[Right ventricular mural endocarditis: description of a case].

We report the case of a 45-year-old man addicted to intravenous drug abuse who was admitted to our hospital for dyspnea, fever and chest pain. Chest X-ray showed diffuse right lung opacity and pleural effusion. Transthoracic echocardiography and contrast-enhanced cardiac magnetic resonance imaging revealed a plurilobated, highly mobile mass in the right ventricle originating from the moderator band near the apical trabeculae.

Metastatic tumor of the heart: description of a case.

We present the case of a 67-year-old man with a carcinoma of the lung and a metastatic tumor of the heart. The diagnosis was made on the basis of echocardiogram. In this patient, the first and unique cardiac symptom was irreversible sustained ventricular arrhythmia leading to death.

[When and how to treat ventricular ectopic beats].

Ventricular ectopic beats are commonly observed in daily clinical practice, either in symptomatic or asymptomatic subjects. In many subjects these arrhythmias are casually detected during a screening visit. Their occurrence is usually associated with no clinical significance.

Intraventricular conduction disturbances and paroxysmal atrioventricular block in a young patient with MELAS.

We present the case of a 36-year-old male patient with MELAS (mitochondrial encephalomyopathy, lactic acidosis and stroke-like episodes) who developed intraventricular conduction disturbances and syncopal episodes due to a paroxysmal atrioventricular block. This case suggests that in MELAS, as well as in other mithochondriopathies, intraventricular conduction disturbances and atrioventricular block can be features of the disease. In our case, progression toward atrioventricular block was rapid, suggesting that in MELAS patients presenting with worsening conduction system anomalies, pacemaker implantation has to be considered without delay, irrespective of age.

Glycaemic fall after a glucose load. A population-based study.

Background And Aims: A blood glucose (BG) fall after an oral glucose load has never been described previously at a population level. This study was aimed at looking for a plasma glucose trend after an oral glucose load for possible blood glucose fall if any, and for its impact on coronary mortality at a population level.

Methods And Results: In subjects from an unselected general population, BG and insulin were detected before and 1 and 2h after a 75-g oral glucose load for insulin sensitivity and β-cell function determination.

Persistent atrial fibrillation associated with syncope due to orthostatic hypotension: a case report.

A 40-year-old man was referred to our Cardiology Unit because of three syncopal episodes. The ECG showed atrial fibrillation with a mean heart rate of 104 bpm. The patient was unable to maintain the upright position because of marked orthostatic hypotension associated with bradycardia and presyncope.

Menopause does not affect blood pressure and risk profile, and menopausal women do not become similar to men.

Objective: Menopause is considered to be a cardiovascular risk factor, but this belief is based on opinions rather than on evidence. Confounding effects of age are often neglected.

Design: Population-based study with further subanalysis of case-to-case age-matched cohorts of men and fertile and menopausal women.

Electrocardiographic criteria of left ventricular hypertrophy in general population.

The question on whether the electrocardiographic criteria are reliable for detection of left ventricular hypertrophy (LVH) and play a role in predicting outcome is open. Answer can only proceed from population-based studies over unselected people followed up for years. In this study, 1,699 subjects from general population underwent echocardiogram and standard electrocardiogram (ECG) codified for LVH with Minnesota code and with other five methods.

Effects of the C825T polymorphism of the GNB3 gene on body adiposity and blood pressure in fertile and menopausal women: a population-based study.

Objectives: The 825T allele of the GNB3 gene is implicated in adipose distribution, predisposing to obesity and hypertension. Menopause is also considered a condition leading to excess adiposity and hypertension. The aim of the present study was to clarify whether the effects of menopause on body weight and blood pressure are influenced by the C825T polymorphism of the GNB3 gene.

Atrio-ventricular block during left atrial flutter ablation.

We present a case of a patient treated with catheter ablation for atrial fibrillation aiming to pulmonary veins isolation. During ablation, atrial fibrillation organized into a left atrial flutter. Electroanatomic and electrophysiologic mapping revealed the anterior left atrium area between the mitral annulus and left atrium septum as a critical region for flutter ablation.

Effect of body weight loss on blood pressure after 6 years of follow-up in stage 1 hypertension.

Background: Although it is known that weight reduction reduces blood pressure (BP) in overweight patients, the optimal body weight (BW) loss in terms of BP response is not yet established. We evaluated the relationship between decrease in BW and BP over time in 796 stage 1 hypertensives.

Methods: The 166 subjects who lost BW were divided into four groups according to percent of BW loss at the end of a 74-month follow-up (G1, >2% to 5%, G2, >5% to 9%, G3, >9% to 13%, and G4, >13%) and were compared to the 219 subjects without changes in BW (G0, -2% to +2%).

Heart rate as a predictor of development of sustained hypertension in subjects screened for stage 1 hypertension: the HARVEST Study.

Objective: Whether heart rate predicts the development of sustained hypertension in individuals with hypertension is not well known. We carried out a prospective study to investigate whether clinic and ambulatory heart rates assessed at baseline and changes in clinic heart rate during 6 months of follow-up were independent predictors of subsequent blood pressure (BP).

Methods: The study was conducted in a cohort of 1103 white, stage 1 hypertensive individuals from the HARVEST study, never treated for hypertension and followed-up for an average of 6.

Long-term outcome of patients with atrioventricular node reentrant tachycardia.

