Cystic Tumor of the Atrioventricular Node Causing Rapid-Onset and Reversible Complete Heart Block.

Cystic tumors of the atrioventricular node are rare primary cardiac neoplasms, frequently reported as a postmortem diagnosis during autopsy. Despite their small size, they can present with complete heart block or sudden cardiac death. Herein, we present a case of rapidly progressing high-grade atrioventricular block that improved after surgery.

Referral Patterns for Primary Prophylaxis Implantable Cardioverter Defibrillator Therapy for an Urban US Population.

Implantable cardioverter defibrillators (ICDs) have been demonstrated to improve survival for both primary and secondary prevention of sudden cardiac arrest. However, studies suggest that ICD therapy is underused in appropriate candidates. Sex and racial disparities in ICD use have been suggested.

Outcomes in patients with various forms of aortic stenosis including those with low-flow low-gradient normal and low ejection fraction.

Low-flow low-gradient aortic stenosis with normal ejection fraction (LFLGNEF AS) is a newly characterized poorly understood entity within the AS spectrum. Whether LFLGNEF AS has a worse prognosis than typical AS remains controversial. We retrospectively identified 4,546 individual patients with any type of AS on echocardiogram from 2003 through 2013 and categorized them into 5 cohorts: (1) mild AS, (2) moderate AS, (3) severe AS, (4) LFLGNEF AS (ejection fraction≥55%), and (5) low-flow low-gradient low ejection fraction AS (LFLGLEF AS; ejection fraction<55%).

Limited yield of hospitalization for the evaluation of syncope in patients presenting to an urban tertiary medical center.

Syncope is a frequent presenting complaint in the emergency department and is associated with significant medical costs. We examined the utility of inpatient evaluation of syncope for patients in whom a diagnosis was not established in the emergency department. We retrospectively reviewed consecutive patients presenting with syncope to an urban tertiary care medical center.

Comparison of radiation dose and image quality of triple-rule-out computed tomography angiography between conventional helical scanning and a strategy incorporating sequential scanning.

Triple-rule-out computed tomographic angiography (TRO CTA), performed to evaluate the coronary arteries, pulmonary arteries, and thoracic aorta, has been associated with high radiation exposure. The use of sequential scanning for coronary computed tomographic angiography reduces the radiation dose. The application of sequential scanning to TRO CTA is much less well defined.

Comparison of image quality and radiation dose of coronary computed tomographic angiography between conventional helical scanning and a strategy incorporating sequential scanning.

Radiation dose from coronary computed tomographic angiography may be decreased using a sequential scanning protocol rather than a conventional helical scanning protocol. We compared radiation dose and image quality from coronary computed tomographic angiography in a single center between an initial period during which helical scanning with electrocardiographically controlled tube current modulation was used for all patients (n = 138) and after adoption of a strategy incorporating sequential scanning whenever appropriate (n = 261). Using the sequential-if-appropriate strategy, sequential scanning was employed in 86.

Medicaid patients at high risk for frequent hospital admission: real-time identification and remediable risks.

Patients with frequent hospitalizations generate a disproportionate share of hospital visits and costs. Accurate determination of patients who might benefit from interventions is challenging: most patients with frequent admissions in 1 year would not continue to have them in the next. Our objective was to employ a validated regression algorithm to case-find Medicaid patients at high-risk for hospitalization in the next 12 months and identify intervention-amenable characteristics to reduce hospitalization risk.

Social Support and Depression After Cardiac Surgery in Elderly Patients.

Two methods of measuring social support components were compared for their ability to predict depression 6 months after cardiac surgery in older patients (N = 155). Multiple regression models were used to compare summary support measures with subtype measures. A personality inventory was also included to rule out the possibility that significant findings about relationships of depression and social support were due primarily to personality dimensions.