Changes in characteristics of hospitalized heart failure patients in ten years: a single-center study.

Background: Progress in therapy and the ageing patients hospitalized with heart failure may have impacted the characteristics of this patients.

Aims: We compared epidemiological data of patients admitted with heart failure during two periods separated by a 10 year interval.

Methods: Characteristics of 353 heart failure patients recruited between 2002 and 2004 with those of 304 heart failure patients recruited between 1992 and 1994 were compared retrospectively.

[Torsades de pointes caused by cetirizine overdose].

Several therapeutic substances can cause torsades de pointes, especially if they prolong the QT interval and/or if there is an associated hypokalaemia. Certain second generation H1 antihistamines have been incriminated in the occurrence of such ventricular arrhythmias, such as terfenadine and astezimole, which have been withdrawn. Cetirizine, widely used in the treatment of allergic reactions, is a second generation H1 antihistamine with as yet no precautions of use regarding rhythm disturbances.

Genetic polymorphisms and coronary artery disease in the south of France.

Vascular disease is a multifactorial disease that involves atherosclerotic and thrombotic factors. Genetic polymorphisms have been associated with myocardial infarction and angina pectoris. The aim of the present study was to assess the relationship between some genetic polymorphisms and myocardial infarction (MI) or vasospastic angina pectoris in a population from southern France.

[Paradoxical pulmonary embolism. A rare complication of arteriovenous fistulization of an aorto-iliac aneurysm].

Aneurysms of the infra-renal abdominal aorta or iliac arteries result in ilio-caval compression in about 10% of cases which may cause venous thrombosis by stasis and pulmonary embolism. Fistulisation of these aneurysms into the inferior vena cava or an iliac vein is rare and paradoxical pulmonary embolism from arterial thrombus of the aneurysmal pouch is exceptionally rare. The authors report a new case in which the ilio-iliac arteriovenous fistula caused high output cardiac failure, ischaemia of the homolateral leg and pulmonary embolism.

[Flecainide exercise induced left bundle branch with chest pain].

Ischaemia has been the suggested mechanism of simultaneous left bundle branch block and chest pain on effort with normal coronary angiography. This hypothesis is very controversial and was not the mechanism in the two new cases of this syndrome. The two patients in whom effort pain and left bundle branch block were observed had been treated for paroxysmal supraventricular tachycardia with flecaine.

[Atrioventricular block at nodal and infrahissian level during atrial tachycardia. Apropos of a case].

The authors report the case of a patient with atrial tachycardia and surface electrocardiographic signs of left anterior hemiblock and complete right bundle branch block with 10/3 atrioventricular block. The regularity of the RR intervals which were an exact multiple of the atrial cycle suggested the absence of a Wenckebach phenomenon. The sequence of atrioventricular conduction cannot be explained by classical models of intranodal conduction.

[Slow ventricular tachycardia caused by naftidrofuryl overdose (naftidrofuryl and ventricular tachycardia)].

Treatment with intravenous naftidrofuryl may be complicated by ventricular arrhythmias. A case of slow ventricular tachycardia occurring in a 65-year-old man with a dilated cardiomyopathy following an accidental overdose of naftidrofuryl (2 x 200 mg ampules in 250 ml of 5% glucose solution in 2 hours) prescribed for complicated arterial disease of the lower limbs is reported. This sustained ventricular tachycardia converted spontaneously after several hours.

[Adjustment of double-chamber pacemakers in VDD mode by measurement of thoracic electric bio-impedance].

An optimal atrioventricular interval (AVI) was sought in 6 patients with a double chamber pacemaker by an non-invasive technique: measurement of stroke volume by thoracic bioimpedance. This method proved to be easy and reliable in practice when there was only one pacing spike (VDD mode). It confirmed the existence of a variable optimal AVI according to individual patients: 250 ms (3 patients), 200-250 ms (1 patient), 150 ms (1 patient), 75-100 ms (1 patient).

[Pulmonary hypertension secondary to talc microemboli in a HIV seropositive heroin-addict woman].

Severe pulmonary hypertension presenting as acute cor pulmonare was observed in a HIV positive heroin addict. The usual aetiological investigations were negative. The apparently primary pulmonary hypertension was resistant oxygen and vasodilator therapy and was fatal in 6 months.

