How Often is Multifocal Atrial Tachycardia Mistaken for Atrial Fibrillation in the Emergency Department?

Objective: Multifocal atrial tachycardia (MAT), characterized by an irregularly irregular rhythm, is often regarded as a clinical imitator of atrial fibrillation (AF). We aimed to evaluate the prevalence of MAT misclassification as AF in the emergency department (ED) setting.

Methods: A retrospective analysis of 1,828 ECGs from patients discharged with AF diagnoses over five years.

ChatGPT: the essential patient's companion for transesophageal echocardiogram education.

Purpose: Transesophageal echocardiography (TOE) necessitates meticulous patient preparation. Artificial intelligence (AI) chatbots, such as ChatGPT, hold promise in delivering medical information. This study sought to assess the suitability of the latest iteration, ChatGPT-4 Omni (GPT-4o), as a supplemental resource for providing information on topics related to TOE.

Three-Cusp View Orientation in TAVI: Evaluating LOA Versus Non-LOA Impact on Outcomes With Contemporary Valve Prostheses.

Background: Optimal projection views during transcatheter aortic valve implantation (TAVI) procedures are critical for procedural success and patient outcomes.

Aims: This study investigated the influence of 3-cusp view orientation-line of alignment (LOA) versus non-LOA-on procedural outcomes in patients undergoing TAVI with contemporary transcatheter heart valves.

Methods: This retrospective analysis included 421 consecutive patients with severe symptomatic aortic stenosis who underwent transfemoral TAVI at a single center between March 2019 and December 2023.

Preoperative Thyroid Assessment in Pacemaker Recipients: Are We Falling Short?

Hypothyroidism is a reversible cause of bradyarrhythmias, including atrioventricular blocks and sinus node dysfunction. Guidelines recommend thyroid function assessment before pacemaker implantation. This study aims to evaluate the extent of preoperative assessment of thyroid dysfunction in pacemaker recipients.

Assessment of remote digital auscultation for identifying significant aortic stenosis: A pilot study.

Background: Aortic stenosis (AS) is the most common valvular disease in the Western world. Technological advances, such as the TytoCare™ device, have introduced remote telemedicine-based cardiac auscultation. Its utility in diagnosing and grading AS remains unexplored.

Recognizing atrial flutter in the emergency department: Challenges in diagnosis.

Introduction: Aside from anticoagulation, atrial fibrillation (AF) and atrial flutter (AFL) require distinct management. Yet, misclassification between the two is not uncommon, potentially resulting in suboptimal care. Computerized interpretation of the ECG (CIE) may mislead clinicians.

Decoding the Rhythm: The Additive Value of Left Atrial Appendage Flow in the Diagnosis of Atrial Tachyarrhythmias.

Background: The diagnosis of atrial tachyarrhythmias might be challenging at times. Assessing Doppler flow patterns of the left atrial appendage (LAA) using echocardiography, mainly transesophageal echocardiography, represents a valuable tool for establishing the diagnosis of atrial tachyarrhythmias, especially when the diagnosis remains unclear.

Result: Despite its effectiveness and simplicity, this technique is often underused in routine clinical practice.

The Prognostic Value of the Triglyceride-Glucose and Fibrosis-4 Indices in Patients Undergoing Coronary Angiography: A Retrospective Cohort Analysis.

Background: The triglyceride-glucose (TYG) index, which reflects insulin resistance, and the fibrosis-4 (FIB-4) index, a measure of liver fibrosis, are noninvasive laboratory-based indicators associated with cardiometabolic risk.

Methods: We performed a retrospective analysis of 12,165 patients who underwent coronary angiography, to investigate the association of the TYG and FIB-4 indices with the occurrence of myocardial infarction, stroke, or all-cause death (major cardiovascular events [MACE]), using multivariate Cox proportional hazards models.

Results: The mean age of the study population was 65 ± 10 years; 63% presented with acute coronary syndrome.

Can ChatGPT accurately detect atrial fibrillation using smartwatch ECG?

Background: Current guidelines require physician confirmation for smartwatch-diagnosed atrial fibrillation (AF), increasing telemedicine workloads. The newest ChatGPT-4o (GPT-4o) incorporates advanced image input capabilities.

