RESUMEN
Spontaneous conduction during the supernormal period (SNP) of accessory pathways (AP) is rare and observed only during atrio-ventricular block (AVB). The effect of exercise and different escape rhythms on the SNP is unknown. We evaluated these factors on the SNP of a para-Hisian AP after a failed ablation complicated by AVB. The SNP onset and duration were later and longer during paced versus junctional rhythm. Exercise caused linear shortening of the SNP that was directly related to junctional cycle length. The SNP is a dynamic window shifting in parallel with AP refractoriness and affected by exercise and type of escape rhythm.
Asunto(s)
Ejercicio Físico , Sistema de Conducción Cardíaco/fisiopatología , Síndrome de Wolff-Parkinson-White/fisiopatología , Adulto , Ablación por Catéter , Prueba de Esfuerzo , Frecuencia Cardíaca , Humanos , Masculino , Marcapaso Artificial , Periodo Refractario Electrofisiológico , Síndrome de Wolff-Parkinson-White/terapiaRESUMEN
We evaluated the treatment pattern of patients with chronic kidney disease presenting with acute coronary syndromes. In a retrospective chart review of 400 patients with and without kidney disease presenting with angina pectoris we found that patients with chronic kidney disease have longer hospital stays, receive fewer diagnostic angiographies, and have a delay in therapy.
Asunto(s)
Angina de Pecho/complicaciones , Fallo Renal Crónico/terapia , Enfermedad Aguda , Anciano , Angina de Pecho/diagnóstico , Femenino , Hawaii , Humanos , Fallo Renal Crónico/complicaciones , Fallo Renal Crónico/diagnóstico , Masculino , Auditoría Médica , Persona de Mediana EdadRESUMEN
We assessed the influence of CKD on bleeding in 200 patients with ACS via retrospective chart analysis. Using K/DOQI guidelines to stratify patients based on GFR, no differences in documented bleeding or antithrombotic utilization were observed among the groups. Due to increased mortality risk of patients with CKD from cardiovascular disease, assessing benefit-to-risk ratios of various medical interventions is crucial.
Asunto(s)
Enfermedad Coronaria/tratamiento farmacológico , Fibrinolíticos/uso terapéutico , Hemorragia/etiología , Fallo Renal Crónico/complicaciones , Enfermedad Aguda , Enfermedad Coronaria/complicaciones , Femenino , Fibrinolíticos/efectos adversos , Hawaii , Humanos , Fallo Renal Crónico/clasificación , Fallo Renal Crónico/fisiopatología , Masculino , Auditoría Médica , Medición de Riesgo , Índice de Severidad de la EnfermedadRESUMEN
We examined treatment patterns of female pts with CKD admitted for ACS. In this retrospective review of 200 patients with chronic kidney disease presenting with acute coronary syndrome, we found that females patients were less likely to receive aspirin and ACE-inhibitors and there was a trend towards less frequent use of coronary angiography
Asunto(s)
Angina Inestable/terapia , Fallo Renal Crónico/complicaciones , Infarto del Miocardio/terapia , Servicios de Salud para Mujeres , Enfermedad Aguda , Anciano , Anciano de 80 o más Años , Angina Inestable/complicaciones , Inhibidores de la Enzima Convertidora de Angiotensina/uso terapéutico , Aspirina/uso terapéutico , Angiografía Coronaria/estadística & datos numéricos , Femenino , Accesibilidad a los Servicios de Salud , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio/complicaciones , Estudios Retrospectivos , Factores SexualesRESUMEN
A retrospective review of 200 patients with acute coronary syndrome (ACS) and chronic kidney disease (CKD) was compared to 200 patients without CKD to investigate the incidence of bleeding. Logistic regression analysis identified CKD as an independent risk factor for bleeding (OR 1.82, 95% CI 1.02 - 3.25). CKD patients with ACS appear to have more bleeding complications.