Management and prognosis of atrial fibrillation in diabetic patients: an EORP-AF General Pilot Registry report.

Aims: Diabetes mellitus (DM) is one of the most important cardiovascular risk factors. The aim of this study was to evaluate clinical correlates of DM, including management and outcomes, in the EURObservational Research Programme (EORP)-Atrial Fibrillation (AF) General Pilot (EORP-AF) Registry of the European Society of Cardiology.

Methods And Results: We studied consecutive patients (N = 3101) enrolled in 70 centres of nine European countries between February 2012 and March 2013, and compared diabetics with non-diabetics during a 1-year follow-up.

[Vest recorder used in diagnostics of occasionally occurring supraventricular tachycardia nearby sinus node - a case report].

Symptoms such as palpitations, fainting, dizziness and unexplained loss of consciousness are often notified by patients in clinical practice. Cardiological causes of these ailments could be various, inter alia, atriaventricular conduction disorders, supraventricular arrythmias or more life-threatening ventricular arrythmias. Diagnostics of these disorders includes a series of basic non-invasive research and more advanced specialistic methods.

Gender-dependent profile of heart rate turbulence parameters in patients after acute myocardial infarction treated invasively.

Background And Aim: The aim of this study was to determine whether gender is related to differences in heart rate turbulence (HRT) parameters and the authors' own predefined HRT categories comprising turbulence timing (TT) in patients at the early stage of acute myocardial infarction (AMI) treated invasively.

Methods: We analysed 489 consecutive patients (147 females and 342 males, aged 63.9 ± 11.

[Atrial fibrillation in patient with concealed Wolff-Parkinson-White syndrome].

We present a case of 33-year-old woman suffered from palpitations and syncope. ECG was normal at the rest and showed irregular tachycardia with wide QRS complex (HR > 300/min) during the effort. The patient was admitted to our department in order to perform detailed diagnostics and therapy.

[Electrical storm in patients with implantable cardioverter-defibrillator].

76 years old patient after the ICD implantation as a primary prevention of sudden cardiac death was admitted to the hospital because of the electrical storm which presented in ECG as a variety ventricular arrhythmia. Because of patients’ resistance for pharmacological treatment and antiarrhythmic therapies delivered from ICD, we performed an ablation and implemented the resynchronization therapy of the heart.

The significance of heart rate turbulence in predicting major cardiovascular events in patients after myocardial infarction treated invasively.

Introduction: The role of heart rate turbulence (HRT) related to baroreflex sensitivity in predicting mortality after myocardial infarction (MI) has been confirmed by several investigators. However, the significance of HRT in predicting major adverse cardiovascular events (MACE) following acute MI is unknown.

Purpose: To analyze the prognostic value of HRT and other independent risk factors associated with autonomic regulation of MACE.

Microvolt T-wave alternans and other noninvasive predictors of serious arrhythmic events in patients with an implanted cardioverter-defibrillator.

Background: Prediction of recurrent malignant ventricular tachyarrhythmias after insertion of a implantable cardioverter-defibrillator (ICD) is challenging. Microvolt T-wave alternans (MTWA) seems to be a promising marker of such events in ICD recipients.

Aim: To assess prognostic significance of MTWA and other noninvasive parameters in the prediction of major arrhythmic events after ICD implantation.

Heart rate turbulence for prediction of heart transplantation and mortality in chronic heart failure.

Background: Previous studies have shown conflicting results about the value of heart rate turbulence (HRT) for risk stratification of patients (pts) with chronic heart failure (CHF). We prospectively evaluated the relation between HRT and progression toward end-stage heart failure or all-cause mortality in patients with CHF.

Methods: HRT was assessed from 24-hour Holter recordings in 110 pts with CHF (54 in NYHA class II, 56 in class III-IV; left ventricular ejection fraction (LVEF) 30%+/- 10%) on optimal pharmacotherapy and quantified as turbulence onset (TO,%), turbulence slope (TS, ms/RR interval), and turbulence timing (beginning of RR sequence for calculation of TS, TT).

Effects of cardiac resynchronization therapy on heart rate turbulence.

Background: Cardiac resynchronization therapy (CRT) improves the clinical status of patients with heart failure (HF), though its effects on heart rate turbulence (HRT) are unknown.

Methods: We measured HRT indices in 58 recipients of CRT systems (mean age = 56 +/- 9 years, 41 men) in New York Heart Association HF functional class III-IV, and with a left ventricular (LV) ejection fraction < or =35%. At 6 months of follow-up, 42 patients were responders and 13 nonresponders to CRT, and three patients died suddenly.

Sleep apnoea as a predictor of mid- and long-term outcome in patients undergoing cardiac resynchronization therapy.

Aims: To assess the impact of baseline apnoea-hypopnoea index (AHI) on mid-term outcome and its change after 6 months of cardiac resynchronization therapy (CRT) on remote outcome.

Methods And Results: In 71 patients with CRT devices, Holter-derived AHI was assessed before and 6 months after the procedure. Baseline AHI >20 was considered abnormal.

Mid-term outcomes of triple-site vs. conventional cardiac resynchronization therapy: a preliminary study.

