[Cardiovascular complications of chemotherapy].

In the last decades, oncological therapy has changed the natural history of many types of cancer, which can now be considered curable or as chronic or slowly progressive diseases. It is well known that chemotherapy and radiotherapy may induce cardiotoxicity. Anthracyclines are among the most active antineoplastic agents, and their cardiac effects have been known for a long time.

[Does echocardiography have any role in selecting patients for cardiac resynchronization therapy?].

Cardiac resynchronization therapy (CRT) has an established role in the treatment of end-stage, drug-refractory heart failure patients. Large randomized controlled trials have demonstrated that CRT improves morbidity and mortality and, in current practice, there is a substantial number of patients treated with CRT for off-label indications. Nevertheless, a significant proportion of patients lack clinical and echocardiographic improvement or even deteriorate.

[Non-pharmacological therapy of decompensated heart failure: the extracorporeal ultrafiltration].

High-dose diuretic therapy frequently leads to diuretic resistance in patients with decompensated heart failure, through several pathophysiological mechanisms. Ultrafiltration is a non-pharmacological technique that is effective in reducing fluid overload, and nowadays it can be performed out of the hemodialysis unit, because of the availability of simplified tools. The ultrafiltrate production is obtained by an extracorporeal circuit with a filter inside.

Implantation of a permanent pacemaker in a pregnant woman under the guidance of electrophysiologic signals and transthoracic echocardiography.

We describe the case of a 30-year-old pregnant woman who underwent pacemaker implantation for recurrent syncope caused by sinus arrest. In order to minimize radiation exposure, which may potentially have teratogenic effects, we decided to perform pacemaker implantation by means of a hybrid technique involving the evaluation of electrophysiologic signals and transthoracic echocardiographic imaging to guide lead positioning within the right ventricle. After the procedure, the patient was always asymptomatic and had no recurrences of syncope.

Thromboembolic risk in atrial flutter. The FLASIEC (FLutter Atriale Società Italiana di Ecografia Cardiovascolare) multicentre study.

Aims: Patients with atrial flutter are believed to be at lower risk of thromboembolism than patients with atrial fibrillation. However, the incidence of atrial thrombi and the need for anticoagulation in patients with atrial flutter is not well established.

Methods And Results: A prospective observational multicentre study was undertaken to assess the frequency of atrial thrombi and spontaneous echocontrast and the prevalence for aortic complex atherosclerotic lesions in a cohort of unselected patients with atrial flutter.