejection fraction (EF) was defined as EF ≥50% and reduced EF as EF less then 50%. All patients were followed-up for 5-7 years. Outcomes studied were overall mortality and cardiovascular mortality. RESULTS A total of 666 HFpEF and 1032 HFrEF were included. In patients with HFpEF, the 5-year overall and cardiovascular mortality was 57% (n=381) and 28% (n=189) respectively. QRS duration was a significant predictor of cardiovascular (adjusted HR 1.010 (95% CI1.002-1.018), p=0.011) but not overall mortality (p=0.190). In patients with HFrEF, the 5-year overall and cardiovascular mortality was 65% (n=673) and 43.0% (n=444). QRS duration was a significant predictor of both overall (adjusted HR 1.005 (95% CI1.001-1.008), p=0.004) and cardiovascular mortality (adjusted HR 1.006 (95% CI1.002-1.010), p=0.003). A cut-off of 100ms was found to provide the optimal discriminatory AUC in both cohorts. click here CONCLUSIONS In our Asian heart failure cohort, QRS duration is a significant predictor of cardiovascular mortality in both HFpEF and HFrEF patients. QRS duration also significantly predicted overall mortality in HFrEF patients.