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Context: Axillary vein puncture is an alternative method for pacemaker leads implantation. However, the safety and effectiveness of axillary vein puncture become an issue for debate now. Aims: The aim of this study was to investigate the safety, feasibility, and efficacy of a modified axillary vein technique for pacemaker implantation. Settings and Design: This modified axillary vein technique refers to a novel axillary vein puncture method combined with caudal 35° fluoroscopy and surface anatomic landmarks including deltopectoral groove, coracoid process, and the first rib. Subjects and Methods: This technique was applied to 139 consecutive patients referred for pacemaker implantation between March 1, 2016, and December 31, 2016, at our department. Statistical Analysis Used: None. Results: Success rate of pacemaker implantation was 96.4% (134/139). Five patients (3.60%) were switched to an alternate approach for leads implantation. There were no procedure-related complications such as pneumothorax, hemopneumothorax, major bleeding, and significant pocket hematoma. Conclusion: This modified axillary vein puncture strategy combining caudal 35° fluoroscopy and surface anatomic landmarks is safe and feasible for pacemaker implantation.

Hutchinson–Gilford Progeria syndrome (HGPS) is characterized by accelerated aging leading to death in the teen years, usually due to severe coronary and/or carotid disease. The clinical presentation includes stunted growth, alopecia, loss of subcutaneous fat, osteoporosis, and cardiovascular disorders occurring in late childhood and the teen years including hypertension and accelerated vascular aging that precipitates myocardial infarction and cerebrovascular attacks. The disease is a nuclear laminopathy, due to a Lmna gene mutation. The aberrant protein (Progerin) accumulates in and distorts the nuclear envelope. We review the genetic and biochemical mechanism of HGPS; the clinical presentation with special attention to the cardiovascular pathology and complications; current therapeutic developments to address the disease; and the results of the clinical trials attempting to translate basic research insights into therapeutic benefit. An understanding of HGPS may lead to better treatment of other age-related disorders, particularly cardiovascular diseases.

Aims: This study investigated the application of the domestic Argus Insight-100 optical coherence tomography (OCT) system in porcine arteries and to evaluate the efficiency and safety of Insight-100°CT immediately after implantation and at 4-week follow-up. Subjects and Methods: Eight porcine arteries were implanted with HELIOS drug-eluting stents. Scans were performed with Insight-100 and C7-XR OCT immediately after implantation and at 4-week follow-up, respectively, to obtain lumen images and measured data. Statistical Analysis Used: SPSS v22 software was used for statistical analysis. Results: Both the Insight-100 and C7-XR scans were successfully performed during the implantation and follow-up. Parameters at 4-week postoperatively showed no significant difference between these two groups. No differences were observed in the reference vessel minimal lumen diameters between Insight-100 and C7-XR in the same frame (2.59 ± 0.18 mm vs. 2.60 ± 0.23 mm, respectively, P = 0.91 and 2.83 ± 0.27 mm vs. 2.98 ± 0.27 mm, respectively, P = 0.19). Moreover, the values of mean lumen diameter in the stent segment are comparable between Insight-100 and C7-XR (2.91 ± 0.11 mm vs. 2.97 ± 0.16 mm, P = 0.50). At 4-week follow-up, the mean lumen diameter of Insight-100 was 2.54 ± 0.28 mm, while that of C7-XR was 2.55 ± 0.32 mm, without difference between two groups (P = 0.92). Conclusions: The Argus OCT system appears to be safe during implantation and follow-up. The efficacy and measurement accuracy of Argus OCT is equivalent to that of the C7-XR.

Objective: The objective of the study is to evaluate the acute effects of extreme cold weather and cold waves on the risk of death from ischemic heart disease (IHD) in Jinan city. Methods: Daily meteorological data, air pollution data, and IHD-related death data in Jinan from January 1, 2011, to December 31, 2017, were collected. The extreme cold weather was defined as temperatures below the 10^th percentile (−1.6 C), 5^th percentile (−3.3 C), and 1^st percentile (−6.4 C) of the daily average temperature during the study period, expressed as P10, P5, and P1 respectively. Cold strokes were defined as P10, P5, or P1 temperatures lasting for 3 days or more, and were expressed as Cold stroke I, Cold stroke II, and Cold stroke III, respectively. A time-stratified case-crossover study was used to assess the acute effects of extreme cold weather and cold strokes on IHD-related deaths. Results: During the 1486 days of the 2011–2017 cold months, 50,845 IHD deaths were detected with an average of 34 daily deaths. The relatively cold years were observed in 2011, 2012, 2013 and 2016 during the study, and the coldest was for 2012. The maximum effects of P10, P5, and P1 on IHD deaths occurred on lag6, lag6, and lag2, respectively, and the results were 1.08 (95% confidence interval [CI]: 1.04, 1.12), 1.10 (95% CI: 1.04, 1.15), and 1.20(95% CI:1.09, 1.32), respectively. The maximum effect of Cold stroke I and Cold stroke II on IHD mortality risk was 1.09 (95% CI: 1.04, 1.14) and 1.11 (95% CI: 1.04, 1.19), respectively, at lag6 and lag2. Conclusions: Extremely cold weather and cold strokes in the cold months of 2011–2017 in Jinan City significantly increased the risk of acute death from IHD. It was also found that the occurrence of cold weather and cold strokes after warm years can further increase the risk of acute death from IHD.

Anomalous aortic origin of a coronary artery (AAOCA) from the inappropriate sinus of Valsalva has received increasing attention due to its association with malignant cardiac events in otherwise healthy and asymptomatic individuals. Despite this, we still face tremendous challenges in detecting the anomalies in a timely fashion to prevent sudden cardiac death. Here, we present two cases of anomalous left coronary artery with single ostium (shared with right coronary artery); in patients with normal cardiac function. The diagnosis of AAOCA in both cases was first suspected on transthoracic echocardiography and was later established using either coronary computed tomography angiography or invasive coronary angiography. Although angiography is the gold standard for diagnosing AAOCA, echocardiography is a more frequently used imaging modality in the workup of cardiac patients.

Online since 8^th January 2018