Cost analysis of telemedicine monitoring of patients with implantable cardioverter-defibrillators in the Czech Republic

Alan Bulava, Ondřej Ošmera, Michal Šnorek, Adam Novotný, Ladislav Dušek

Cor Vasa 2016, 58(3):e293-e302 | DOI: 10.1016/j.crvasa.2015.08.006  

Introduction: Telemonitoring of patients with implantable cardioverters-defibrillators (ICD) is, in general, considered safer, more efficious and increasingly cost-effective. The aim of our work was to assess the long--term economic benefit associated with telemetric monitoring of patients with newly implanted ICD using the Home Monitoring™ (HM) system compared to standard outpatient care in the Czech Republic.Methods: Patients were randomized to telemetric monitoring using the HM system with daily automated data transfer and outpatient follow-up at 12-month intervals (HM+) or standard outpatient follow-up (HM-). Average total costs per patient...

Diagnostic value of electrocardiographic (resting and 24-h Holter) monitoring in comparison with NT-proBNP in the differential diagnosis of patients with cardiogenic and neurogenic syncope

Piotr J. Stryjewski, Agnieszka Kuczaj, Ryszard Braczkowski, Jadwiga Nessler, Ewa Nowalany-Kozielska

Cor Vasa 2016, 58(3):e303-e309 | DOI: 10.1016/j.crvasa.2015.09.001  

Background: Syncope is a cause of 1-6% of hospitalizations. Both European and American syncope guidelines recommend a 12-lead ECG as part of the evaluation of all patients with unexplained loss of consciousness.Objectives: The aim of this study was the assessment of the significance of ECG, Holter ECG and the concentration of NT-proBNP that would be useful in the differentiation of patients with cardiac and reflex syncope.Methods: We investigated 100 patients (56 men), aged 18-77 years with reflex or cardiac syncope over the last 3 years. The following factors were investigated: age, sex, systolic and diastolic blood pressure, the presence...

(Can normal findings in non-invasive examinations (duplex carotid sonography and ankle brachial pressure index) predict a normal result of coronarography?

Lucia Kocůrková, Jan Mrózek, Radim Kryza

Cor Vasa 2016, 58(3):e310-e316 | DOI: 10.1016/j.crvasa.2015.09.003  

Introduction: Ankle-brachial pressure index (ABI) and duplex carotid sonography (DCS) are simple non-invasive investigations that can be used for detection of atherosclerosis and, consequently, for prediction of risk of cardiovascular diseases in patients. Numerous studies proved a positive correlation between pathological findings in ABI or DCS and the presence of ischemic heart disease (IHD). We are however not aware of any study dealing with a question whether and how reliably physiological findings in DCS and/or ABI can predict a physiological coronarography result.Methods: 219 patients admitted to our cardiology department for elective coronarography...

Operations of adults with congenital heart disease - Single center experience with 10-year results

Jana Rubáčková Popelová, Roman Gebauer, Štěpán Černý, Petr Pavel, Ferdinand Timko, Pavel Jehlička, Petr Plášil, Jakub Tomek, Markéta Tomková, Ivo Skalský

Cor Vasa 2016, 58(3):e317-e327 | DOI: 10.1016/j.crvasa.2015.12.005  

During the last 10 years, 844 operations of 805 adults with congenital heart disease (CHD) were performed in Hospital Na Homolce in Prague, Czech Republic. The median age was 37 (interquartile range 25-49, full range 16-81) years. Operations of complex and rare CHD represented 47%. Fourty-four percent of patients (354) underwent previous cardiac surgery in childhood or adulthood. Three and more operations were performed in 14% (113 patients). Combined surgical procedures were performed in 70% of operations.Thirty-day mortality was 1.36%, hospital mortality 1.7% and 5-year survival probability 97%. The risk factors for early and late mortality were...

