Aortic Dissection With Cardiac Tamponade in Pregnancy: A Challenging Clinical Scenario.

Aortic dissection is the acute aortic syndrome with the highest mortality, and pregnancy and arterial hypertension are known risk factors. Its association with the perinatal period is a particularly unique and potentially devastating clinical catastrophe which is why the approach to a pregnant woman in cardiorespiratory arrest (CRA) should be multidisciplinary and early, with extraction of the fetus ideally within five minutes after the arrest. We present the case of a 39-year-old pregnant woman, who presented with a cardiorespiratory arrest in the context of an aortic dissection with cardiac tamponade and the need for an urgent perimortem cesarean section.

A good excuse for skipping the test: electrical storm in a teenager.

We describe the case of a teenager with a structurally normal heart that presented with and cardiac arrest. He had a history of epilepsy in childhood, mild cognitive impairment and cognitive visual dysfunction. The baseline electrocardiogram had prominent J waves and a marked early repolarization pattern in all the leads, with normal QT interval.

Efficacy And Safety Of Implantable Loop Recorder: Experience Of A Center.

Symptoms like syncope or palpitations frequently present a diagnostic challenge. An implantable loop recorder (ILR) is an important aid in the management of these patients. A retrospective study of patients that underwent ILR implantation from November 2007 to 2014.

Permanent pacemaker implantation using a femoral approach.

We describe two cases in which a permanent pacemaker was implanted via the femoral vein, because the cephalic and subclavian veins were not patent. The technique and its indications, advantages and potential complications are reviewed.

Thyroid storm and arrhythmic storm: a potentially fatal combination.

Thyroid storm is a rare clinical emergency with a mortality rate between 20% and 30%. Cardiac arrhythmias associated with thyrotoxicosis are usually supraventricular. Ventricular arrhythmias are rarely associated with this entity and tend to occur in patients with intrinsic cardiac disease.

Dilated cardiomyopathy and sinoatrial dysfunction in an Estrela mountain dog.

A 1 yr old male Estrela mountain dog was evaluated as a part of a screening program for dilated cardiomyopathy. The dog came from a family with a history of dilated cardiomyopathy but was asymptomatic. Occult dilated cardiomyopathy and sino-atrial dysfunction were diagnosed based on echocardiography and electrocardiography.

[Circumferential pulmonary vein isolation with the cryoballoon technique].

We present a clinical case on cryoballoon ablation of paroxysmal atrial fibrillation. This is a report of the first case performed at our center using this new technology.

Atrial fibrillation ablation using simultaneous multielectrode application of radiofrequeney energy.

Despite technological advances in equipment for ablation of atrial fibrillation (AF), conventional pulmonary vein (PV) isolation with point-by-point radiofrequency application encircling the PV ostia remains a complex procedure requiring a high degree of operator skill and experience. Novel multielectrode catheters have been developed that deliver duty-cycled bipolar and unipolar radiofrequency energy, designed for PV electrical isolation and for ablation of complex fractionated electrograms in the left atrium. Initial studies suggest good results, reducing procedure time and with safety and efficacy equivalent to the conventional method.

Coronary sinus pacing in a patient with a tricuspid prosthesis.

We present images of a permanent pacing lead implanted in the coronary sinus of a patient with a tricuspid prosthesis.

Ventricular tachycardia ablation in patients with coronary heart disease: beyond the reentry circuit.

Introduction: Patients with coronary heart disease and left ventricular dysfunction are at increased risk for the development of ventricular tachycardia (VT) related to areas of myocardial fibrosis. Although the mechanism and the circuit of this arrhythmia are well understood, little is known about the triggers that precipitate VT episodes. Purkinje fiber potentials may be responsible for idiopathic VT, and recent studies have related them to polymorphic VT and ventricular fibrillation.