Exercise testing in the presence of complete heart block.

A 28-yr-old female presented for preoperative evaluation. The resting ECG revealed sinus arrhythmia with complete heart block with a junctional escape rhythm and a ventricular rate of 43 bpm. The patient was in no apparent distress, and resting blood pressure was 80/50 mm Hg.

Repetitive monomorphic ventricular tachycardia associated with exercise--a case report.

The case of a 45-year-old man suffering from a catecholamine-sensitive ventricular tachycardia originating from the right ventricular outflow tract is reported. The authors describe a novel noninvasive treatment strategy for the management of this patient.

Usefulness of P-wave morphology during submaximal treadmill exercise to predict coronary artery disease.

Standard electrocardiographic criteria for exercise testing require near maximal exertion and fail to detect ischemia in the presence of previous infarction or conduction or repolarization abnormalities, in women, or in the presence of certain drugs. Changes in P-wave morphology have been suggested as having diagnostic utility; however, no specific criteria exist, and it is not clear which changes are most useful. This investigation evaluated the ability to detect the presence of coronary artery disease by examining changes in P-wave morphology during exercise.

New-onset congestive heart failure secondary to a "huge" right atrial mass--a case report.

Transesophageal echocardiography is a useful adjunct to other diagnostic modalities in uncovering the etiology of congestive heart failure. The authors describe the case of a 75-year-old woman with a 4-week history of progressive congestive heart failure, in whom transesophageal echocardiography played a critical role in the diagnosis of a right atrial mass, accounting for this patient's constellation of symptoms.

Correction of AV-nodal block in a 27-year-old man with severe obstructive sleep apnea--a case report.

A 27-year-old morbidly obese man diagnosed with severe obstructive sleep apnea (OSA) and experiencing significant ventricular asystoles at times exceeding 8 seconds, during polysomnography. The bradyarrhythmias were successfully corrected with the application of a nasal continuous positive airway pressure (CPAP) mask. Follow-up 24-hour ambulatory Holter monitoring without the aid of a nasal CPAP mask and repeat polysomnography with a CPAP mask after several weeks of continuous CPAP therapy during sleep revealed no evidence of ventricular asystole, despite no change in the patient's body mass index.

Amiodarone-induced torsade de pointes during bladder irrigation: an unusual presentation--a case report.

The authors present a case of early (within 4 days) development of torsade de pointes (TdP) associated with oral amiodarone therapy. Consistent with other reports this case of TdP occurred in the context of multiple exacerbating factors including hypokalemia and digoxin excess. Transient prolongation of the QT during bladder irrigation prompted the episode of TdP.