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Öğe CHA2DS2-VASc score and modified CHA2DS2-VASc score can predict mortality and intensive care unit hospitalization in COVID-19 patients(Springer, 2021) Gunduz, Ramazan; Yildiz, Bekir Serhat; Ozdemir, Ibrahim Halil; Cetin, Nurullah; Ozen, Mehmet Burak; Bakir, Eren Ozan; Bayturan, OzgurIn this study, we investigated whether the CHA2DS2-VASc score could be used to estimate the need for hospitalization in the intensive care unit (ICU), the length of stay in the ICU, and mortality in patients with COVID-19. Patients admitted to Merkezefendi State Hospital because of COVID-19 diagnosis confirmed by RNA detection of virus by using polymerase chain reaction between March 24, 2020 and July 6, 2020, were screened retrospectively. The CHA2DS2-VASc and modified CHA2DS2-VASc score of all patients was calculated. Also, we received all patients' complete biochemical markers including D-dimer, Troponin I, and c-reactive protein on admission. We enrolled 1000 patients; 791 were admitted to the general medical service and 209 to the ICU; 82 of these 209 patients died. The ROC curves of the CHA2DS2-VASc and M-CHA2DS2-VASc scores were analyzed. The cut-off values of these scores for predicting mortality were >= 3 (2 or under and 3). The CHA2DS2-VASc and M-CHA2DS2-VASc scores had an area under the curve value of 0.89 on the ROC. The sensitivity and specificity of the CHA2DS2-VASc scores were 81.7% and 83.8%, respectively; the sensitivity and specificity of the M-CHA2DS2-VASc scores were 85.3% and 84.1%, respectively. Multivariate logistic regression analysis showed that CHA2DS2-VASc, Troponin I, D-Dimer, and CRP were independent predictors of mortality in COVID-19 patients. Using a simple and easily available scoring system, CHA2DS2-VASc and M-CHA2DS2-VASc scores can be assessed in patients diagnosed with COVID-19. These scores can predict mortality and the need for ICU hospitalization in these patients.Öğe Coexistence of atrioventricular accessory pathways and drug-induced type 1 Brugada pattern(Wiley, 2018) Hasdemir, Can; Juang, Jimmy Jyh-Ming; Kose, Sedat; Kocabas, Umut; Orman, Mehmet N.; Payzin, Serdar; Sahin, Hatice; Celen, Candan; Ozcan, Emin E.; Chen, Ching-Yu Julius; Gunduz, Ramazan; Turan, Oguzhan E.; Senol, Oktay; Burashnikov, Elena; Antzelevitch, CharlesBackgroundAtrial arrhythmias, particularly atrioventricular nodal reentrant tachycardia, can coexist with drug-induced type 1 Brugada electrocardiogram (ECG) pattern (DI-Type1-BrP). The present study was designed to determine the prevalence of DI-Type1-BrP in patients with atrioventricular accessory pathways (AV-APs) and to investigate the clinical, electrocardiographic, electrophysiologic, and genetic characteristics of these patients. MethodsOne-hundred twenty-four consecutive cases of AV-APs and 84 controls underwent an ajmaline challenge test to unmask DI-Type1-BrP. Genetic screening and analysis was performed in 55 of the cases (19 with and 36 without DI-Type1-BrP). ResultsPatientswith AV-APs were significantly more likely than controls to have a Type1-BrP unmasked (16.1vs 4.8%, P=0.012). At baseline, patients with DI-Type1-BrP had higher prevalence of chest pain, QR/rSr' pattern in V-1 and QRS notching/slurring in V-2 and aVL during preexcitation, rSr' pattern in V-1-V-2, and QRS notching/slurring in aVL during orthodromic atrioventricular reentrant tachycardia (AVRT) compared to patients without DI-Type1-BrP. Abnormal QRS configuration (QRS notching/slurring and/or fragmentation) in V-2 during preexcitation was present in all patients with DI-Type1 BrP. The prevalence of spontaneous preexcited atrial fibrillation (AF) and history of AF were similar (15%vs 18.3%, P=0.726) in patients with and without DI-Type1-BrP, respectively. The prevalence of mutations in Brugada-susceptibility genes was higher (36.8%vs 8.3%, P=0.02) in patients with DI-Type1-BrP compared to patients without DI-Type1-BrP. ConclusionsDI-Type1-BrP is relatively common in patients with AV-APs. We identify 12-lead ECG characteristics during preexcitation and orthodromic AVRT that point to an underlying type1-BrP, portending an increased probability for development of malignant arrhythmias.