Objective: The aim of this work was to compare the safety and effectiveness of the BioMime and the thicker strut Ultimaster sirolimus-eluting stents (SESs) in patients presenting with ST-elevation myocardial infarction (STEMI) and single-vessel disease undergoing primary percutaneous coronary intervention (PCI).

Method: This prospective, single-center, non-inferiority study was carried out on 221 STEMI individuals aged 19 to 65 years, both sexes, diagnosed with STEMI. All patients were subjected to electrocardiograms, echocardiography, and clinical follow-up. Quantitative coronary angiography was done at baseline and follow-up.

Results: Post-procedure quantitative coronary angiography (QCA) demonstrated no significant differences regarding acute luminal gain and residual stenosis between the BioMime and Ultimaster groups. Binary restenosis was slightly greater in the BioMime group (7 [15.2%]) compared to the Ultimaster group (6 [13.3%], relative risk [95% confidence interval, CI]: 0.947 [0.329–2.725], P = 0.797). The variation in in-stent late lumen loss (LLL) between the groups was minimal (0.33 ± 0.3 mm in the BioMime group vs. 0.32 ± 0.4 mm in the Ultimaster group, Diff [95% CI]: 0.007 [−0.16–0.17], P = 0.935; prespecified non-inferiority = 0.024). Clinical endpoints at 30 days and 14 months, as well as patient- and device-oriented endpoints at 14 months, were not significantly different between the BioMime and Ultimaster groups. Subgroup analysis revealed a potential benefit of the Ultimaster stent in older patients (>70 years) regarding target vessel failure (TVF).

Conclusion: In primary PCI for STEMI patients, BioMime stents were non-inferior to Ultimaster stents at one-year follow-up. Further studies with longer follow-up durations are warranted to validate these results.

Objective: Transvenous lead extraction (TLE) is used in various clinical scenarios, such as device-related infections. Mechanically powered sheaths are one of the most commonly used tools for TLE procedures. We evaluated the procedural and clinical outcomes of a novel extraction technique for chronically implanted leads in the treatment of device-related infections.

Method: The novel extraction technique utilizing standard implantation stylets, snares, reused rotational sheaths, catheters, and wires was evaluated for procedural success and clinical outcomes.

Results: A total of 12 consecutive patients with device-related infections underwent the novel TLE procedure. Complete procedural success was achieved in all patients, with a minor complication rate of 8% (one patient). No major complications or procedure-related mortality were observed. During a median follow-up period of 435 days, one patient died due to a multidrug-resistant systemic infection, one due to end-stage heart failure, and one underwent valve surgery for concomitant valve endocarditis. No cases of reinfection were reported in the study population. Additionally, this novel technique was approximately 85% less costly than the conventional standard technique using locking stylets and unused rotational sheaths.

Conclusion: In situations where unused extraction tools are unavailable or limited by reimbursement constraints, this novel TLE technique offers an effective and safe alternative.

Objective: Catheter-based ablation is now widely recognized as a beneficial therapeutic option for managing atrial fibrillation (AF). However, the extended duration and pain associated with the procedure may cause patient movements, potentially leading to disruptions in electro-anatomical mapping systems. Sedative and analgesic agents are used to prevent body movements and manage pain. This study aimed to compare the safety and effects of ketamine and propofol for deep sedation on outcomes in AF patients undergoing radiofrequency ablation.

Method: This retrospective, single-center study included 108 patients who underwent radiofrequency AF ablation under deep sedation (without intubation) in our hospital. The patients were categorized into two groups based on the anesthetic agent administered for deep sedation: the propofol group and the ketamine group. Procedure duration, success rates, and recovery times were compared.

Results: Of the 108 patients, 54 were in the propofol group and 54 were in the ketamine group. The procedure durations were similar in both groups (propofol group: 135 min (120–145) vs. ketamine group: 140 min (120–155), P = 0.803). The eye-opening time after the procedure was 275 seconds in the propofol group and 266 seconds in the ketamine group (P = 0.530). Additionally, no significant variation was detected in the initial measurements of systolic and diastolic blood pressure or heart rate.

Conclusion: There was no significant difference between the propofol group and the ketamine group in terms of outcomes. To the best of our knowledge, this is the first study to assess the efficacy of ketamine and propofol in the radiofrequency AF ablation patient group.

Objective: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia and has a detrimental impact on psychological well-being. This study aims to determine the prevalence of anxiety and depression in patients with non-valvular AF and to investigate the relationship between these psychological conditions and the treatment regimens administered.

Method: This cross-sectional study included 255 individuals diagnosed with non-valvular AF who were treated between 2021 and 2022. Psychiatric evaluation was conducted using the Beck Depression Inventory and Beck Anxiety Inventory. Multivariate regression analysis was performed to identify predictors of depression and anxiety.

Results: Of the patients included, 62 were on warfarin, 124 were on novel oral anticoagulants (NOACs), and 69 were not receiving any oral anticoagulant (OAC) therapy. Overall, 68.6% had depression and 64.7% had anxiety at a moderate or higher severity level. Although there was no notable variation in anxiety and depression scores between patients on NOACs and those not undergoing OAC treatment, the warfarin group had significantly higher scores than the other two groups. Age, anxiety, C-reactive protein (CRP) levels, and CHA2DS2-VASc scores (Congestive heart failure, Hypertension, Age ≥ 75 years, Diabetes mellitus, prior Stroke/transient ischemic attack-Vascular disease, Age 65-74 years, Sex category) all positively correlated with the severity of depression. Anxiety, in turn, was positively associated with age, depression, and CHA2DS2-VASc scores, and negatively associated with ejection fraction. Regression analysis revealed a strong correlation between warfarin treatment and anxiety severity.

