Prospective screening of 5,615 high school athletes for risk of sudden cardiac death.

Sudden cardiac death among high school athletes is a very infrequent though tragic occurrence. Despite widespread preparticipation screening for known causes of this event, the frequency has not changed. The ECG is an acknowledged sensitive screening tool for the common causes of sudden cardiac death in young athletes.

Atrial sensing performance of the single-lead VDD pacemaker during exercise.

Objectives: The purpose of this study was to examine the atrial sensing performance of the single-lead VDD pacing system during exercise and concomitant changes in the amplitude of the atrial electrogram.

Background: Studies of conventional dual-chamber pacing have demonstrated an overall reduction in the atrial signal amplitude and a variable incidence of atrial undersensing during vigorous exercise.

Methods: The telemetered atrial electrogram and simultaneous surface electrocardiogram (ECG) were continuously recorded in 12 patients (mean age 70.

Hemodynamic response to intravenous enalaprilat in patients with severe congestive heart failure and mitral regurgitation.

The hemodynamic response 1 hour after 1.25 mg of intravenous (IV) enalaprilat was examined in 20 patients (mean age 75 years) with severe congestive heart failure (CHF) and mitral regurgitation (MR), secondary to ischemic heart disease (NYHA Class IV). Patients were classified into two groups based upon the magnitude of MR as derived from Doppler color flow imaging: Group I (n = 13) had severe MR and Group II (n = 7) had moderate MR.

Multifocal atrial arrhythmia--a frequent misdiagnosis? A correlative study using the computerized ECG.

All computerized ECGs taken over a 17-week study period were reviewed for the detection of multifocal atrial arrhythmia (MAA)--tachycardia or rhythm--and correlated with the diagnostic statement of the ECG computer system. MAA was identified by the authors in 96 of 11,610 (0.8%) computerized ECGs.

The RSR' complex not related to right bundle branch block: diagnostic value as a sign of myocardial infarction scar.

An abnormal electrocardiographic (ECG) wave pattern--the RSR' complex--associated with a wide QRS (greater than or equal to 110 msec), unrelated to right bundle branch block (RBBB) or left bundle branch block (LBBB) was identified in 26 patients with old myocardial infarction. Patients were assigned to three groups: in group I (n = 13) the RSR' was present in the precordial leads; in group II (n = 9) the RSR' was present in the inferior limb leads; and in group III (n = 4) the RSR' was present in both. For each patient a severe segmental wall motion abnormality (akinetic in 16 and dyskinetic in 10 patients) consistent with myocardial infarction scar tissue was detected using the equilibrium radionuclide angiocardiogram (n = 24) and the two-dimensional echocardiogram (n = 2).

Pulmonary artery sarcoma: another cause of sudden death.

A patient hospitalized for recurrent syncope and dyspnea died suddenly before a definite clinical diagnosis could be established. At autopsy a large sarcomatous mass (undifferentiated type) was found to arise and totally occlude the pulmonary trunk without evidence of distant metastasis.