Potential benefit of optimizing atrioventricular & interventricular delays in patients with cardiac resynchronization therapy.

Background & Objectives: The clinical benefit of optimization (OPT) of atrioventricular delay (AVD) and interventricular delay (VVD) in cardiac resynchronization therapy (CRT) remains debatable. This study was aimed to determine the influence of AVD and VVD OPT on selected parameters in patients early after CRT implantation and at mid-term follow up (FU).

Methods: Fifty two patients (61±10 yr, 23 males) with left bundle branch block, left ventricular ejection fraction (LVEF) ≤35 per cent and heart failure were selected for CRT implantation.

Relationship Between Changes in Pulse Pressure and Frequency Domain Components of Heart Rate Variability During Short-Term Left Ventricular Pacing in Patients with Cardiac Resynchronization Therapy.

BACKGROUND The aim of the study was to explore the relationship between changes in pulse pressure (PP) and frequency domain heart rate variability (HRV) components caused by left ventricular pacing in patients with implanted cardiac resynchronization therapy (CRT). MATERIAL AND METHODS Forty patients (mean age 63±8.5 years) with chronic heart failure (CHF) and implanted CRT were enrolled in the study.

[Comparison of basic electrical features of ICD defibrillating leads implanted to right ventricular apex or right ventricular outflow track and septum].

Unlabelled: Automatic implantable cardioverter-defibrillators (ICDs) are nowadays an essential tool for reducing mortality due to sudden cardiac death. Technological advances in the miniaturization of devices and lead fixation, and the development of surgical techniques has led to more frequent implantation of the defibrillation leads outside the right ventricular apex (RVA), especially in those patients requiring cardiac pacing, as data from large clinical trials showed that chronic RVA pacing is harmful, especially in heart failure subjects, who are an important target for the ICD. Very few studies have been published comparing the electrical characteristics of leads placed in the RVA versus those implanted outside the RVA, mainly to right ventricular outflow tract of the heart (RVA), hence any subsequent analysis of this issue seems to be a valuable addition to the available information in this topic.

A new type of dual atrioventricular nodal nonreentrant tachycardia.

Dual atrioventricular nodal nonreentrant tachycardia (DAVNNT) is very rarely observed clinically. The first review of this arrhythmia was published in 2011 by Wang, where four types of DAVNNT were described. Our case report presents a phenomenon that has never been published before.

[Abnormal filter setting or Brugada syndrome?].

26-year old patient was admitted to our department with suspected Brugada syndrome (BrS). He complained of recurrent dizziness due to which he was taken by a team of rescuers to the district hospital, where the recorded ECG demonstrated isolated 3–7 mm ST segment elevation in leads V1–V3. Coronary angiography performed in this hospital was normal.

Noninvasive assessment of autonomic cardiovascular activity in patients with inappropriate sinus tachycardia.

Inappropriate sinus tachycardia (IST) is a clinical syndrome characterized by excessive resting heart rate (HR) or disproportional HR increase during exercise. The etiology of IST has not been fully elucidated and remains controversial. The aim of the present study was to assess autonomic function by means of noninvasive tests and commonly available electrocardiographic methods in a series of consecutive patients with symptomatic IST.

[Complete atrio-ventricular block as a first symptom of borreliosis: antibiotic treatment instead of pacemaker implantation].

We present a 46-year-old male patient with complete atrio-ventricular block. A inflammatory etiology was suspected and finally lyme carditis was diagnosed. The conduction abnormalities disappeared with antibiotic treatment and a pacemaker implantation was not needed.

Ivabradine in combination with metoprolol succinate in the treatment of inappropriate sinus tachycardia.

Background: Inappropriate sinus tachycardia (IST) is a clinical syndrome characterized by excessive resting heart rate (HR) or a disproportional increase in HR during exercise. β-blocker or calcium channel-blocker therapy is often noneffective or not well tolerated. The HR reduction on ivabradine is similar to β-blockers but in some patients its efficacy to resolve all IST-related symptoms is limited.

Ivabradine in the treatment of inappropriate sinus tachycardia in patients after successful radiofrequency catheter ablation of atrioventricular node slow pathway.

Background: Inappropriate sinus tachycardia (IST) occurs relatively common after catheter ablation of slow pathway in patients with atrioventricular nodal reentrant tachycardia. The treatment of IST symptoms using β-blockers or calcium channel-blockers are often noneffective or not well tolerated. Ivabradine is a new heart rate (HR)-decreasing agent inhibiting sinus node If current.

Metoprolol succinate vs. ivabradine in the treatment of inappropriate sinus tachycardia in patients unresponsive to previous pharmacological therapy.

Aims: Inappropriate sinus tachycardia (IST) is a clinical syndrome characterized by excessive resting heart rate (HR) or disproportional increasing HR during exercise. The treatment of IST symptoms using beta-blockers or calcium channel-blockers is often non-effective or not well tolerated. Ivabradine is a new agent inhibiting sinus node I(f) current, resulting in a decrease of HR without haemodynamic compromise.