Conclusion: The findings of this study suggest that warfarin treatment is associated with significant psychological effects in patients with AF. Considering that comorbid psychiatric disorders are linked to unfavorable prognosis and higher mortality, the development of appropriate intervention strategies that address psychological distress as part of the treatment process may provide substantial clinical benefits.

Objective: Originally designed to evaluate stroke risk in individuals with atrial fibrillation unrelated to valvular disease, the CHA2DS2-VASc score (Congestive heart failure, Hypertension, Age ≥ 75 years, Diabetes mellitus, prior Stroke/transient ischemic attack/systemic embolism, Vascular disease, Age 65–74 years, and Sex category – female) is now additionally utilized for the prognostic evaluation of cardiovascular diseases. This study aimed to evaluate the predictive role of the CHA2DS2-VASc score for lesion severity and long-term survival outcomes in individuals with peripheral artery disease (PAD).

Method: This retrospective analysis included 784 patients diagnosed with PAD via computed tomography (CT) angiography, consecutively enrolled from two medical centers. The CHA2DS2-VASc score was determined for all participants. Lesion severity was assessed according to the TASC II (Trans-Atlantic Inter-Society Consensus II) criteria, and patients were categorized into TASC-AB (simple) and TASC-CD (complex) lesion groups. Mortality data were obtained from hospital and social security records.

Results: The study included 784 patients (average age: 61.7 ± 9.9 years; 17.2% female). In the regression analysis performed to predict lesion severity, we found that the CHA2DS2-VASc score (P < 0.007) and left ventricular ejection fraction (P = 0.009) were independent predictors. The receiver operating characteristic (ROC) curve indicated that a CHA2DS2-VASc score threshold of 3.5 predicted long-term mortality with 70% sensitivity and 79% specificity (P < 0.001). Kaplan-Meier survival estimates indicated that patients with higher CHA2DS2-VASc scores had significantly lower survival rates over the 60-month follow-up period (P < 0.001).

Conclusion: The CHA2DS2-VASc score was independently associated with both lesion severity and adverse long-term outcomes in individuals with PAD.

Objective: Management of aortic stenosis (AS) requires integrating complex clinical, imaging, and risk stratification data. Large language models (LLMs) such as ChatGPT and Gemini AI have shown promise in healthcare, but their performance in valvular heart disease, particularly AS, has not been thoroughly assessed. This study systematically compared ChatGPT and Gemini AI in addressing guideline-based and clinical scenario questions related to AS.

Method: Forty open-ended AS-related questions were developed, comprising 20 knowledge-based and 20 clinical scenario items based on the 2021 European Society of Cardiology/European Association for Cardio-Thoracic Surgery (ESC/EACTS) guidelines. Both models were queried independently. Responses were evaluated by two blinded cardiologists using a structured 4-point scoring system. Composite scores were categorized, and comparisons were performed using Wilcoxon signed-rank and chi-square tests.

Results: Gemini AI achieved a significantly higher mean overall score than ChatGPT (3.96 ± 0.17 vs. 3.56 ± 0.87; P = 0.003). Fully guideline-compliant responses were more frequent with Gemini AI (95.0%) than with ChatGPT (72.5%), although the overall compliance distribution difference did not reach conventional significance (P = 0.067). Gemini AI performed more consistently across both question types. Inter-rater agreement was excellent for ChatGPT (κ = 0.94) and moderate for Gemini AI (κ = 0.66).

Conclusion: Gemini AI demonstrated superior accuracy, consistency, and guideline adherence compared to ChatGPT. While LLMs show potential as adjunctive tools in cardiovascular care, expert oversight remains essential, and further model refinement is needed before clinical integration, particularly in AS management.

This review provides a structured overview of ten published case reports of anomalous origin of the left coronary artery from the pulmonary artery (ALCAPA) syndrome in adults, with a focus on clinical presentation, diagnostic methods, and treatment approaches. A narrative review was conducted using the PubMed database to identify English-language case reports of adult patients with ALCAPA. Ten cases were selected based on clearly reported clinical features, diagnostic methods, and treatment approach. The most common symptoms included atrial fibrillation, chest pain, dyspnea, and syncope. Surgical correction was performed in four cases, while others were managed conservatively or with medical therapy. Adult-type ALCAPA presents with variable clinical manifestations and requires individualized treatment. Timely diagnosis and appropriate management are crucial for optimal outcomes.

Cardiac embolic origin is a significant etiological factor in patients presenting with stroke. Thrombi located in the left ventricle may result from various underlying causes. This case report examines a thrombus located in the left ventricular apex of a 76-year-old female patient and presents a comprehensive analysis of the clinical findings, laboratory results, and multimodality imaging techniques used. Furthermore, this report provides a detailed summary of the diagnostic approach to Loeffler endocarditis, a rare but important differential diagnosis.

We performed cryoballoon ablation on a 61-year-old female patient with recurrent paroxysmal atrial fibrillation. Pre-procedural contrast-enhanced computed tomography (CT) angiography, used to assess the patient's pulmonary vein anatomy, revealed an accessory pulmonary vein originating from the left atrial roof. Cryoballoon ablation was successfully applied to this accessory vein, which represents a rare anatomical variant not commonly described in the literature.

Coronary artery rupture is a rare but potentially fatal complication of coronary procedures. This case report describes a 63-year-old male patient with coronary atherosclerotic heart disease who presented with typical symptoms. However, echocardiography, myocardial injury markers, and electrocardiograms did not indicate an acute myocardial infarction. Coronary angiography (CAG) revealed lesions in two vessels, requiring intervention. During the procedure, a coronary artery rupture occurred. Intravascular ultrasound (IVUS) revealed negative vessel remodeling in the affected arteries. Coronary artery rupture is uncommon in clinical practice and is primarily documented in case reports. Due to the limited information available on its management, early detection and timely treatment are essential.