Background: The primary objectives of this study were to compare the implantation course of triple-site (double left-single right) and conventional cardiac resynchronization devices. The secondary target was to assess mid-term outcomes of both types of cardiac resynchronization therapy (CRT).

Methods: Fifty-four patients with NYHA classes III-IV, left ventricular EFor=120 ms were included; 27 received triple-site pacemakers (TRIV group), 27 conventional CRT devices (BIV group).

[Heart rate turbulence--a new predictor of sudden cardiac death].

Prevention of sudden cardiac deaths (SCD) is one of major challenges of todays cardiology. Factors, that would permit identification of patients with highest risk of SCD, have been sought for many years now. Although ventricle-dependent sinus arrhythmia has been observed for a few decades, quantification of this phenomenon was performed by Schmidt et al.

Triple-site biventricular pacing in patients undergoing cardiac resynchronization therapy: a feasibility study.

Aims: To evaluate implantation safety and efficiency of triple-site (double left-single right) cardiac resynchronization therapy (CRT) and to assess the outcome of this procedure.

Methods And Results: Twenty-six patients with New York Heart Association (NYHA) class III-IV, left ventricular ejection fraction (EF) < or = 35%, and QRS > or = 120 ms underwent triple-site CRT. Procedural course and complications were analysed.

Different types of renal dysfunction in patients with acute myocardial infarction treated with percutaneous coronary intervention.

Background: The prognostic significance of different types of renal dysfunction in patients with acute myocardial infarction (AMI) treated with percutaneous coronary intervention (PCI) has not been well characterized.

Methods: The single-center AMI registry encompassed 1,486 consecutive AMI patients treated with PCI, who were followed by mean 29.7 months.

Effect of percutaneous interventions within the coronary sinus on the success rate of the implantations of resynchronization pacemakers.

Background: Cardiac resynchronization therapy (CRT) becomes a "gold standard" in therapy of selected patients with advanced heart failure. We set out to evaluate the feasibility and safety of percutaneous interventions within coronary sinus (CS) and their effect on the success rate of left ventricular (LV) lead implantation during CRT.

Methods: The study analyzed eight consecutive patients with the indications for CRT, who needed additional procedures within CS to overcome technical problems during left ventricular (LV) electrode implantation.

Current developments in microvolt T-wave alternans.

Microvolt T-wave alternans (MTWA), the beat-to-beat fluctuation in T wave amplitude and morphology, is closely linked to vulnerability to ventricular arrhythmias in various experimental and clinical conditions. Clinically, MTWA is most commonly measured using the spectral method, although non-spectral methods for its assessment from ambulatory electrocardiographical recordings also have been developed. Recent studies suggest that the quantitative assessment of TWA may also be clinically relevant.

Methods of assessment and clinical relevance of QT dynamics.

The dependence on heart rate of the QT interval has been investigated for many years and several mathematical formulae have been proposed to describe the QT interval/heart rate (or QT interval/RR interval) relationship. While the most popular is Bazett's formula, it overcorrects the QT interval at high heart rates and under-corrects it at slow heart rates. This formulae and many others similar ones, do not accurately describe the natural behaviour of the QT interval.

[Holter monitoring in the prognosis of sudden cardiac death--new experiences and possibilities].

Sudden cardiac death is a great problem of nowadays. Patients suffer from coronary artery disease, myocarditis, dilated and hypertrophic cardiomyopathy, congenital and acquired heart diseases have a higher risk of sudden cardiac death. Holter monitoring allows to estimate the sudden cardiac death risk by risk factors analysis.

Effectiveness of radiofrequency catheter ablation of right ventricular outflow tract tachycardia using the CARTO system.

Background: Ventricular ectopy or ventricular tachycardia (VT) originating from the right ventricular outflow tract (RVOT) are the most common forms of arrhythmias in patients with structurally normal heart. Pharmacological treatment is effective in no more than 50% of patients, whereas radio-frequency catheter ablation (RFCA) offers a much higher success rate.

Aim: To assess early and late outcome in patients with RVOT arrhythmias treated with RFCA combined with electro-anatomical mapping system (CARTO).

Circadian and sex-dependent QT dynamics.

The dynamic QT relationship between the QT and RR intervals in normal individuals, including sex differences, has not been well examined. The aim of this Holter monitor-based study was to assess circadian and sex-related variations in QT dynamics in healthy subjects. The study population consisted of 50 healthy volunteers (mean age = 32 +/- 6 years, 25 men), in whom 24-hour digital Holter monitoring and QT interactive, beat-by-beat analyses were performed.

QT dynamics and the risk of sudden arrhythmic cardiac death in ischemic heart disease.

The relationship between altered QT dynamics and the risk of sudden arrhythmic death has not been established so far. This article describes the behavior of QT dynamics assessed in a patient with ischemic heart disease after two documented cardiac arrests due to sustained ventricular arrhythmia.

Heart rate variability in heart failure.

Background: Heart rate variability (HRV) depicts the functional status of the autonomic nervous system and its effects on sinus node. Recently, HRV analysis has been introduced in patients with heart failure (CHF) to identify those who are at risk of cardiac death.

Aim: To analyse HRV in patients with CHF with depressed left ventricular ejection fraction (EF) and to relate HRV parameters to EF, NYHA functional class and other clinical parameters.