Low-energy cardioversion of spontaneous atrial fibrillation. Immediate and long-term results.

Background: Recent studies have suggested that induced atrial fibrillation (AF) could be successfully terminated by using a two-catheter electrode system and low energy (< 400 V). This study evaluated the efficacy and safety of low-energy cardioversion in spontaneous chronic and paroxysmal AF.

Methods And Results: Forty-two consecutive patients with spontaneous AF underwent low-energy electrical cardioversion.

[Pharmacological treatment of ventricular tachycardia].

Pharmacological antiarrhythmic therapy is the treatment of first intention for the prevention of ventricular tachycardia (VT). In sustained VT, electrophysiological investigations without treatment enable the induction of VT, the demonstration of its reproducibility, the confirmation of diagnosis (if necessary), the determination of its mechanism and the choice of treatment. In an effort to standardise the technique, a minimum acceptable protocol of stimulations was agreed upon: at least 2 cycles (600 milliseconds and 400 milliseconds) and 3 extrastimuli (S2, S3, S4).

[Atrioventricular block at nodal and infrahissian level during atrial tachycardia. Apropos of a case].

The authors report the case of a patient with atrial tachycardia and surface electrocardiographic signs of left anterior hemiblock and complete right bundle branch block with 10/3 atrioventricular block. The regularity of the RR intervals which were an exact multiple of the atrial cycle suggested the absence of a Wenckebach phenomenon. The sequence of atrioventricular conduction cannot be explained by classical models of intranodal conduction.

[Pulmonary hypertension secondary to talc microemboli in a HIV seropositive heroin-addict woman].

Severe pulmonary hypertension presenting as acute cor pulmonare was observed in a HIV positive heroin addict. The usual aetiological investigations were negative. The apparently primary pulmonary hypertension was resistant oxygen and vasodilator therapy and was fatal in 6 months.

Endless-loop tachycardias: description and first clinical results of a new fully automatic protection algorithm.

Endless-loop tachycardia (ELT) is one of the most common pacemaker mediated tachycardia. An innovative ELT protection algorithm has proven to be clinically effective. A new improved version that will eliminate the need to program any parameter is now under clinical evaluation.

[Epidemiologic aspects of polyarterial pathology].

Unlabelled: With the considerable technical progress in vascular investigations made in the last decade, evaluation of multifocal ischemic pathology (MIP) has become easier and allows better assessment of strategy for reperfusion. In vascular surgery, 50% of post-operative mortality and morbidity are related to coronary heart disease (CHD). Epidemiologic data, not biased by specific recruitment of medical and surgical departments, are needed to assessing the real incidence of MIP.

[Urokinase recanalization of extensive thrombosis of the superior vena cava secondary to an implantable perfusion device].

A superior vena cava syndrome developed suddenly in a 36 year old man who had been undergoing chemotherapy via an implanted venous access catheter for 18 months. Venography showed superior vena cava thrombosis extending bilaterally to the subclavian veins. Direct local thrombolysis with low-dose Urokinase resulted in partial recanalisation with an excellent clinical result despite the persistence of an endovenous sequestrum situated at the catheter tip, a sequela of previous thrombosis.

[Atrioventricular block, a complication of radiotherapy of the mediastinum].

Cardiac complications of mediastinal irradiation usually concern the pericardium, the ventricular myocardium and the coronary arteries. We report the case of a 42-year old woman who experienced a syncopal atrioventricular (AV) block 12 years after irradiation of a mediastinal Hodgkin's lymphoma. Electrophysiological recordings showed infranodal conduction disturbances.

[Carcinoid cardiopathy: value of ultrasonography and MRI. Apropos of a case related to bronchial tumor. Review of the literature].

A case of carcinoid cardiopathy (C.C.) of the right heart, related to liver metastases secondary to a bronchial tumor, is reported.

Long-term follow-up of patients treated with VVI pacing and sequential pacing with special reference to VA retrograde conduction.

The aim of this prospective study is comparing long-term prognosis in patients implanted with a VVI pacemaker (group A) with those implanted with a sequential pacing device, AAI or DDD, (group B). Both groups of 45 patients each, were comparable as regards to age, sex, pacing indications, underlying heart disease, and technical conditions of implantation and were followed-up over 55 months. Atrial arrhythmias (A.

Diaphragmatic origin of false atrial dissociation evidenced through intra-vascular recordings.

In a patient suffering from respiratory insufficiency, an atrial dissociation pattern was found in the surface ECG recording, having the appearance of ectopic P waves, independent from sinus P waves and followed by microfibrillation waves of 450 ms duration. No electrical activity corresponding to the presumed ectopic P waves could be recorded from left and right atria. Conversely, such activity was recorded from the inferior vena cava (IVC) 1.

[Polyarterial pathology. Epidemiological aspects].

Polyarterial arteriosclerosis is a problem facing more and more clinicians because of the technical advances in exploration and revascularization methods. Epidemiologic data are rare in this field except for Framingham's study. We are reporting here the results of a French epidemiologic study regarding a representative sample of a group of 11,000 active men and women, with age ranging between 25 and 65 years.