Atrial fibrillation recurrence after drug-induced typical atrial flutter ablation.

Background: Catheter ablation of typical atrial flutter (AFL) occurring in patients who take antiarrhythmic drugs for atrial fibrillation (AF) has been proposed as a curative approach for AF. The aim of this study was to evaluate the efficacy of this technique.

Methods: Forty-six consecutive patients (30 males, 16 females, mean age 67 +/- 9 years) with paroxysmal or persistent AF were submitted to right atrial isthmus ablation: 1) 33 patients (group 1) in whom typical AFL spontaneously occurred during oral treatment with propafenone (n = 19), flecainide (n = 9) or amiodarone (n = 6); 2) 13 patients (group 2) submitted to electrophysiological study while taking oral propafenone (n = 3), flecainide (n = 8) or amiodarone (n = 1), in whom sustained AFL was induced (n = 9) or AF was induced and AFL was obtained by intravenous administration of class IC drugs (n = 4).

Proximal internal mammary in situ graft and distal coronary-coronary graft.

When a left anterior descending coronary artery passes over the cardiac apex and presents with 2 stenoses, 1 proximal and 1 distal, the available bypass conduit often is too short to enable both the anastomosis below the distal stenosis and the sequential anastomosis on the arterial segment between the 2 stenoses. In this circumstance, we graft the internal mammary artery in situ onto the proximal segment of the left anterior descending coronary artery, then use a short residual segment of the internal mammary to perform a coronary-coronary bypass of the distal stenosis. This technique also spares segments of the internal mammary for other purposes.

Direct comparison of early elevations of cardiac troponin T and I in patients with clinical unstable angina.

Background: The aim of this study was to compare the prognostic efficacy of cardiac troponin T (cTnT) and I (cTnI) in patients with clinical unstable angina.

Methods: We studied 74 patients with chest pain at rest, electrocardiographic evidence of myocardial ischemia, and normal (<6.7 ng/mL) values of creatine kinase-MB.

Prognostic influence of elevated values of cardiac troponin I in patients with unstable angina.

Background: Elevations of the MB isoform of creatine kinase (CK) and cardiac troponin T seem to confer an adverse prognosis in unstable angina. We examined whether this prognostic influence is also present for cardiac troponin I (cTnI), a new and even more specific marker of myocardial injury.

Methods And Results: We studied 106 patients with the clinical diagnosis of unstable angina showing chest discomfort at rest within 48 hours of admission, ECG evidence of myocardial ischemia, and normal values of total CK over the initial 16 hours of observation.

The importance of antibody specificity in measuring cross-linked fibrin degradation products by ELISA.

We and others have previously shown that plasma concentrations of XL-FDPs are accurately characterized with an enzyme-linked immunosorbent assay (ELISA) based on the monoclonal antibody DD-3B6/22, which is specific for D-dimer, and a pan-specific tag antibody (DD-4D2/182) in patients with thrombotic disorders. However, in patients treated with fibrinolytic agents, increases in non-cross-linked fibrin(ogen) degradation products are detected by the pan-specific tag antibody due to formation of complexes between non-cross-linked derivatives and XL-FDPs. Assays based on the use of fibrin degradation product-specific tag antibodies appear to be more specific, but whether they would be clinically more informative is unclear.