The width of life is more important than the length of life

A 58-year-old man with previous inferior myocardial infarction (MI) was referred for cardiac resynchronization therapy pacemaker (CRT-P) for decreased left ventricular ejection fraction (LVEF; 45%) and left bundle branch block (LBBB) (Figure 1). He had New York Heart Association Class I functional classification but palpitation for 3 months. General physical and cardiac examinations were normal. On the admission day, the electrocardiogram showed a narrow QRS rhythm with and without tachycardia (Figures 2 and 3). Would you recommend or consider a CRT-P device or a CRT defibrillator or only an implantable cardioverter defibrillator (ICD) based on these clinical and electrocardiographic findings, or ablation or medical therapy only

Convergent double coronary sinus potentials during atrial tachycardia

The analysis of the patterns and timing of coronary sinus activation provides a rapid stratification of the most likely macro-re-entrant atrial tachycardias and points toward the likely origin of centrifugal ones by comparing the left atrial and coronary sinus activation sequence and morphology during sinus rhythm and atrial tachycardia. The analysis of both the near- and far-field electrogram morphology of atrial signals also gives important clues in determining the mechanism of the arrhythmia

The width of life is more important than the length of life

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Atherogenic index of plasma and triglyceride- glucose index to predict more advanced coronary artery diseases in patients with the first diagnosis of acute coronary syndrome

OBJECTIVE: Coronary heart dis-ease (CHD) is the most common cause of mor-tality and morbidity. Acute coronary syndrome (ACS) is the most advanced form of the CHD spectrum. The triglyceride-glucose index (TGI) and atherogenic plasma index (AIP) are asso-ciated with future cardiovascular events. This study investigated the association of these pa-rameters with the severity of CAD and prognosis in the first-diagnosed ACS patients.PATIENTS AND METHODS: Our study was designed retrospectively, including 558 patients. Patients were divided into four subgroups: high and low TGI and high and low AIP. SYNTAX scores, in-hospital mortality, major adverse car-diac events (MACE), and survival were com-pared at 12-month follow-up.RESULTS: More three-vessel disease and high-er SYNTAX scores have been detected in the high AIP and TGI groups. More MACEs have been ob-served in high AIP and TGI groups than low groups. AIP and TGI were found to be independent predic-tors for SYNTAX = 23. While AIP has been found to be an independent risk factor for MACE, TGI has not been detected as an independent risk factor. In addition to AIP, age, three-vessel disease, and low-er EF were the independent risk factors for MACE. Survival was lower in high TGP and AIP groups.CONCLUSIONS: AIP and TGI are costless bedside parameters that can be easily calculat-ed. These parameters can predict the severity of CAD in first-diagnosed ACS patients. Besides, AIP is an independent risk factor for MACE. AIP and TGI parameters can guide our treatment in this patient population