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    Persistent left superior vena cava: Is it an incidental pathology detected during pacemaker implantation or one of the causes of sick sinus syndrome?
    (Oxford University Press, 2022) Akşit, Ercan; Taylan, Gökay; Çinier, Göksel; Karabay, Can Yücel; Akgün, Taylan
    We read with interest the article by Archontakis et al.1 in which they implanted a pacemaker via an optimal technique in a patient with isolated persistent left superior vena cava (PLSVC) anomaly, syncope attacks, and sick sinus syndrome (SSS). In this article, we were more interested in the comorbidity of PLSVC and SSS. In our previous experimental study, using the chronic coronary venous insufficiency model, we showed that the exposure of the coronary veins to high pressure and volume load leads to haemosiderin deposition in the myocardial tissue.2 It is known that chronic iron overload selectively reduces CaV1.3-mediated L-type Ca2+ channels and causes bradycardia, heart block, and atrial fibrillation (AF).3 In some patients with PLSVC (especially those with underdeveloped coronary venous collaterals, thebesian vein, and sinusoidal vein network), chronic iron overload in the myocardial tissue may lead to SSS development due to chronic volume and pressure load on the coronary sinus and coronary veins over the years.
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    The importance of autopsy studies in elucidating coronary venous diseases
    (Oxford University Press, 2021) Akşit, Ercan; Kırılmaz, Bahadır; Kaya, Hakkı; Karabay, Can Yücel
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  • Küçük Resim
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    Turkish real life atrial fibrillation in clinical practice: TRAFFIC study
    (Turkish Society of Cardiology, 2024) Karabay, Can Yücel; Taşolar, Hakan; Kunak, Ayşegül Ülgen; Çap, Murat; Astarcıoğlu, Mehmet Ali; Şen, Taner; Akşit, Ercan
    Background: Atrial fibrillation (AF) is the most prevalent cardiac arrhythmia worldwide and is associated with an increased risk of thromboembolism, ischemic stroke, impaired quality of life, and mortality. The latest research that shows the prevalence and incidence of AF patients in Türkiye was the Turkish Adults’ Heart Disease and Risk Factors study, which included 3,450 patients and collected data until 2006/07.The Turkish Real Life Atrial Fibrillation in Clinical Practice (TRAFFIC) study is planned to present current prevalence data, reveal the reflection of new treatment and risk approaches in our country, and develop new prediction models in terms of outcomes. Methods: The TRAFFIC study is a national, prospective, multicenter, observational registry. The study aims to collect data from at least 1900 patients diagnosed with atrial fibrillation, with the participation of 40 centers from Türkiye. The following data will be collected from patients: baseline demographic characteristics, medical history, vital signs, symptoms of AF, ECG and echocardiographic findings, CHADS2-VASC2 and HAS-BLED (1-year risk of major bleeding) risk scores, interventional treatments, antithrombotic and antiarrhythmic medications, or other medications used by the patients. For patients who use warfarin, international normalized ratio levels will be monitored. Follow-up data will be collected at 6, 12, 18, and 24 months. Primary endpoints are defined as systemic embolism or major safety endpoints (major bleeding, clinically relevant nonmajor bleeding, and minor bleeding as defined by the International Society on Thrombosis and Hemostasis). The main secondary endpoints include major adverse cardiovascular events (systemic embolism, myocardial infarction, and cardiovascular death), all-cause mortality, and hospitalizations due to all causes or specific reasons. Results: The results of the 12-month follow-up of the study are planned to be shared by the end of 2023. Conclusion: The TRAFFIC study will reveal the prevalence and incidence, demographic characteristics, and risk profiles of AF patients in Türkiye. Additionally, it will provide insights into how current treatments are reflected in this population. Furthermore, risk prediction modeling and risk scoring can be conducted for patients with AF.