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Recent studies suggest vasovagal syncope (VVS) has a significant heritable component (crude estimate sibling relative risk (λ s ): 1080) indicating that at least some forms of VVS may have a genetic cause. Here we present the first study examining a potential genetic abnormality in VVS.DNA was collected from consecutive patients attending our unit with head up tilt confirmed VVS (n=165). One...
Ventricular tachycardia originating from the right ventricular septum is very uncommon. In a 54-year-old male patient with right ventricular tachycardia, the focus of the ventricular tachycardia was localized to the subtricuspid septum of the right ventricle, which could be successfully eliminated with radiofrequency catheter ablation. The patient's echocardiogram and coronary angiogram were normal...
The aim of our study was to establish the efficiency of fibrin sealant in the prevention of pocket related complications in patients undergoing pacemaker implantation who are receiving anticoagulant treatment.The study was performed on 40 and 41 patients prospectively randomized into treatment and control groups who underwent pacemaker implantation procedure between January 2002 and July 2004 at the...
This multicentre prospective randomised trial was undertaken to evaluate the usefulness of an electrophysiological study (EPS)–guided/implantable cardioverter defibrillator (ICD) strategy in patients at high risk of sudden death (SD) early after myocardial infarction (MI). Previous studies have shown the benefits of such a strategy only in high-risk patients late after MI.We enrolled 143 survivors...
A 78-year-old female with prior atrioventricular junctional ablation for paroxysmal atrial fibrillation and implantation of DDDR pacemaker underwent repair of severe tricuspid insufficiency. Effects of biventricular pacing were tested with temporary wires at the conclusion of cardiopulmonary bypass.An ultrasonic flow probe was placed on the ascending aorta for real time cardiac output measurements...
To investigate the relationship between serum content of n-3 polyunsaturated fatty acids (PUFA) and the incidence of ventricular arrhythmias in patients with an implantable cardioverter defibrillator (ICD).We included 98 patients with ischaemic heart disease and an ICD. The numbers of ventricular fibrillation (VF) and ventricular tachycardia (VT) events were assessed during a 12-month period and related...
Management of patients (pts) presenting syncope diverges markedly from the guidelines of the European Society of Cardiology (ESC). To improve this management, the easiest option seemed to be to educate physicians. The aim of the study was to evaluate the impact of an educational process on the use of unnecessary neurological investigations.Charts of pts presenting syncope during two 12-month periods...
Primary prevention trials of implantable cardioverter defibrillator (ICD) therapy have generally excluded patients early after revascularization. Clinicians are commonly faced with patients who have ventricular dysfunction and nonsustained ventricular tachyarrhythmia developing shortly after revascularization. Since there are no evidence-based guidelines, management is currently at the discretion...
The beneficial use of biventricular pacing is reported in a patient with end-stage hypertrophic cardiomyopathy, intraventricular conduction delay and echocardiographic evidence of intraventricular dyssyncrony. Marked improvement in clinical status, left ventricular ejection fraction and peak VO2 were observed. As far as we know, this is the first report of a beneficial effect of a biventricular device...
The aims of the study were to evaluate the 24-h beat-to-beat heart rate (RR) and blood pressure changes during closed loop stimulation (DDD-CLS) pacing and conventional fixed rate DDD pacing with respect to spontaneous activity.We simultaneously and continuously measured beat-to-beat heart rate and blood pressure for 24h in patients implanted with Inos 2+ (Biotronik GmbH, Berlin, Germany)...
A case of a 51-year old male is presented. A left bundle branch block inferior axis tachycardia was manifest. At electrophysiological study this tachycardia was inducible and was ablated in the septal right ventricular outflow tract (RVOT). Two other tachycardias were identified both with right bundle branch block (RBBB) morphology raising the suspicion of diffuse pathology. Arrythmogenic right ventricular...
In the absence of comparative studies, recommended routine follow-up (FU) intervals for implantable cardioverter defibrillator (ICD) patients range from 1 to 6 months; most patients are followed at 3 month intervals.Six hundred and eighteen ICD patients were routinely seen 4 weeks after implant and then every 3 months. Unplanned visits (UPV) were either patient initiated or due to manufacturer recalls...
A 46-year-old male patient who had long-term right ventricular (RV) pacing for symptomatic complete heart block, initially by an epicardial, later with an endocardial pacing lead at the RV apex, developed congestive heart failure (CHF) and chronic atrial fibrillation 7 years following the pacemaker implantation and was medically treated. During follow-up, his pacemaker was upgraded to a cardiac resynchronisation...
Manufacturers of pacemakers (PM) and of magnetic resonance imaging (MRI) devices state that MRI scanning of PM wearers is contraindicated. This paper tries to summarise which effects can interfere with PM, what can be hazardous, and how treatment of PM in MRI can be modified to guarantee compatibility.All PM tested were from deceased patients. Reed contact thresholds and reactions were investigated...
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