Current ACCF/AHA guidelines recommend fibrinolysis (FL) as the preferred reperfusion strategy for ST-segment elevation myocardial infarction (STEMI) patients with expected delays of > 120 minutes from first medical contact to percutaneous coronary intervention (PCI). The guidelines recommend this be followed by transfer to a PCI center with angiography/PCI within 3-24 hours. However, assessment of reperfusion prior to angiography may not be accurate based on clinical and electrocardiogram (ECG) criteria alone. Recent data suggested increased recurrent ischemic events within the first 24 hours. The aim of this study, which was conducted from 2003-2015, was to assess the safety of very early PCI (< 3 hours) following FL.

Patients who undergo minimally invasive heart valve replacement, known as transcatheter aortic valve replacement (TAVR), sometimes develop heart rhythm problems that necessitate placement of a permanent pacemaker. However, when a pacemaker is needed soon after TAVR, patients often have worse outcomes than those who did not need a pacemaker, according to a study published recently in JACC: Cardiovascular Interventions. The study shows that the risks are both short- and long-term and include lengthier hospital and intensive care unit stays as well as a greater risk of death.