Time trends in the intracardiac potential recorded by pacemaker telemetry: comparison between steroid-eluting small area electrodes.

We assessed the time course of electrograms sensed both in the atrium and ventricle by two different steroid-eluting electrodes: Medtronic Capsure SP (with an area of 5.5 mm2) and Z (with an area of 1.2 mm2).

[Silent myocardial infarction caused by acute carbon monoxide poisoning].

This report describes a 63 year-old man who suffered an acute myocardial infarction after carbon monoxide exposure. When evaluated in the Emergency Room the patient was completely conscious and did not experience any chest pain. The electrocardiogram showed non-specific T wave abnormalities in inferolateral leads.

Antiaggregating therapy in acute myocardial infarction.

The clinical benefit of aspirin in the acute phase of myocardial infarction is dramatically suggested by the results of the ISIS-2 trial. However, the time course of pathophysiological events that lead to such a determining involvement of platelets still appears uncertain and further study is needed to single out exactly how early and how long antiplatelet drugs should be given, since there is a risk of bleeding complications due to the combination of the different antithrombotic therapies. Thrombolytic agents and heparin are in fact widely used for patients with acute myocardial infarction, even if the optimal schedule of treatment, including anti-aggregating therapy, is not yet firmly established.

[Well's syndrome with eosinophilic vasculitis, coronary aneurysms and myocardial infarction].

This report describes a 40-year-old man suffering from Well's syndrome (recurrent granulomatous dermatitis with eosinophilia) who presented an anterior myocardial infarction complicated by shock and 3rd degree A-V block. The patient died within 12 hours of admission to the hospital. At autopsy, both main coronary arteries showed proximal aneurysms occluded by thrombi.

[Acoustic, mechanical and electric alternans in heart tamponade. Clinical case and review of the literature].

The uncommon observation of alternation of the first heart sound in intensity, associated with mechanical and electric alternans is reported in a patient with cardiac tamponade due to large hemorrhagic pericardial effusion. Following pericardiocentesis and removal of 400 millilitres of fluid, all alternation phenomena disappeared. The combination of three alternation phenomena may be a helpful physical diagnostic sign of cardiac tamponade.