Öğe Comparison of anti-factorXa assay and rotational thromboelastogram in evaluating the efficacy of enoxaparine treatment in patients with acute coronary syndrome without ST-segment elevation(Cukurova Univ, Fac Medicine, 2021) Gunduz, Ramazan; Yildiz, Bekir Serhat; Ozdemir, Ibrahim Halil; Ozen, Mehmet Burak; Cetin, Nurullah; Yavuzgil, OguzPurpose: The aim of this study was to compare anti-factor Xa assay and tromboelastogram in evaluation of efficacy of enoxaparin in patients with acute coronary syndrome without ST-segment elevation. Materials and Methods: Twenty-five patients with acute coronary syndrome were involved. Two blood samples were taken on admission and 4 hours after the subcutaneous injection of third dose of 1mg/kg enoxaparin to the patients. AntiFXa, tromboelastogram, activated coagulation time were calculated. Results: A non-significant increase in activated coagulation time was observed after the injection of enoxaparin. After injection enoxaparin thromboelastography parameters changed maximum amplitude(MA) increased (MA basal 65.4 +/- 11.9 after 63.4 +/- 7.8), R time increased (from 5 +/- 1.7 to 8.4 +/- 4.6,), K time increased (from 1.89 +/- 1.06 to 2.56 +/- 1.4), angle increased (from 66.34 +/- 5.6 to 57.9 +/- 11.4). AntiFXa increased. (from 0.122 +/- 0.06 to 0.501 +/- 0.359). Conclusion: Tromboelastography method can be used in assessment of efficacy of enoxaparin in patients with acute coronary syndrome without ST-Segment elevation.Öğe Effect of Coronary Thrombus Aspiration in Non ST Elevation Acute Coronary Syndrome Patients on Three-Year Survival- Does it add any Benefit?(Sage Publications Inc, 2022) Yildiz, Bekir S.; Cetin, Nurullah; Gunduz, Ramazan; Bilge, Adnan; Ozgur, Su; Orman, Mehmet N.We assessed the effect of thrombus aspiration (TA) during percutaneous coronary intervention (PCI) on in-hospital and 3-year mortality in consecutive non-ST segment elevation myocardial infarction (n = 189) and unstable angina pectoris (n = 148) patients (n = 337) between 2011 and 2016. In total, 153 patients (45.4%) underwent TA. The number of patients with postoperative thrombolysis in terms of myocardial infarction grade 3 blood flow (P < .001) and myocardial blush grade 3 (P < .001) were significantly higher in all TA groups. At 6-, 12- and 24-month post-PCI, the mean left ventricular ejection fraction was significantly higher in the all TA groups versus the stand alone PCI group (P < .001). Thrombus aspiration was associated with a significant improvement both in epicardial flow, myocardial perfusion and left ventricular ejection fraction. Thrombus aspiration during PCI in all acute coronary syndrome (except ST segment elevation) patients was associated with better survival compared with stand alone PCI group at 3-year follow-up (P = .019).Öğe Frontal QRS/T angle can predict mortality in COVID-19 patients(W B Saunders Co-Elsevier Inc, 2022) Gunduz, Ramazan; Yildiz, Bekir Serhat; Ozgur, Su; Ozen, Mehmet Burak; Bakir, Eren Ozan; Ozdemir, Ibrahim Halil; Cetin, NurullahAims: The frontal QRS-T (fQRS) angle has been investigated in the general population, including healthy people and patients with heart failure. The fQRS angle can predict mortality due to myocarditis, ischaemic and nonischaemic cardiomyopathies, idiopathic dilated cardiomyopathy, and chronic heart failure in the general population. Moreover, no studies to date have investigated fQRS angle in coronavirus disease 2019 (COVID-19) patients. Thus, the purpose of this retrospective multicentre study was to evaluate the fQRS angle of COVID-19 patients to predict in-hospital mortality and the need for mechanical ventilation.Methods and results: An electrocardiogram was performed for 327 COVID-19 patients during admission, and the fQRS angle was calculated. Mechanical ventilation was needed in 119 patients; of them, 110 died in the hospital. The patients were divided into two groups according to an fQRs angle >90 degrees versus an fQRS angle <_90 degrees. The percentages of mortality and the need for mechanical ventilation according to fQRS angle were 67.8% and 66.1%, respectively, in the fQRs >90 degrees group and 26.1% and 29.9% in the fQRS <_90 degrees group. Heart rate, oxygen saturation, fQRS angle, estimated glomerular filtration rate, and C-reactive protein level were predictors of mortality on the multivariable analysis. The mortality risk increased 2.9-fold on the univariate analysis and 1.6-fold on the multivariate analysis for the fQRS >90 degrees patient group versus the fQRS <_90 degrees group.Conclusion: In conclusion, a wide fQRS angle >90 degrees was a predictor of in-hospital mortality and associated with the need for mechanical ventilation among COVID-19 patients.