Current treatment of left main coronary artery disease

Lucian M. Predescu, Lucian Zarma, Pavel Platon, Marin Postu, Adrian Bucsa, Marian Croitoru, Dan E. Deleanu, Carmen Ginghina

Cor Vasa 2016, 58(3):e328-e339 | DOI: 10.1016/j.crvasa.2015.05.007  

The patients with severe left main stem (LMS) stenosis have a very high risk of major cardiovascular events because of the extent of ischaemic myocardium. At 3rd year, the mortality rate for patients with significant LMS stenosis treated medically is 50%. Coronary artery bypass grafting (CABG) is considered the gold standard for the treatment of complex LMS stenosis, especially if it is associated with multivessel coronary disease. Many studies have showed that percutaneous coronary interventions (PCI) can be a safe and efficient alternative to CABG in carefully selected patients by the Heart Team, with similar mortality rates. The LMS PCI results...

Echocardiography and cardiac resynchronization therapy

Josef Marek, Jana Gandalovičová, Eva Kejřová, Miroslav Pšenička, Aleš Linhart, Tomáš Paleček

Cor Vasa 2016, 58(3):e340-e351 | DOI: 10.1016/j.crvasa.2015.08.001  

Cardiac resynchronization therapy (CRT) is an effective therapeutic option in patients with congestive heart failure, left ventricular ejection fraction ≤ 35%, and a widened QRS complex. However, a significant proportion of individuals do not respond to CRT favorably. Understandably, a large number of studies have addressed various techniques to improve patient selection for CRT and to improve responder rate in patients with CRT devices. A large proportion of these approaches utilize echocardiography.Techniques for improved patient selection include various metrics of dyssynchrony associated with response to CRT and long-term outcome. Partly...

Undiagnosed tandem stenosis of the internal carotid artery - A case report

Hana Pluháčková, Robert Staffa, Tomáš Novotný, Zdeněk Kříž, Jan Buček

Cor Vasa 2016, 58(3):e361-e364 | DOI: 10.1016/j.crvasa.2015.06.001  

We report a case of a 77-year-old patient with a tandem carotid stenosis diagnosed intraoperatively. Even though standard computed tomography angiography was performed before surgery, second stenosis distal to carotid bifurcation had not been detected. No recommendations or guidelines for managing tandem stenosis are available. It remains an unsolved issue in vascular surgery.

Multimodality imaging of right ventricular outflow tract obstruction in hypertrophic cardiomyopathy

Giulio Prati, Daisy Pavoni, Gaetano Nucifora

Cor Vasa 2016, 58(3):e365-e366 | DOI: 10.1016/j.crvasa.2015.05.003  

Right ventricular outflow obstruction is a rare finding in hypertrophic cardiomyopathy; it is usually due to hypertrophy of the right ventricle, which is considered caused by the same cardiac sarcomere mutations leading to the phenotypical expression of left ventricular hypertrophy. In the case described in the present report, the presence of a sub-pulmonary membrane likely concurred to right ventricular hypertrophy. The complementary use of transthoracic echocardiography, magnetic resonance imaging and computed tomography allowed to precisely evaluate the anatomical, functional and structural characteristics of both the left and right ventricle.

Antithrombotic management in patients undergoing electrophysiological procedures: A European Heart Rhythm Association (EHRA) position document. Summary of the document prepared by the Czech Society of Cardiology

Miloš Táborský, Martin Fiala, Miroslav Novák

Cor Vasa 2016, 58(3):e352-e360 | DOI: 10.1016/j.crvasa.2016.02.013  

Jaká bude budoucnost specializačního vzdělávání kardiologů v České republice?

prof. MUDr. Petr Widimský, DrSc., FESC, FACC, prof. MUDr. Miloš Táborský, CSc., FESC, FACC, MBA, prof. MUDr. Aleš Linhart, DrSc.

Cor Vasa 2016, 58(3):397-398  

Zápis ze schůze výboru ČKS konané 25. listopadu 2015 v salonku hotelu Diplomat v Praze

L. Klímová, M. Táborský, T. Bracková

Cor Vasa 2016, 58(3):401-403  

Jan Mach: Medicínské právo - co a jak. Praktické rady pro lékaře a zdravotníky

Prof. MUDr. Jan Petrášek, DrSc.

Cor Vasa 2016, 58(3):399  

Vzpomínka na profesora MUDr. Františka Kölbela, DrSc.

prof. MUDr. Jaromír Hradec, CSc., prof. MUDr. Michael Aschermann, DrSc.

Cor Vasa 2016, 58(3):396  

Editorial Board

Editorial board

Cor Vasa 2016, 58(3):i | DOI: 10.1016/S0010-8650(16)30053-4