Safi, Morteza
International Journal of Cardiovascular Practice

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Syncope during pregnancy in a patient with permanent cardiac pacemaker, due to increased pacing threshold. Akbarzadeh, Mohammad Ali; Safi, Morteza; Khaheshi, Isa; Bahrololoumi Bafruee, Negar
International Journal of Cardiovascular Practice Vol 1, No 2 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (149.449 KB) | DOI: 10.21859/ijcp-010207

Abstract

A 22-year-old pregnant woman referred with syncope due to pacemaker malfunction. During the second trimester of pregnancy, the right ventricular (RV) lead pacing threshold increased and led to early generator depletion. We believe that this might happen due to lead micro-dislodgement or less probably effect of hormonal changes during pregnancy on electrode-myocardium interface.
Acute Myocardial Infarction in a Patient With Elevated ST-Segment in aVR Lead and Diffuse ST Segment Depression in Other Leads: A Case Report Safi, Morteza; Khaheshi, Isa; Memaryan, Mehdi
International Journal of Cardiovascular Practice Vol 1, No 1 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (128.401 KB) | DOI: 10.20286/ijcp-010102

Abstract

ST elevation in aVR in conjunction with diffuse ST depression in precordial leads may indicate occlusion of very proximal portion of the left anterior descending artery. We present a 54-year old man, with crushing retrosternal pain and ST-segment elevation only in aVR lead and diffuse ST-segment depression in inferior, lateral and precordial leads. The patient was scheduled for emergent coronary angiography, which showed that left anterior descending (LAD) artery was cut off at very proximal portion and urgent CABG was performed for the patient.
Chronic Total Occlusion-Angioplasty with Antegrade Approach: A two-Year Experience in “Modarres Hospital”, A Tertiary University Hospital, Tehran, Iran Safi, Morteza; Namazi, Mohammad Hasan; Sadeghi, Hamid; Saadat, Habibollah; Vakili, Hossein; Alipour Parsa, Saeed; Khaheshi, Isa; Ataeinia, Bahar
International Journal of Cardiovascular Practice Vol 1, No 3 (2016)
Publisher : International Journal of Cardiovascular Practice

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (152.925 KB) | DOI: 10.21859/ijcp-010307

Abstract

Introduction: New techniques for the percutaneous treatment of coronary chronic total occlusions (CTO) have had a high success rate since a few years ago, so the interest for this treatment has been increasing these days.Methods: The current observational study was performed in Modarres hospital as a tertiary referral center. All the patients with documented stable angina who had failed to response to full guideline-mediated medical therapy, referred to our hospital, were candidates for coronary angiography. Antegrade strategy was applied for all these patients. The length of the lesion, the fluoroscopy time of the CTO angioplasty, consumed contrast volume, the number of guide wires used, whether a corsair or tornus micro-catheter was used or not, and the success rate of the angioplasty were documented for further analysis.Results: A total of 47 patients with documented stable angina were finally included. The median age was 59 (45-78) and 70.2% were male. The mean length of the lesion was 34.0 ± 1.1 .The mean fluoroscopy time and contrast volume were 57.9 ± 3.2 minutes and 525.9 ± 20.9 mL, respectively. In average, 2.2 guide wires were used. Corsair and tornus micro-catheters were applied in 30 (63.8%) and 5 (10.6%) of the cases, respectively. Seven complications (all including coronary dissection) occurred. In-hospital major adverse cardiac events (MACE) rate was 10.6%, all of which were non-Q wave myocardial infarction. The success rate was 85.1%. The higher number of used wires, use of corsair, and tornus micro-catheter were not significantly concordant with success rate (P-value > 0.05); in addition, longer lesion was not concordant with unsuccessfulness rate (P-value > 0.05).Conclusions: Patient selection for CTO-angioplasty should be performed more carefully. Patients’ quality of life and risk of probable procedural complications and future cardiac events should be assessed to decide the best treatment approach. Radiation exposure, contrast consumption and fluoroscopy time are recommended to be monitored during the procedure and thresholds should be defined to enhance safety and efficacy.