Multiple coronary micro-aneurysm formation after drug-eluting stent implantation.

Although there are limited data regarding the formation of coronary artery aneurysms (CAAs) after drug-eluting stent (DES) implantation, CAAs appear to be a rare complication of coronary stenting. The exact mechanism of CAA formation is unknown, but several hypotheses have been proposed. As the use of DES increases, the clinical significance of these findings will become clearer.

Marked troponin elevation after implantation of a permanent antibradycardia pacemaker.

Introduction: Transvenous insertion of endocardial leads for permanent pacing is often accompanied by minor myocardial damage, detected thanks to the high sensitivity of cardiac troponins. It is unknown whether higher troponin levels, commensurate with more severe myocardial damage, can be encountered after implantation procedures.

Methods: Over a 3-year period, 283 patients underwent an implantation of a full antibradycardia pacemaker system (pulse generator plus leads).

Effect of high doses of magnesium on converting ibutilide to a safe and more effective agent.

Ibutilide is a class III antiarrhythmic agent indicated for cardioversion of atrial fibrillation and atrial flutter to sinus rhythm (SR). The most serious complication of ibutilide is torsades de pointes (TdP). Magnesium has been successfully used for the treatment of TdP, but its use as a prophylactic agent for this arrhythmia has not yet been established.

Biochemical evidence of cardiac damage following transvenous implantation of a permanent antibradycardia pacemaker lead.

Objectives: We tested the hypothesis that transvenous permanent pacemaker lead implantation causes clinically detectable myocardial damage.

Background: Histological evidence of myocardial damage has been reported after antibradycardia pacemaker lead implantation.

Methods: We studied 30 patients undergoing implantation of a full antibradycardia pacemaker system (pulse generator plus leads) and 10 patients in whom only a generator was implanted.

Early brain natriuretic peptide increase reflects acute myocardial ischemia in patients with ongoing chest pain.

Background: Plasma brain natriuretic peptide levels increase during acute ischemic events. In this study we tested the diagnostic performance of brain natriuretic peptide measurements in the detection of acute myocardial ischemia.

Methods: Blood brain natriuretic peptide was measured in 101 patients with ongoing chest pain but no heart failure or an ST-segment elevation myocardial infarction on arrival at the emergency department (baseline) and at 2 and 6 h later.

Adenosine stress myocardial perfusion tomographic imaging in patients with significant aortic stenosis.

Background: Myocardial perfusion scintigraphy has been used by some investigators for the diagnosis of coronary artery disease (CAD) in patients with mild, moderate, and moderate to severe aortic stenosis, with various results. The aim of this study was to assess the safety and diagnostic accuracy of adenosine stress myocardial perfusion scintigraphy (adenosine single photon emission computed tomography [Ad-SPECT]) for the detection of CAD in patients with significant aortic stenosis.

Methods And Result: The study included 75 patients with significant aortic stenosis (maximal instantaneous aortic valve gradient >80 mm Hg [range, 81-149 mm Hg] and aortic valve area <0.