Background: Little information is available on the natural history of patients with AVNRT. The purpose of this study was to compare the outcome of patients with Atrioventricular node reentrant tachycardia (AVNRT) who underwent ablation with those on antiarrhythmic therapy and those not receiving drugs.

Methods: 93 consecutive patients (mean age=33.

Long term follow up of radiofrequency catheter ablation of atrial flutter: clinical course and predictors of atrial fibrillation occurrence.

Objectives: To evaluate the time to onset and the predictors of atrial fibrillation (AF) during long term follow up of patients with typical atrial flutter (AFL) treated with transisthmic ablation.

Design: Prospective multicentre study.

Methods And Results: 383 patients (75.

[Circumferential isolation of pulmonary veins with transcatheter radiofrequency ablation in the treatment of atrial fibrillation].

Background: Circumferential anatomical isolation of the pulmonary veins by radiofrequency transcatheter ablation is a new technique for the treatment of atrial fibrillation (AF). The aim of our study was to evaluate the efficacy and the safety of circumferential radiofrequency ablation of the pulmonary veins and to analyze clinical, echocardiographic and procedural parameters as possible predictors of clinical success.

Methods: We performed circumferential isolation of the pulmonary veins in 33 patients with paroxysmal (15 patients) or persistent AF (18 patients) refractory to at least two antiarrhythmic drugs.

Variables correlated with early relapses after external electrical cardioversion of persistent atrial fibrillation.

Background: The aim of this study was to identify the clinical and echocardiographic variables possibly correlated with the early relapses of atrial fibrillation (AF) after external electrical cardioversion (EC) in a large cohort of patients with persistent AF.

Methods: Two hundred patients (117 males, 83 females, mean age 67.9 +/- 8.

Electrophysiological demonstration of dissociation of pulmonary vein potentials through electroanatomically guided circumferential ablation.

A 57-year-old woman with frequent isolated and repetitive premature atrial contractions initiating paroxysmal atrial fibrillation, underwent electrophysiological study and catheter ablation. A real-time three-dimensional map of the left atrium was reconstructed using a nonfluoroscopic navigation system. By means of a deflectable decapolar catheter, the left superior pulmonary vein (PV) was identified as the arrhythmogenic vein, and PV potentials were found in the left inferior and right superior veins.

Radiofrequency ablation of atrioventricular nodal reentrant tachycardia: the risk of intraprocedural, late and long-term atrioventricular block. The Veneto Region multicenter experience.

Background: Radiofrequency ablation of either the fast or the slow pathway in atrioventricular nodal reentrant tachycardia (AVNRT) can be complicated by transient or permanent atrioventricular (AV) block. Little is known about the possibility of AV block occurring during the first weeks after the procedure and nothing about the risk of AV block during the long-term follow-up.

Methods: To clarify these latter points, from February 1990 to December 2000 we enrolled 510 consecutive patients (56 males, 454 females, mean age 55 +/- 16 years) with AVNRT.

Effects of verapamil and metoprolol on recovery from atrial electrical remodeling after cardioversion of long-lasting atrial fibrillation.

The aim of this prospective, randomized study was to investigate the effect of pretreatment with two different intracellular calcium-lowering drugs (verapamil and metoprolol) on recovery from atrial effective refractory period (AERP) shortening after internal electrical cardioversion (EC) of persistent atrial fibrillation (AF) in patients on amiodarone. Twenty-one patients on amiodarone for at least 30 days were referred to our hospital for internal EC of a persistent AF refractory to external EC. They were randomized to receive only amiodarone (group AMI, n=7), or amiodarone and verapamil 240 mg/day (group VER, n=7), or amiodarone and metoprolol 100 mg/day (group MET, n=7).

Success of serial external electrical cardioversion of persistent atrial fibrillation in maintaining sinus rhythm; a randomized study.

Aims: The aim of this prospective, randomized study was to determine the efficacy of a serial external electrical cardioversion strategy in maintaining sinus rhythm after 12 months in patients with recurrent persistent atrial fibrillation.

Methods And Results: Ninety patients with persistent atrial fibrillation lasting more than 72 h but less than 1 year were randomized in a one to one fashion to repetition of up to two electrical cardioversions in the event of relapse of atrial fibrillation detected within 1 month of the previous electrical cardioversion (Group AGG), or to non-treatment of atrial fibrillation relapse (Group CTL). ECGs were scheduled at 6 h, 7 days, and 1 month.

Electrophysiological properties of the atrioventricular node and ageing: evidence of a lower incidence of dual nodal pathways in the elderly.

Aims: The purpose of this study was to investigate the relationship between the incidence of dual atrioventricular (AV) nodal pathways and age. Age-related changes in the AV node electrophysiological properties have rarely been investigated. AV nodal re-entrant tachycardia is more frequent in the young than in the elderly.

The duration of atrial fibrillation influences the long-term efficacy of low-energy internal cardioversion.

Background: It is commonly held that long-lasting atrial fibrillation (AF), especially if associated with marked enlargement of the left atrium, is a negative predictive factor for both the recovery and the maintenance of sinus rhythm. The aim of the present study was to identify the clinical features of patients who have a greater likelihood of success both in the acute phase and, especially, in the medium-long term.

Methods: Since June 1997, we have performed low-energy internal cardioversion to 93 patients (66 males, 27 females, mean age 62 +/- 9 years, range 26-80 years) with a mean duration of AF of 922 +/- 1032 days.