By Michela Casella, Antonio Dello Russo
Interventional cardiac electrophysiology has passed through a swift improvement in procedure and alertness in recent times. New three-dimensional recommendations were proposed for catheter navigation within the center yet, an updated X-ray advisor remains to be imperative for the right kind positioning of catheters within the diverse cardiac chambers. An Atlas of Radioscopic Catheter Placement offers primary wisdom approximately radiographic anatomy of the center and a few advices to properly stream and rotate the catheters, in a concise and transparent demeanour.
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Additional resources for An Atlas of Radioscopic Catheter Placement for the Electrophysiologist
In fact, there is evidence that intracoronary administration of a glycoprotein IIb/IIIa inhibitor may reduce adverse cardiac events  compared with intravenous administration. 13) . 009). 6) . Further study of upstream versus deferred use of eptifibatide is underway in the EARLY ACS trial. Glycoprotein IIb/IIIa inhibitor recommendation Glycoprotein IIb/IIIa inhibitors are best suited for patients with ACS who undergo percutaneous coronary intervention [4,5]; however, conservatively treated patients with diabetes may also derive benefit from their use .
Bivalirudin has also been studied in ST-elevation myocardial infarction. This agent compared favorably to heparin and a glycoprotein IIb/IIIa inhibitor by reducing cardiovascular death, myocardial infarction, and bleeding. This was partially offset by an increase in periprocedural stent thrombosis . Direct thrombin inhibitor recommendation Bivalirudin, with the option of a glycoprotein IIb/IIIa inhibitor as a bailout, is a reasonable alternative to heparin plus routine use of a glycoprotein IIb/IIIa inhibitor for non-ST-elevation ACS .
Circulation 2003; 107:1840–1843. 33. ; ACUITY Investigators. Routine upstream initiation vs deferred selective use of glycoprotein IIb/IIIa inhibitors in acute coronary syndromes: the ACUITY timing trial. JAMA 2007; 297:591–602. 34. Manoukian SV, Feit F, Mehran R, et al. Impact of major bleeding on 30-day mortality and clinical outcomes in patients with acute coronary syndromes: an analysis from the ACUITY trial. J Am Coll Cardiol 2007; 49:1362–1368. , fondaparinux). The interest behind the use of anti-thrombin agents stems from the fact that ACS patients who are only treated with anti-platelet agents are still at risk of significant ischemic events.