[Predictors of efficacy initial low energy of external rectilinear biphasic cardioversion in persistent atrial fibrillation].

Unlabelled: Rectilinear biphasic cardioversion (Bi-DC) has been shown to be very effective for restoration of sinus rhythm in patients with persistent atrial fibrillation (AF). There is, however, limited information on factors influencing effectiveness of the initial energy of 50 J for Bi-DC of atrial fibrillation.

Aim Of The Study: Evaluation of efficacy of 50 J shock of Bi-DC for restoration sinus rhythm and development of point score system to predict high conversion rate of 50 J shock in persistent atrial fibrillation.

A simple point score system for predicting the efficacy of external rectilinear biphasic cardioversion for persistent atrial fibrillation.

Aims: To develop a simple point score system that can accurately predict the optimal energy of initial rectilinear biphasic (RLB) waveform shock for cardioversion (DC) of persistent atrial fibrillation (AF).

Methods And Results: Data from 302 consecutive patients with AF who underwent a step-up protocol of sequential shocks of 50 J-from 1 up to 2 J/kg-200 J of RLB waveform DC were prospectively examined. Using a logistic regression model, three variables independently predicted the need for 2 J/kg shocks: AF duration > 7 months, previous DC, and increased left atrial (LA) diameter > 4.

Low serum triiodothyronine in acute myocardial infarction indicates major heart injury.

Aims: In patients with acute myocardial infarction (MI), low serum triiodothyronine (T3) concentration is commonly associated with a severe clinical course. The aim of this prospective study was to investigate whether a severe clinical course in patients with low T3 is related to the magnitude of myocardial injury assessed by echocardiography.

Methods And Results: Out of 635 patients with MI we enrolled 100 consecutive patients.

Lipid profile during the first 24 hours after myocardial infarction has significant prognostic value.

Aims: A high level of total cholesterol and LDL-cholesterol disturbs the endothelial function. Thus it can be expected, that hypercholesterolaemia may unfavourably influence the course of the acute myocardial infarction. The aim of the study was to check whether patients with lipid levels above normal during the first hours of myocardial infarction have an unfavourable clinical outcome.

Is preinfarction angina associated with better outcome after myocardial infarction?

Background: In a clinical setting of acute myocardial infarction (MI), short-lasting and transient anginal pain, preceding the development of acute MI, is regarded as a symptom representing ischaemic preconditioning. Some experimental and clinical data suggested that preinfarction angina may favourably influence the course of acute MI.

Aim: We sought to examine the hypothesis that preinfarction angina occurring within 24 hours prior to the onset of acute MI favourably influences the outcome.

Is chest pain still the most important symptom of acute coronary syndrome?

Background: Acute coronary syndrome (ACS) carries the risk of death due to electrical or haemodynamical disturbances. Thus, rapid in-hospital treatment is necessary. To achieve this, a patient, his family and his physician should correctly diagnose ACS, based mainly on clinical symptoms.