Tako-Tsubo syndrome: an important differential diagnosis in patients with acute chest pain.

Background: The syndrome of Tako-Tsubo cardiomyopathy (TTC) is characterized by the occurrence of acute chest pain, electrocardiographic signs of ischemia, and transient balloon-like abnormalities in cardiac wall motion mostly involving the left ventricular apex. Significant obstructive coronary artery disease is absent. Owing to its clinical and imaging characteristics, TTC is frequently misdiagnosed as an acute coronary syndrome.

Optimization of initial energy for cardioversion of atrial tachyarrhythmias with biphasic shocks.

Objective: Recommendations for optimal first-shock energies with biphasic waveforms are conflicting. We evaluated prospectively the relation between type and duration of atrial tachyarrhythmias and the probability of successful cardioversion with a specific biphasic shock waveform to develop recommendations for the initial energy setting aiming at the lowest total cumulative energy with 2 or less consecutive shocks.

Methods: We analyzed 453 consecutive patients undergoing their first transthoracic electrical cardioversion, including 358 attempts for atrial fibrillation (AF) and 95 attempts for atrial flutter (AFL) or atrial tachycardia (AT).

Does early administration of selenium improve neurological outcome after cardiac arrest?

Objective: Existing data indicate that selenium supplementation may be beneficial in critically ill patients and in those with ischemic stroke. The purpose of this retrospective study was to explore the influence of early administration of selenium on neurological outcome after cardiopulmonary resuscitation (CPR).

Methods: We examined 227 consecutive unconscious patients after CPR and excluded 1 individual.

Prediction of neurological outcome after cardiopulmonary resuscitation by serial determination of serum neuron-specific enolase.

Aims: Data on the diagnostic accuracy of neuron-specific enolase (NSE) as marker of hypoxic brain damage are conflicting. The purpose of this prospective observational cohort study was to explore the prognostic value of serum NSE after cardiopulmonary resuscitation (CPR) and to define the most sensitive cutoff value with a specificity of 100% for the prediction of persistent coma.

Methods And Results: Serum NSE concentrations were serially determined in 227 consecutive unconscious patients after CPR who were classified according to the best Glasgow-Pittsburgh cerebral performance categories (CPC, 1-4) achieved within 6 months follow-up.

Flecainide versus ibutilide for immediate cardioversion of atrial fibrillation of recent onset.

Aims: This study compared the efficacy and safety of intravenous flecainide and ibutilide for immediate cardioversion of atrial fibrillation (AF).

Methods And Results: We conducted a prospective, randomised trial, including 207 patients with AF of recent onset (< or = 48 h). Flecainide was given over 20 min at a dose of 2 mg/kg body weight (maximum 200 mg), ibutilide was infused at a dose of 1 mg (or 0.