Objective: To assess GPT-4o's performance in identifying AF from smartwatch recordings.

Emotional Stress Triggered Severe Mitral Regurgitation: The Multifactorial Interplay of the Mitral Valve.

• MR is a dynamic condition affected by multiple hemodynamic factors. • MV assessment should be performed under optimal psychological factors. • Routine preassessment of BP should be considered when evaluating for MV disease.

Extreme hypercalcemia secondary to parathyroid adenoma obscured by excessive coffee consumption and premature ventricular complexes.

Severe hypercalcemia has an arrhythmogenic effect. We present a case of a young male falsely diagnosed with premature ventricular complexes attributed to heavy coffee consumption, while symptoms and electrocardiographic findings of hypercalcemia were disregarded. Delayed work-up identified extreme hypercalcemia, and subsequently, parathyroid adenoma was diagnosed.

Accelerated structural valve deterioration in systemic sclerosis patients following transcatheter aortic valve replacement: a case series.

Background: Systemic sclerosis (SSc) is marked by an excessive systemic accumulation of collagen. Recent literature implies that aortic stenosis is more prevalent in patients with SSc than previously thought. While there are limited feasibility studies on transcatheter aortic valve replacement (TAVR) in this population, the long-term outcomes remain uncertain.

Glycemic control after aortic valve replacement: A retrospective study.

Background: Aortic stenosis (AS) is treated through transcatheter aortic valve implantation (TAVI) or surgical aortic valve replacement (SAVR), with diabetes being prevalent among these patients. Inflammation participates in the pathogenesis of AS, and emerging evidence suggests that TAVI may exert anti-inflammatory effects. Given the established link between diabetes and inflammation, we sought to evaluate the impact of aortic valve replacement (AVR) on glycemic control.

Diagnostic Blind Spot: Physicians Overlook Atrial Fibrillation in Pacemaker-Dependent Patients.

Background: Pacemaker recipients demonstrate a higher prevalence of atrial fibrillation (AF), yet the regular ventricular activation in pacemaker-dependent patients with AF presents a substantial diagnostic challenge.

Methods: A total of 310 medical practitioners completed a brief, validated survey consisting of three electrocardiograms displaying AF with ventricular pacing. Participants were instructed to identify the underlying rhythm.

In the face of confounders: Atrial fibrillation detection - Practitioners vs. ChatGPT.

Introduction: Atrial fibrillation (AF) is the most common arrhythmia in clinical practice, yet interpretation concerns among healthcare providers persist. Confounding factors contribute to false-positive and false-negative AF diagnoses, leading to potential omissions. Artificial intelligence advancements show promise in electrocardiogram (ECG) interpretation.

Polymorphic Ventricular Tachycardia Detected by a Smartwatch in a Patient With Recurrent Syncope.

The diagnosis of vasospastic angina remains challenging. It may present with syncope and life-threatening arrhythmia. Patients with syncope usually require automatic modes of recording.

The alternative vagal maneuver; converting atrioventricular nodal re-entrant tachycardia by a rectal thermometer.

Vagal maneuvers are techniques used to increase parasympathetic tone, particularly useful in the management of hemodynamically stable supraventricular tachycardias. If ineffective, adenosine can be attempted. We present a patient with atrioventricular nodal re-entrant tachycardia (AVNRT), who could not effectively perform Valsalva maneuvers and had contraindications for carotid massage and adenosine administration, that converted into sinus rhythm by using a rectal thermometer.

A Patient With Single Coronary Artery and Pectus Excavatum Presenting With Non-ST Elevation Myocardial Infarction.

We report the case of a 51-year-old male with pectus excavatum (PEX) who presented with stress-related chest pain as a symptom of acute non-ST elevation myocardial infarction. Coronary angiography (CAG) revealed a suspected single coronary artery (SCA) anatomy with diffuse atherosclerotic narrowing, without evidence of other coronary ostia in the aortic root. The diagnosis was confirmed on cardiac computed tomography (CCTA) as the SCA of the R-I type by Lipton classification.