Clinical Cardiology Alert – September 1, 2023

Rates of Ad Hoc PCI Remain Higher for Multivessel and Left Main Disease

In this retrospective analysis of patients from the New York state percutaneous coronary intervention (PCI) and coronary artery bypass grafting databases, ad hoc PCI was performed frequently among patients with left main and multivessel disease. Also, variability in ad hoc PCI use among hospitals and physicians for these populations was high.

Detecting Left Ventricular Thrombi

A study of early post-ST-elevation myocardial infarction patients who underwent echocardiographic testing and cardiac MRI showed echo misses about two-thirds of cardiac MRI-discovered left ventricular thrombi. However, an echo apical wall motion score can identify most patients in whom echo may miss thrombi for the selective use of cardiac MRI.

Clinical Outcomes of Left Bundle Branch Area Pacing vs. Biventricular Pacing

Researchers compared biventricular pacing to left bundle branch area pacing (LBBAP) for cardiac resynchronization among patients living with heart failure caused by reduced left ventricular ejection fraction, along with either LBB block or need for ventricular pacing. The combined endpoint of all-cause mortality rates or heart failure hospitalizations was significantly lower with LBBAP.

Researchers Report on the Efficacy of the Subcutaneous Implantable Cardioverter-Defibrillator

An FDA-mandated post-approval study of the subcutaneous cardioverter-defibrillator system in a real-world population revealed excellent safety and efficacy over five years.

This Leadless Dual-Chamber Pacing System Is Coming

The initial 90-day experience with a dual-chamber leadless pacemaker system showed reliable atrial pacing and atrioventricular synchrony, with complication rates similar to conventional lead-based systems.