No evidence of automatic atrial overdrive pacing efficacy on reduction of paroxysmal atrial fibrillation.

Aims: Paroxysmal atrial fibrillation (PAF) is frequently encountered in pacemaker patients, most commonly in sick sinus syndrome. The combination of site-specific pacing in conjunction with an overdrive algorithm combined with antiarrhythmic drugs on the incidence of PAF in patients with a conventional indication for pacing is unknown.

Methods And Results: Patients with pacemaker indication and PAF received a DDDR-pacemaker, which included an automatic atrial overdrive (AO) algorithm.

[Clinical case of the month. Left ventricular apical ballooning (Tako-Tsubo cardiomyopathy)].

A 80-year-old European woman was admitted for a cardiac syndrome which mimics acute coronary insufficiency, with apical akinesis and basal hyperkinesis. The first description of this syndrome (Tako-Tsubo cardiomyopathy) was reported in Japanese patients in the 90's. Recently this reversible left ventricular cardiomyopathy was also described in USA and Europe in white patients.

Presence and development of atrial fibrillation in chronic heart failure. Experiences from the MERIT-HF Study.

Background: Atrial fibrillation is common in heart failure, but data regarding beta-blockade in these patients and its ability to prevent new occurrence of atrial fibrillation are scarce.

Methods: Baseline ECGs in MERIT-HF were coded regarding baseline rhythm, and outcome was analyzed in relation to rhythm. Occurrence of atrial fibrillation during follow-up was also analyzed.

[Clinical case of the month. Triple valvular dysfunction associated with long-term ergotamine therapy].

We report the case of a 48-year-old woman who present a tricuspid, mitral and aortic regurgitation after long term ingestion of ergot alkaloids. Tricuspid and mitral fibrosis associated with retraction of the aortic leaflets are the causes of heart failure. Replacement of the three valves will be necessary.

The influence of concomitant drug therapy on the efficacy of atrial overdrive stimulation for prevention of atrial tachyarrhythmias.

Data from the completed "Suppression of Atrial Fibrillation by DDD+ Overdrive Pacing with Inos2 CLS (closed-loop system) Pacemakers" multicenter trial were retrospectively evaluated to examine the influence of concomitant antiarrhythmic drugs on the clinical success of conventional single site right atrial overdrive pacing compared with DDD pacing. The DDD+ overdrive algorithm provided > 90% atrial pacing at a rate slightly above the intrinsic atrial rate. Seventy-five patients with conventional pacing indications and paroxysmal, recurrent atrial tachyarrhythmia have completed the study.