Computer software tool for heart rate variability (HRV), T-wave alternans (TWA) and heart rate turbulence (HRT) analysis from ECGs.

Background: This paper presents a software package for quantitative evaluation of heart rate variability (HRV), heart rate turbulence (HRT), and T-wave alternans (TWA) from ECG recordings. The software has been developed for the purpose of scientific research rather than clinical diagnosis.

Material/methods: The software is written in Matlab Mathematical Language.

Clinical and electrocardiographic covariates of deceleration capacity in patients with ST-segment elevation myocardial infarction.

Background: Deceleration capacity (DC) is a novel electrocardiography (ECG) parameter characterizing the overall capacity of slowing down the heart rate. The aim of this study was to evaluate clinical and ECG covariates of DC in patients with the first episode of ST-segment elevation myocardial infarction (STEMI) treated with primary angioplasty.

Methods: Deceleration capacity, heart rate variability (HRV) and heart rate turbulence (HRT) were assessed from 24-hour ECG Holter recordings in 70 patients (66 male, mean age 57 years) with STEMI.

[Effect of spironolactone on mortality in patients with severe left ventricular dysfunction after acute myocardial infarction].

Background: Spironolactone--non-selective mineralocroticoid receptor blocker in patients with chronic heart failure reduces the risk of death. Its efficacy was not assessed in patients with postinfarction (post-MI) left ventricular dysfunction. The purpose of this study was to evaluate the effect of spironolactone on mortality in survivors of acute myocardial infarction with depressed ejection fraction < 30% (EF%) during a 24-month, long-term observation.

[Effect of low doses of metoprolol, bisoprolol and carvedilol on mortality in patients with left ventricular dysfunction after acute myocardial infarction].

Unlabelled: Beta-blocking agents (B-A) in patients with postinfarction left ventricular dysfunction or heart failure reduce the risk of death. Some patients do not tolerate high doses of medications which benefit was well documented in multicentre trials. The purpose of this study was to evaluate the effect of low dose of metoprolol, bisoprolol and carvediolol on mortality in postinfarction (post-MI) patients (pts) with depressed < or =35% left ventricular ejection fraction (EF) in 24-month observation.

[Effect of chronic therapy with low dose of angiotensin converting enzyme inhibitors on mortality in patients with left ventricular dysfunction after acute myocardial infarction].

Unlabelled: Angiotensin converting enzyme inhibitors (ACE-I) used in patients with postinfarction left ventricular dysfunction reduce the risk of death. Some patients do not tolerate high dose of medications which benefit was well documented in multicentre trials.

The Aim Of This Study: was to evaluate the effect of low doses of ACE-I on mortality rate in patients with ejection fraction (EF) below < or = 35% after acute myocardial infarction (MI) in long-term observation.

Usefulness of prolonged P-wave duration on signal averaged ECG in predicting atrial fibrillation in acute myocardial infarction patients.

Background: Atrial fibrillation (AF) is a frequent complication of acute myocardial infarction (AMI), with a reported incidence of 7-18%. The incidence of congestive heart failure, in-hospital mortality, and long-term mortality is higher in AMI patients with AF than in those without. P-wave duration (PWD) on Signal-Averaged ECG is a non-invasive marker of intra-atrial conduction disturbances, which are believed to be the main electrophysiological cause of AF.

Most ventricular depolarization and repolarization abnormalities are not predictors of arrhythmic events in postinfarction patients with normal intraventricular conduction.

Background: Survivors of acute myocardial infarction (AMI) are at increased risk for arrhythmic events (AE), which include sudden death (SD) or sustained ventricular tachycardia (sVT). In the prethrombolytic era, abnormal parameters of depolarization and repolarization were considered to be markers of susceptibility to these events. The purpose of the present study was to assess whether these variables should still be considered predictors of AE in postinfarction patients with normal intraventricular conduction.

P wave dispersion and P wave duration on SAECG in predicting atrial fibrillation in patients with acute myocardial infarction.

Background: Atrial fibrillation (AF) is a frequent complication of acute myocardial infarction (AMI), with reported incidence of 7% to 18%. The incidence of congestive heart failure, in-hospital mortality, and long-term mortality is higher in AMI patients with AF than in AMI patients without AF. P wave duration on signal-averaged ECG (PWD) and P wave dispersion on standard ECG (Pd) are noninvasive markers of intra-atrial conduction disturbances, which are believed to be the main electrophysiological cause of AF.

The impact of very late revascularization of occluded infarct-related artery on cardiac mortality and the incidence of sudden death in survivors of acute myocardial infarction - long-term observation.

Background: In survivors of acute myocardial infarction (AMI), an occluded infarct-related artery (IRA) is an important predictor of cardiac death (CD) and sudden death (SD). Early reperfusion of the IRA was associated with improved survival rate. The purpose of the present study was to assess if late IRA revascularization, performed 10-30 days after AMI, also has a beneficial effect on the incidence of CD and SD during an 18-month follow-up.