Apple Watch-assisted supraventricular tachycardia detection and qualification for electrophysiological study

Zaburzenia rytmu są częstą przyczyną odczuwanych kołatań serca. Najczęściej objawy występują jedynie okresowo, dlatego też postawienie prawidłowego rozpoznania niejednokrotnie może stanowić wyzwanie. Na rynku dostępnych jest obecnie szereg zakładanych na nadgarstek urządzeń monitorujących czynność rytmu serca. W przedstawionym przypadku, nowoczesna technologia — AppleWatch®, wykryła epizod AVNRT. Przyczyniło się to do szybszej kwalifikacji pacjentki do badania elektrofizjologicznego i wcześniejszego wykonania skutecznej ablacji. Dzięki temu nie dopuszczono do dalszego pogarszania się jakości życia pacjentki oraz rozwoju potencjalnych poważnych powikłań, w tym kardiomioptaii tachyarytmicznej. W przedstawionym przypadku zilustrowano przydatność kliniczną aplikacji mobilnych wykonujących badanie EKG w monitorowaniu rytmu serca pacjentów w codziennej praktyce. Możliwość wykorzystania AppleWatcha® w innych typach zaburzeń rytmu serca wymaga dalszych badań. Poszerzenie obecnych wytycznych, dotyczących wykorzystania nowoczesnych technologii w zaburzeniach rytmu serca, pozostaje tematem dalszych dyskusji.Cardiac arrhythmias are a common cause of heart palpitations. As symptoms usually occur only temporarily, diagnosis is often challenging. The current market offers a variety of wearable heart rhythm monitors. In the presented case, a novel technology, the AppleWatch®, detected an episode of AVNRT. It contributed to faster qualification for electrophysiological study and subsequent successful ablation. As a result, a further decrease in patients’ quality of life was halted. The development of potentially severe complications, including tachycardia-mediated cardiomyopathy, was prevented. This case exemplifies the clinical utility of ECG-based mobile applications in monitoring patients’ heart rhythms in everyday clinical practice. The feasibility of AppleWatch® in other types of arrhythmias remains underinvestigated. Broadening current guidelines for the use of digital health solutions in cardiac rhythm abnormalities should be further discussed

Expression of miR-223 to predict outcomes after transcatheter aortic valve implantation

Background: Transcatheter aortic valve implantation (TAVI) is an established treatment for aortic stenosis (AS) in patients at increased surgical risk. Up to 29% of patients annually experience major adverse cardiac and cerebrovascular events (MACCE) after TAVI. MicroRNAs (miRNA) are currently widely investigated as novel cardiovascular biomarkers. The aim of this study was to determine the influence of TAVI on the expressions of selected miRNAs associated with platelet function (miR-125a-5p, miR-125b and miR-223), and evaluate the predictive value of these miRNAs for MACCE in 65 patients undergoing TAVI. Methods: Venous blood samples for miRNA expression analysis were collected 1 day before TAVI and at hospital discharge. The expression of miR-223, miR-125a-5p, miR-125b was evaluated in platelet-depleted plasma. Results: The expression of miR-223 and miR-125b increased after TAVI, compared to the measurement before (p = 0.020, p = 0.003, respectively). Among 63 patients discharged from the hospital, 18 patients experienced MACCE (29%) during the median 15 months of observation. Baseline low miR-223 expression was a predictor of MACCE in univariate Cox regression analysis (hazard ratio [HR]: 2.71, 95% confidence interval [CI]: 1.04–7.01; p = 0.041). After inclusion of covariates, age, gender (male), New York Heart Association class and diabetes into the multivariate Cox regression model, miR-223 did not reach statistical significance (HR: 2.56, 95% CI: 0.79–8.33; p = 0.118). Conclusions: To conclude, miR-223 might improve risk stratification after TAVI. Further studies are required to confirm the clinical applicability of this promising biomarker

Systematic review and meta-analysis of serum amyloid a prognostic value in patients with COVID-19

INTRODUCTION: This study was designed to assess the levels of human serum amyloid A (SAA) among COVID-19 patients.MATERIAL AND METHODS: A systematic review and meta-analysis were conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. A comprehensive literature search was performed (PubMed, Web of Science, Scopus, and Cochrane network), and studies comparing SSA levels in: (A) with non-severe vs severe COVID-19; (B) severe vs critical COVID-19 condition; (C) survived vs died due to COVID-19 in-hospital treatment period — were included. Random-effects meta-analyses were performed to obtain pooled estimates.RESULTS: Thirty studies met the criteria and were included in the meta-analysis. Pooled analysis showed that SAA levels were statistically significantly lover in non-severe group 58.7 ± 53.9 mg/L compared to 154.5 ± 169.6 mg/L for patients with severe condition (MD = –120.29; 95% CI: –135.35 to –105.22; p < 0.001). SAA levels among patients with critical condition were 89.5 ± 90.4 mg/L compared to 195.3 ± 206.2 mg/L (MD = –56.66; 95% CI: –101.81 to –11.51; p = 0.01). SAA levels in patient who survived were 108.7 ± 157.3 mg/L, and 206.8 ± 58.8 mg/L for patients who not survived (MD = –85.04; 95% CI: –145.78 to –24.29; p = 0.006).CONCLUSIONS: In conclusion, this updated meta-analysis suggests that SAA concentrations are positively correlated with the severity of the COVID-19. Therefore, SAA can be considered a biomarker for predicting the severity and prognosis of COVID-19. Measurement of this parameter might assist clinicians in monitoring and evaluating the severity and prognosis of COVID-19