Consecutive Eyeball Pressure Tests Reflect Clinically Relevant Vagal Dysfunction and Recovery in a Patient With Guillain-Barré-Syndrome With Tenacious Cardiac Dysautonomia.

Cardiac dysautonomia is a potentially life-threatening complication of Guillain-Barré syndrome (GBS). Proper and prompt recognition of patients at risk and subsequent intensive care unit (ICU) monitoring are mandatory to prevent fatal outcome. Eyeball pressure testing (EP) has been suggested as an easy applicable bedside test for vagal overreactivity in GBS and thus identifying patients at risk.

Mitral valve pressure gradient after percutaneous mitral valve repair: every beat counts.

A patient presented with symptoms of decompensated heart failure 2 months after percutaneous mitral valve (MV) repair. Echocardiography demonstrated impaired left ventricular function with elevated MV pressure gradients and pulmonary pressures during rapid atrial fibrillation. Heart rate control was achieved by implantation of a biventricular pacemaker with subsequent His-bundle ablation because atrial fibrillation was refractory to medical treatment.

ST-elevation during biventricular pacing.

Pacemakers devaluate the accuracy of the electrocardiogram (ECG) for the diagnosis of myocardial ischaemia. We present the case of a 53-year-old man with ischaemic cardiomyopathy and acute chest pain. Besides biventricular pacing, new ST-segment elevations were present leading to the diagnosis of myocardial infarction.

[Is intraoperative ICD-testing still necessary?].

Intraoperative ICD-testing is traditionally performed in many hospitals in order to ensure reliable sensing, detection, and defibrillation of induced ventricular fibrillation. The technical progress of defibrillators allows rapid detection and delivery of high energy shocks which defibrillates effectively in the vast majority all patients at implant. This review describes arguments pro and contra of systematic testing of the defibrillation threshold in all patients.