An unusual case of iatrogenic Twiddler's syndrome.

: Twiddler's syndrome is an uncommon cause of cardiac implantable electronic device malfunction, usually due to manipulation of the pulse generator. A few spontaneous cases have already been described. We present the unique case of a 77-year-old woman who experienced iatrogenic Twiddler's syndrome.

A novel methodology for AV and VV delay optimization in CRT: results from a randomized pilot clinical trial.

The aim of this work was to determine whether the use of a newly developed methodology (Alg1) for AV and VV optimization improves cardiac resynchronization therapy (CRT) clinical and echocardiographic (ECHO) outcomes. In this single-center pilot clinical trial, 80 consecutive patients (79 % male; 70.1 ± 11.

Work burden with remote monitoring of implantable cardioverter defibrillator: is it time for reimbursement policies?

Aims: The efficacy and accuracy, as well as patients' satisfaction, of device remote monitoring are well demonstrated. However, the workload of remote monitoring management has not been estimated and reimbursement schemes are currently unavailable in most European countries. This study evaluates the workload associated with remote monitoring systems.

Predictive value of fragmented QRS in primary prevention implantable cardioverter defibrillator recipients with left ventricular dysfunction.

Introduction: In primary prevention implantable cardioverter defibrillator (ICD) patients, the incidence of appropriate ICD therapy is relatively low, prompting better risk stratification. Fragmented QRS (fQRS) on a 12-lead ECG has been associated with adverse outcomes. The aim of this study was to evaluate the prognostic value of fQRS in ICD recipients.

Safety and efficacy of a new magnetic resonance imaging-compatible pacing system: early results of a prospective comparison with conventional dual-chamber implant outcomes.

Background: A new pacing system has been designed and tested preclinically for safe use in the magnetic resonance imaging (MRI) environment. Experience with this innovative system has not yet been reported.

Objective: The purpose of this study was to verify the safety and effectiveness of this newly designed system compared to conventional DDD implant outcomes.

Prevalence and significance of Brugada-type ECG in 12,012 apparently healthy European subjects.

Background: The prevalence of the Brugada-type ECG and its natural history are still unclear. The recently proposed diagnostic criteria have not been systematically applied in a European general population.

Methods: We retrospectively analyzed ECGs and clinical data of 12,012 apparently healthy individuals who had undergone medical examination for occupational reasons.

Appropriateness of ECG Holter requests in an outpatient service: a prospective study.

Background: Electrocardiographic ambulatory ECG monitoring plays a central role in the diagnostic evaluation of patients with cardiac arrhythmias. We sought to evaluate the appropriateness of the prescription of ECG Holter recordings performed at our centre.

Methods: We interviewed 2489 consecutive patients (49% male, aged 61 +/- 32 years) undergoing ECG Holter.

Feasibility and safety of a simplified draping method for pacing procedures.

Aims: Traditional draping for pacing procedures is time-consuming. We evaluated prospectively the safety of a simplified method using a single adhesive drape intended for use in cardiac catheterization.

Methods And Results: A single disposable adhesive drape was used in each of 250 consecutive pacing procedures by the same operator including 200 device implants and 50 revision procedures.

Coronary spasm: a case of transient ST elevation and syncopal ventricular tachycardia without angina.

We report the case of a 60-year-old male with recurrent pre-syncope, referred with a provisional diagnosis of carotid sinus syndrome on the basis of a 4 s asystolic pause following carotid sinus massage. On repeat Holter monitoring there was ST-segment elevation followed by episodes of polymorphic ventricular tachycardia during a mild episode of pre-syncope. Coronary angiography showed mild right coronary artery irregularity without significant stenosis.

Distribution and prognostic significance of QT intervals in the lowest half centile in 12,012 apparently healthy persons.

The presence of an abnormally short QT interval has been noted among survivors of idiopathic ventricular fibrillation and among close relatives of victims of unexplained sudden death. Most reported cases have had rate-corrected QT (QTc) intervals of <300 ms. The prevalence of such values in the community has not been documented.

Effects of carbon-coated coronary stents on the markers of inflammation, thrombin generation and platelet and endothelial activation.

Background: The effects of stent carbon coating on the activation of inflammatory and endothelial cells and of coagulation were assessed in patients undergoing coronary artery stent implantation.

Methods: Forty-four consecutive patients with stable angina and an isolated significant stenosis in a native coronary vessel undergoing stent implantation were randomized to a carbon-coated stent (Carbostent, n = 23) or an uncoated stent with a similar design (Multilink, n = 21). The markers of inflammation, of hemostasis and of platelet and endothelial activation were determined before and 6, 24, 48 and 72 hours after the procedure.