Influence of advancing age on clinical presentation, treatment efficacy and safety, and long-term outcome of pre-excitation syndromes: a retrospective cohort study of 961 patients included over a 25-year period.

Objectives: There are very little data on pre-excitation syndrome (PS) in the elderly. We investigated the influence of advancing age on clinical presentation, treatment and long-term outcome of PS.

Setting: Single-centre retrospective study of patient files.

Rapid and low-cost method to prove the nature of no documented tachycardia in children and teenagers without pre-excitation syndrome.

Aims Symptoms in children are often difficult to interpret. The purpose of this study was to report the results of transoesophageal electrophysiological study (EPS) performed in children complaining of sudden onset tachycardia with normal non-invasive studies. Methods and results Eighty-two children and teenagers (mean age 15 +/- 3 years) presented with suspected but no documented paroxysmal supraventricular tachycardia (SVT).

[Transesophageal electrophysiological study in non sedated children younger than 11 years with a Wolff-Parkinson-White syndrome].

Unlabelled: The electrophysiological evaluation of Wolff-Parkinson-White syndrome (WPW) is recommended in children aged more than five years to detect a risk of life-threatening arrhythmia. The purposes of the study were to determine the feasibility of transesophageal EPS in a child between six and 10 years in out-patient clinic.

Methods: Electrophysiological study (EPS) was indicated in 22 children, aged six to 10 years, with a manifest WPW either for no documented tachycardia (n=7), unexplained dizziness (n=2) or for a sportive authorization in 10 asymptomatic children.

Antithrombotic therapy is associated with better survival in patients with severe heart failure and left ventricular systolic dysfunction (EPICAL study).

Background: In patients with congestive heart failure (CHF), clinical trials have demonstrated the benefit of a number of drugs on morbidity and mortality. Nevertheless so far, there is no published controlled study of long-term antithrombotic therapy in patients with CHF. The aim of this work was to identify the relationship between cardiovascular drug use, especially antithrombotic therapy, and survival of CHF patients in current clinical practice, using an observational, population-based database.

A simplified normalized ejection phase index measured by Doppler echocardiography for the assessment of left ventricular performance.

Although useful for the assessment of directional changes in contractility in individual patients, resting peak aortic blood velocity is of limited value for differentiating among patients with different levels of basal cardiac function. A dimensional analysis based on fluid dynamics shows that peak aortic blood velocity is not only generated by the contracting myocardium but also reflects the convective acceleration of blood from the left ventricle to the aorta. The reduction of cross-sectional area from the midleft ventricle to the aorta at the time of peak aortic blood velocity generates the convective acceleration.

A new Doppler method of assessing left ventricular ejection force in chronic congestive heart failure.

A noninvasive method using Doppler echocardiography was developed to determine the force exerted by the left ventricle in accelerating the blood into the aorta. The value of this new Doppler ejection index in the assessment of left ventricular (LV) performance was tested in 36 patients with chronic congestive heart disease undergoing cardiac catheterization and in 11 age-matched normal control subjects. The 36 patients were subgrouped into 3 groups based on angiographic ejection fraction (LV ejection fraction greater than 60, 41 to 60 and less than or equal to 40%).

Loss of efficacy of flecainide in the Wolff-Parkinson-White syndrome after isoproterenol administration.

Although anterograde conduction through a Kent bundle with a short refractory period was suppressed by 300 mg of flecainide acetate, the infusion of small amounts of isoproterenol caused the reappearance of WPW and permitted the induction of an atrial tachycardia with 1/1 conduction through the accessory pathway at a rate of 260 beats min-1. This case shows that the effect of isoproterenol may be maintained after apparently successful flecainide therapy.

[Value and limitations of pulsed Doppler echocardiography in the determination of pressure gradients in children].

The aim of this study was to evaluate the results of pulsed Doppler echocardiography in assessing pressure gradients in children despite the theoretical limitations of this technique in the measurement of high velocity blood flow (due mainly to the phenomenon of "aliasing"). 20 patients with an average age of 6.7 years (range 3 months to 19 years) were studied by 2D echocardiography and pulsed Doppler within 48 hours of cardiac catheterisation.

[Evaluation of the pulmonary artery and its branches by two-dimensional echocardiography in the tetralogy of Fallot and pulmonary atresia in infants. Angiocardiographic correlation and therapeutic implications].

Twenty-two infants aged 5 days to one year (mean: 3.8 months), consisting of 17 with tetralogy of Fallot and 5 with pulmonary atresia-ventricular septal defect, were prospectively investigated by two dimensional echocardiography (2 D echo) in order to evaluate the severity of the impairment of the pulmonary outflow tract and value of 2 D echo in the preoperative evaluation. Right pulmonary artery (PA), observed by angiography in 20 patients, was correctly recorded and could be measured in all cases (20/20), whereas the left PA was seen in 19 patients (19/20).

[Williams-Beuren facies with mental retardation and tetralogy of Fallot].

The "elfin facies", described by Williams and Beuren, is usually associated, beside mental retardation, with a supravalvular aortic stenosis and, more broadly, with multiple arterial stenoses. Other types of cardiac defects were described in this context, but the case reported by the authors is the first one with a tetralogy of Fallot. The hypothesis of widerspread histodysplastic lesions is discussed: the process may be early enough to alter the morphogenesis of the cardiac conus and to produce, more lately, the classical stenotic lesions of the arterial wall.