(c) 2022 Elsevier Inc. All rights reserved.Öğe Left ventricular lead delivery system used to implant right ventricular lead via persistent left superior vena cava(Wiley, 2023) Yildiz, Bekir Serhat; Gunduz, Ramazan; Ozgur, Su[No abstract available]Öğe Left Ventricular Lead Delivery System Used to Implant Right Ventricular Lead Via Persistent Left Superior Vena Cava(Wiley, 2023) Yildiz, Bekir Serhat; Gunduz, Ramazan; Ozgur, M. D. Su[Abstarct Not Available]Öğe Multi-Center Experience of Coronary Artery Perforation During Percutaneous Coronary Intervention: Clinical and Angiographic Characteristics, Management, and Outcomes Between 2010 and 2020(Aves, 2022) Gunduz, Ramazan; Yildiz, Bekir Serhat; Cetin, Nurullah; Ozgur, Su; Cizgici, Ahmet Yasar; Tuluce, Kamil; Tuluce, Selcen YakarBackground: Coronary artery perforations are one of the most feared, rare, and catastrophic complication of percutaneous coronary intervention. Despite the remarkable increase in coronary angiography and percutaneous coronary intervention, there is no large database that collects coronary artery perforation for the Turkish population. Our study aimed to report our experience over a 10-year period for clinical and angiographic characteristics, management strategies, and outcomes of coronary artery perforation during the percutaneous coronary intervention at different cardiology departments in Turkey. Methods: The study data came from a retrospective analysis of 48 360 percutaneous coronary intervention procedures between January 2010 and June 2020. A total of 110 cases who had coronary artery perforation during the percutaneous coronary intervention were found by angiographic review. Analysis has been performed for the basic clinical, angiographic, procedural characteristics, the management of coronary artery perforation, and outcome of all patients. Results: The coronary artery perforation rate was 0.22%. Out of 110 patients with coronary artery perforation, 66 patients showed indications for percutaneous coronary intervention with acute coronary syndrome and 44 patients with stable angina pectoris. The most common lesion type and perforated artery were type C (34.5%) and left anterior descending (41.8%), respectively. The most observed coronary artery perforation according to Ellis classification was type III (37.2%). Almost 52.7% of patients have a covered stent implanted in the perforated artery. The all-cause mortality rate of coronary artery perforation patients in the hospital was 18.1%. Conclusion: The observed rate of coronary artery perforation in our study is consistent with the studies in this literature. However, the mortality rates related to coronary artery perforation are higher than in other studies in this literature. Especially, the in-hospital mortality rate was higher in type II and type III groups due to perforation and its complications. Nevertheless, percutaneous coronary intervention should be done in selected patients despite catastrophic complications.Öğe A patient with Duchenne muscular dystrophy and complete AV block undergoing a successful left bundle area pacing implantation(Czech Soc Cardiology & Czech Soc Cardiovascular Surgery, 2024) Gunduz, Ramazan; Yildiz, Bekir Serhat; Ozgur, SuThe use of septal pacing, a novel pacemaker technique, is particularly recommended for patients with heart failure and a pacing requirement of >= 40% within a 24-hour period. The feasibility and effectiveness of left bundle area pacing remain unknown in Duchenne muscular dystrophy patients. Our case represents the first instance in Duchenne muscular dystrophy patients demonstrating the applicability of conduction system pacing.Öğe Premature Atrial Contraction-Induced Cardiomyopathy: Recognition of a Distinct Phenotype of Arrhythmia-Induced Cardiomyopathy in Humans(Excerpta Medica Inc-Elsevier Science Inc, 2023) Hasdemir, Can; Kocabas, Umut; Kilic, Selim; Kose, Sedat; Kilic, Salih; Gunduz, Ramazan; Ulucan, Cem[No abstract available]
