Infra-Hisian block as cause of Wenckebach's phenomenon in an asymptomatic middle-aged man.

We report the case of a 60-year-old man with asymptomatic sinus bradycardia and Holter recording showing episodes of Wenckebach block alternating with episodes of 2:1 block. Electrophysiological testing revealed Infra-Hisian block with progressive prolongation of the H-V interval resulting in block after H potential. This produced typical Wenckebach-type block on surface electrocardiogram resembling the clinical one.

Acute beta-adrenoceptor blockade improves efficacy of ibutilide in conversion of atrial fibrillation with a rapid ventricular rate.

Aims: Activation of beta-adrenoceptors attenuates prolongation of action potential duration induced by blockade of the delayed rectifier potassium current. We examined whether acute administration of beta-blocker could enhance ibutilide (IB) efficacy in conversion of atrial fibrillation (AF) with a rapid ventricular rate.

Methods And Results: Ninety patients (aged 63 +/- 13.

The value of adenosine test in the diagnosis of sick sinus syndrome: susceptibility of sinus and atrioventricular node to adenosine in patients with sick sinus syndrome and unexplained syncope.

Aims: Patients (pts) with sick sinus syndrome (SSS) and unexplained syncope show increased susceptibility of sinus and atrioventricular node (AVN) to intravenous adenosine, respectively. Our aim is to assess the diagnostic value of adenosine test in pts with SSS, as well as to evaluate the response of AVN to adenosine either in pts with unexplained syncope or in pts with syncope and known SSS.

Methods And Results: The effect of adenosine administration on the sinus and AVN was studied in a population consisted of 19 pts with clinical SSS (group SSS), 7 pts with syncope of unknown origin (group SUO), and 12 control subjects (group C).

Brugada type electrocardiographic changes induced by concomitant use of lithium and propafenone in patient with Wolff-Parkinson-White syndrome.

We report a case of ST elevation in right precordial leads compatible with type 1 Brugada syndrome following administration of propafenone in a patient with Wolff-Parkinson-White syndrome who was receiving lithium at concentrations within therapeutic levels. The mechanism of the electrocardiogram changes was considered to be caused by the two drugs synergistic sodium channel blocking effects.

Trimetazidine administration minimizes myocardial damage and improves left ventricular function after percutaneous coronary intervention.

Background And Objective: The aim of this study was to evaluate whether the administration of trimetazidine, a piperazine derivative, to patients before and after percutaneous coronary intervention (PCI) minimizes the PCI-induced myocardial damage and improves left ventricular function 1 and 3 months after the procedure.

Methods: Fifty-two patients hospitalized for acute coronary syndromes (ACS) were included in this study. Patients were randomized into two groups: group A (trimetazidine group; n = 27) and group B (placebo group; n = 25).

The effect of two different doses comprising the simultaneous administration of intravenous B-complex vitamins and oral folic acid on serum homocysteine levels in hemodialysis patients.

Background: Several regimens using different doses of folic acid (FA) alone or supplemented with B-complex vitamins (BCVs) have been tested for their ability to reduce total homocysteine (tHcy) serum levels in hemodialysis (HD) patients. In the present study, we assessed the effect of two different doses comprising the simultaneous administration of intravenous (IV) BCVs and an oral FA supplementation on serum tHCy levels in HD patients.

Patients-methods: In a cohort of 49 patients (31 male, 18 female) undergoing chronic HD treatment for a mean of 40.

Uncommon cause of syncope in patient with bundle branch block and negative electrophysiological study.

We report a case study of a patient with bifascicular block, episodes of syncope, and negative electrophysiological study (EPS) who diagnosed to have sinus arrest with the help of an implantable loop recorder. This case emphasizes that atrioventricular (AV) block is not the only mechanism of syncope in patients with bundle branch block (BBB) and negative EPS.

Efficacy and safety of ibutilide for cardioversion of atrial flutter and fibrillation in patients receiving amiodarone or propafenone.

Aim: The effectiveness and safety of ibutilide (IB) use in patients receiving amiodarone or propafenone for atrial flutter (AFL) and atrial fibrillation (AF) were compared to IB alone.

Methods And Results: In 104 consecutive patients with AF (65%) or AFL (35%), receiving amiodarone (n = 46), propafenone (n = 30), or no specific antiarrhythmic drug (n = 28), IB was given for cardioversion. Fifteen patients in amiodarone group were loaded with 1.

Idiopathic right ventricular outflow tract tachycardia induced during acute episode of atrial fibrillation.

Tachycardia-induced tachycardia is a rare condition. We report a case in which an episode of paroxysmal atrial fibrillation led to right ventricular outflow tract tachycardia. We also analyse all potential mechanisms that might contribute to the coexistence of these two different arrhythmias in the same patient.

Sepsis severity is the major determinant of circulating thrombopoietin levels in septic patients.

Objective: To measure serum thrombopoietin levels and to investigate their relationship with platelet counts and other potential determinants in septic patients.

Design: Prospective study comparing septic patients and healthy volunteers.

Setting: General intensive care units in two tertiary university hospitals.

The effect of long-term intravenous high dose B-complex vitamins with or without folic acid on serum homocysteine in hemodialysis patients.

Background: Many regimens using different doses of folic acid (FA) alone or with supplementation of B-complex vitamins (BCV) have been tested for the reduction of total homocysteine (tHcy) levels in hemodialysis (HD) patients. BCV are usually administered orally and for a short period. In the present study, we assessed the effect of long-term intravenous (IV) BCV on serum tHCy levels in HD patients, and the effect produced by moderate oral supplementation with FA.