[Epidemiologic aspects of polyarterial pathology].

Unlabelled: With the considerable technical progress in vascular investigations made in the last decade, evaluation of multifocal ischemic pathology (MIP) has become easier and allows better assessment of strategy for reperfusion. In vascular surgery, 50% of post-operative mortality and morbidity are related to coronary heart disease (CHD). Epidemiologic data, not biased by specific recruitment of medical and surgical departments, are needed to assessing the real incidence of MIP.

[Urokinase recanalization of extensive thrombosis of the superior vena cava secondary to an implantable perfusion device].

A superior vena cava syndrome developed suddenly in a 36 year old man who had been undergoing chemotherapy via an implanted venous access catheter for 18 months. Venography showed superior vena cava thrombosis extending bilaterally to the subclavian veins. Direct local thrombolysis with low-dose Urokinase resulted in partial recanalisation with an excellent clinical result despite the persistence of an endovenous sequestrum situated at the catheter tip, a sequela of previous thrombosis.

[Atrioventricular block, a complication of radiotherapy of the mediastinum].

Cardiac complications of mediastinal irradiation usually concern the pericardium, the ventricular myocardium and the coronary arteries. We report the case of a 42-year old woman who experienced a syncopal atrioventricular (AV) block 12 years after irradiation of a mediastinal Hodgkin's lymphoma. Electrophysiological recordings showed infranodal conduction disturbances.

[Carcinoid cardiopathy: value of ultrasonography and MRI. Apropos of a case related to bronchial tumor. Review of the literature].

A case of carcinoid cardiopathy (C.C.) of the right heart, related to liver metastases secondary to a bronchial tumor, is reported.

Long-term follow-up of patients treated with VVI pacing and sequential pacing with special reference to VA retrograde conduction.

The aim of this prospective study is comparing long-term prognosis in patients implanted with a VVI pacemaker (group A) with those implanted with a sequential pacing device, AAI or DDD, (group B). Both groups of 45 patients each, were comparable as regards to age, sex, pacing indications, underlying heart disease, and technical conditions of implantation and were followed-up over 55 months. Atrial arrhythmias (A.

Long-term follow-up of atrioventricular junctional transcatheter electrical ablation.

Complete data concerning long-term results of transcatheter electrical ablation of the atrioventricular junction is not available. At the request of the French Cardiac Arrhythmia Working group we undertook an inquiry in October 1983. All centers potentially able to perform such procedures were asked to report their experience.

[Prevalence of arterial hypertension and its treatment in 2,595 adults].

The prevalence of arterial hypertension, as defined by the W.H.O.

Diaphragmatic origin of false atrial dissociation evidenced through intra-vascular recordings.

In a patient suffering from respiratory insufficiency, an atrial dissociation pattern was found in the surface ECG recording, having the appearance of ectopic P waves, independent from sinus P waves and followed by microfibrillation waves of 450 ms duration. No electrical activity corresponding to the presumed ectopic P waves could be recorded from left and right atria. Conversely, such activity was recorded from the inferior vena cava (IVC) 1.

[Polyarterial pathology. Epidemiological aspects].

Polyarterial arteriosclerosis is a problem facing more and more clinicians because of the technical advances in exploration and revascularization methods. Epidemiologic data are rare in this field except for Framingham's study. We are reporting here the results of a French epidemiologic study regarding a representative sample of a group of 11,000 active men and women, with age ranging between 25 and 65 years.

[Ischemic cardiopathies, environment and personality. Role of type A behavior].

Type A represents a type of behavior manifested by an almost constant pressure of time, a deep desire of social success and a considerable underlying hostility which is largely repressed. A critical study is presented in light of the results of two prospective epidemiological surveys. The evaluation methods (interview, questionnaires) are described and seem to offer a satisfactory concordance ratio.

[Angina accelerated under betablockers].

An observation of angina aggravated in a concomitant manner with the introduction of treatment with beta blockers is reported. The exacerbation of a vasospastic component with this treatment is evoked on clinical, electrical and coronarographic grounds.