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    Can utilization of therapeutic hypothermia with cold saline infusion and external cooling be increased in Turkey? Reply
    (Turkish Society of Cardiology, 2016) Aruğaslan, Emre; Karaca, Mehmet; Özcan, Kazım Serhan; Zengin, Ahmet; Tatlısu, Mustafa Adem; Bozbeyoğlu, Emrah; Satılmış, Seçkin; Yıldırımtürk, Özlem; Yekeler, İbrahim; Nurkalem, Zekeriya
    We have recently read with great interest the manuscript by Aruğaslan et al. describing experience with mild therapeutic hypothermia in patients with cardiac arrest complicating ST elevation myocardial infarction.[1] Thanks are due to the authors for sharing their valuable experience with mild therapeutic hypothermia in the comatose patient group.
  • Küçük Resim
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    Neurologic outcome in patients with cardiac arrest complicating ST elevation myocardial infarction treated by mild therapeutic hypothermia: The experience of a tertiary institution
    (Turkish Soc Cardiology, 2016) Aruğaslan, Emre; Karaca, Mehmet; Özcan, Kazım Serhan; Zengin, Ahmet; Tatlısu, Mustafa Adem; Bozbeyoğlu, Emrah; Satılmış, Seçkin; Yıldırımtürk, Özlem; Yekeler, İbrahim; Nurkalem, Zekeriya
    Objective: Therapeutic hypothermia improves neurologic prognosis after cardiac arrest. The aim of this study was to report clinical experience with intravascular method of cooling in patients with cardiac arrest resulting from ST-segment elevation myocardial infarction (STEMI). Methods: Thirteen patients (11 male, 2 famele; mean age was 39.6+/-9.4 years) who had undergone mild therapeutic hypothermia (MTH) by intravascular cooling after cardiac arrest due to STEMI were included. Clinical, demographic, and procedural data were analyzed. Neurologic outcome was assessed by Cerebral Performance Category (CPC) score. Results: Anterior STEMI was observed in 9 patients. One patient died of cardiogenic shock complicating STEMI. Mean cardiopulmonary resuscitation (CPR) duration and door-to-invasive cooling were 32.9+/-20.1 and 286.1+/-182.3 minutes, respectively. Precooling Glasgow Coma Scale score was 3 in 9 subjects. Twelve patients were discharged, 11 with CPC scores of 1 at 1-year follow-up. No major complication related to procedure was observed. Conclusion: In comatose survivors of STEMI, therapeutic hypothermia by intravascular method is a feasible and safe treatment modality.
  • Küçük Resim
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    Prognostic significance of fragmented QRS in acute pulmonary embolism
    (Acta Cardiologica, 2016) Karaca, Mehmet; Tatlısu, Mustafa Adem; Özcan, Kazım Serhan; Güngör, Barış; Bozbeyoğlu, Emre; Yıldırımtürk, Özlem; Arugaslan, Emre; Zengin, Ahmet; Çalık, Ali Nazmi; Nurkalem, Zekeriya; Çam, Neşe
    Background Presence of fragmented QRS (fQRS) complex in a 12-lead electrocardiogram (ECG) has been shown to represent alternation of myocardial activation owing to myocardial scar. The aim of this study was to investigate whether presence of fQRS complex predicts in-hospital and long-term mortality in patients with acute pulmonary embolism (APE). Methods This study included 186 consecutive patients with APE. Computed tomography pulmonary angiography (CTPA) was used to diagnose APE. ECG was obtained immediately after admission. Results Patients were divided into two groups: patients who had fQRS on their ECG (n = 52), and patients who did not have fQRS on their ECG (n = 134). The fQRS was associated with not only in-hospital mortality (P = 0.02) but also long-term mortality (P = 0.01). Furthermore, the fQRS was found to be a significant predictor of in-hospital and long-term mortality in multivariable Cox analyses. Conclusion In this study, fQRS was found to be predictors of both in-hospital and long-term mortality. Electrocardiography can be used to detect high-risk patients in APE; moreover, it bears little risk, is inexpensive, and easy to perform.