Phantom arrhythmia: is it a clinical myth?

Artificial pacemakers and automatic implantable cardioverter-defibrillators are life-saving devices that generally improve patient quality of life. However, some patients report adverse effects such as anxiety, depression, and phantom shocks or, less often, phantom arrhythmia. The authors report the case of an 81-year-old woman who received a permanent artificial pacemaker and later described having rapid and irregular heartbeats and "pounding sounds," which were suggestive of arrhythmia.

Cardiovascular manifestations of substance abuse: part 2: alcohol, amphetamines, heroin, cannabis, and caffeine.

The abuse of alcohol is associated with chronic cardiomyopathy, hypertension, and arrhythmia. Abstinence or using alcohol in moderation can reverse these cardiovascular problems. Alcohol is also distinguished among the substances of abuse by having possible protective effects against coronary artery disease and stroke when used in moderate amounts.

Cardiovascular manifestations of substance abuse part 1: cocaine.

Substance abuse with cocaine is associated with multiple cardiovascular conditions, including myocardial infarction, dissection, left ventricular hypertrophy, arrhythmias, sudden death, and cardiomyopathy. Cocaine has effects to potentiate the physiologic actions of catecholamines and has direct effects on voltage-dependent sodium ion channels related to local anesthetic properties. The effects of cocaine can be augmented with concomitant alcohol consumption.

Smoking, Nicotine, Nicotine Replacement, and Cardiovascular Disease.

Cigarette smoking is a major risk factor for the development of coronary artery disease and its complications. Nicotine is one of the major substances that contributes to the pharmacologic activity of cigarette smoke, its toxicity, as well as its addictive nature. Strategies have been developed that utilize nicotine as a replacement substance in motivated patients who wish to stop smoking.