New diagnosis of arrhythmogenic right ventricular cardiomyopathy in an octogenarian with the help of Fontaine electrocardiographic leads.

We report an 85-year-old man with arrhythmogenic right ventricular cardiomyopathy who presented with monomorphic ventricular tachycardia. This is the oldest patient recorded with this disease. The presence of epsilon waves by the Fontaine lead system provided a high degree of suspicion for the disease.

Preferred QT correction formula for the assessment of drug-induced QT interval prolongation.

Introduction: There is debate on the optimal QT correction method to determine the degree of the drug-induced QT interval prolongation in relation to heart rate (DeltaQTc).

Methods: Forty-one patients (71 +/- 10 years) without significant heart disease who had baseline normal QT interval with narrow QRS complexes and had been implanted with dual-chamber pacemakers were subsequently started on antiarrhythmic drug therapy. The QTc formulas of Bazett, Fridericia, Framingham, Hodges, and Nomogram were applied to assess the effect of heart rate (baseline, atrial pacing at 60 beats/min, 80 beats/min, and 100 beats/min) on the derived DeltaQTc (QTc before and during antiarrhythmic therapy).

Heart rate-dependence of QTc intervals assessed by different correction methods in patients with normal or prolonged repolarization.

Background: There is a continuing debate about the optimal method for QT interval adjustment to heart rate changes. We evaluated the heart rate dependence of QTc intervals derived from five different QT correction methods.

Methods: Study patients (n = 123, age 68 +/- 11 years) were dual-chamber device recipients with baseline normal or prolonged QT interval who had preserved intrinsic ventricular activation with narrow QRS complexes.

Usefulness of rate regulation through continuous ventricular pacing in patients with drug-controlled slower atrial fibrillation and normal or depressed left ventricular systolic function.

We studied 33 clinically stable patients with permanent atrial fibrillation (AF), implanted with a ventricular demand rate-responsive (VVIR) pacemaker or an automatic defibrillator, in order to evaluate whether continuous right ventricular apex pacing (VP) conferring rate regulation may be advantageous when compared with slower drug-controlled AF. Devices were chronically programmed at ventricular backup pacing. Patients were divided in two groups according to their normal (n = 17) or depressed (n = 16) left ventricular systolic function (LVSF).

Short-coupled variant of Torsade de Pointes as a cause of electrical storm and aborted sudden cardiac death: insights into mechanism and treatment.

This case report describes a 50-year-old woman with normal repolarization duration who survived multiple electrical storms and cardiac arrest related to recurrent short-coupled torsade de pointes (TdP). Overdrive ventricular pacing could not prevent malignant TdP, but exposed a pause-related TdP initiation pattern. Isoproterenol and atrial pacing completely suppressed TdP, suggesting that ventricular pacing may entail vulnerability to this condition.

Unfavourable effects of continuous, atrial-synchronised ventricular pacing on ventricular systolic and diastolic function in patients with normal left ventricular ejection fraction: usefulness of tissue and colour Doppler echocardiography.

Introduction: Conventional, atrial-synchronised, right ventricular apical pacing (VP) may compromise ventricular function by causing ventricular desynchronisation. The aim of this study was to evaluate the long-term effects of VP on left and right ventricular systolic and diastolic function.

Methods: We studied 21 clinically stable dual-chamber pacemaker recipients (mean age 68 +/- 9 years) with normal left ventricular (LV) systolic function.

Permanent and atrial-synchronized ventricular stimulation for clinically stable patients with normal or impaired left ventricular systolic function.

Background: Ventricular desynchronization imposed by permanent dual-chamber ventricular pacing (VDD) may compromise ventricular function.

Methods: We investigated the impact of background VDD pacing on the right and left ventricular (LV) function on 129 clinically stable outpatients (mean age 69 +/- 10) implanted chronically with a dual-chamber pacemaker or an automatic defibrillator by using echocardiographic techniques including tissue doppler imaging (TDI) and color M-mode (CMM) examinations, and B-type natriuretic peptide (BNP) measurements. Patients were divided into two groups of normal (n = 65) or impaired (n = 64) LV systolic function (ejection fraction 63 +/- 6% and 38 +/- 10%, respectively) according to clinical and echocardiographic criteria.