Cardiac rehabilitation after catheter ablation of atrial fibrilation

Atrial fibrillation is the most common arrhythmia worldwide. Besides antiarrhythmic drugs and electrical cardioversion, atrial fibrillation can be treated with a newer technique called catheter ablation. Patients suffering a catheter ablation can benefit from an integrated rehabilitation programme like all other patients suffering a cardiac surgery. Physical training and psycho-educative consultations are specific after catheter ablation and integrated rehabilitation can improve mental health, physical capacity and permits return to sports activities

Major Left Bundle Branch Block and Coronary Heart Disease—Are There Any Differences between the Sexes?

Left bundle branch block is not a benign pathology, and its presence requires the identification of a pathological substrate, such as ischemic heart disease. Left bundle branch block appears to be more commonly associated with normal coronary arteries, especially in women. The objectives of our study were to describe the particularities of left bundle branch block in women compared to men with ischemic heart disease. Result: We included seventy patients with left bundle branch block and ischemic heart disease, with a mean age of 67.01 ± 8.89 years. There were no differences in the profile of risk factors, except for smoking and uric acid. The ventricular depolarization (QRS) duration was longer in men than women (136.86 ± 8.32 vs. 132.57 ± 9.19 msec; p = 0.018) and also men were observed to have larger left ventricular diameters. Left bundle branch block duration was directly associated with ventricular diameters and indirectly associated with left ventricular ejection fraction value, especially in women (R = −0.52, p = 0.0012 vs. R = −0.50, p = 0.002). In angiography, 80% of women had normal epicardial arteries compared with 65.7% of men; all these patients presented with microvascular dysfunction. Conclusion: The differences between the sexes were not so obvious in terms of the presence of risk factors; instead, there were differences in electrocardiographic, echocardiographic, and angiographic aspects. Left bundle branch block appears to be a marker of microvascular angina and systolic dysfunction, especially in women

RISK ASSOCIATED WITH HUMAN EXPOSURE TO TRIHALOMETHANES (THMs) IN THE WATER DISTRIBUTION NETWORK OF CLUJ-NAPOCA

Trihalomethanes (THMs), as disinfection by-products resulted from water chlorination, can get into the body through ingestion of beverages, food or drinking water. This paper discusses the relationship between the use of drinking water from the public distribution network of Cluj-Napoca and exposure to trihalomethanes. To better characterize individual water consumption, at home and at work, we applied a questionnaire to a group of 211 subjects from Cluj-Napoca, while assessing their current exposure to THMs by collecting and analyzing water from different points of the distribution network. The data obtained were statistically processed and then used to calculate the exposure dose and cancer risk for both adults and children. The results showed that subjects consumed for drinking both bottled water and water from the distribution network, but for preparing food and beverages (tea, coffee) they used only water from the public distribution network. The average daily consumption of drinking water from the distribution network, is 1.4 l/day for adults, including beverages prepared with treated water. The surveyed subjects declared that they consume coffee or tea, in percentage of 88%, 94.4% respectively. The calculation of the exposure dose, daily intake and risk of cancer was achieved by using a model developed by the Agency for Toxic Substances and Disease Registry (ATSDR) from the USA to calculate the dose and assess the risk of cancer. Our study shows that the cancer risk to THMs is increasing related to the higher daily intake of the drinking water, being higher for chloroform compared to dibromochloroform. For the measured concentrations of chloroform and dibromochloroform in drinking water and the average daily consumption of 1.4 l water/day, the probability of new cancers occurrence is at least 2.4 additional cases for 25 years of exposure and maximum 4.61 cases for 35 years of exposure in the existing background of a 1 million people

The role of cardiovascular rehabilitation in women with ischemic heart disease and rhythm disorders

The incidence and prevalence of cardiovascular disease among women has increased significantly over the last 50 years. However, women diagnosed with ischemic cardiopathy benefit to a much lesser extent from both pharmacological or interventional treatment and inclusion in cardiovascular rehabilitation programs. Cardiovascular rehabilitation programs in women should be individualized, taking into account the particularities of cardiovascular risk factors, effort, aritmogenic risk, socio-economic status. Women's cardiovascular rehabilitation programs need to be diversified and deployed in smaller groups of female patiens. These programs should include, besides physical recovery, emotional, social and psychological support. The purpose of this article is to synthesize some of the particularities of cardiovascular rehabilitation in women with ischemic heart disease and rhythm disorders

The Role of IL-6 and ET-1 in the Diagnosis of Coronary MicroVascular Disease in Women

Background: Microvascular angina is a common clinical entity, with about a three-fold higher frequency in women. The pathogenesis of microvascular angina has not been much studied, but inflammation and endothelial dysfunction have been incriminated as the main mechanisms of this disease. Methoss: Our purpose was to analyze whether certain inflammatory markers, i.e., interleukin 6 (IL-6) and endothelin 1 (ET-1), can play a role in the diagnosis of microvascular angina in women. Results: Ninety women with ischemic heart disease were divided into two groups, based on their affliction with either microvascular or macrovascular disease. In general, the levels of IL6 and ET1 were similar between the two groups. Analyzing these marker levels according to the number of coronary lesions, we obtained an increased IL6 value that was similar for patients with microvascular angina, one-vessel, and two-vessel coronary disease, but significantly lower than in women with three-vessel coronary lesions. Also, in microvascular angina, IL6 level was correlated with the NYHA IV functional class. Unexpectedly, the level of ET1 was correlated with left ventricular systolic dysfunction. Conclusions: In women with an increased suspicion of microvascular angina, in whom microvascular dysfunction cannot be tested invasively, IL-6 level, unlike the ET-1 level, might be considered a diagnostic marker of this disease