Present criteria for prophylactic ICD implantation: Insights from the EU-CERT-ICD (Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators in EUrope) project.

Background: The clinical effectiveness of primary prevention implantable cardioverter defibrillator (ICD) therapy is under debate. It is urgently needed to better identify patients who benefit from prophylactic ICD therapy. The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators (EU-CERT-ICD) completed in 2019 will assess this issue.

Rationale and design of the EU-CERT-ICD prospective study: comparative effectiveness of prophylactic ICD implantation.

Aims: The clinical effectiveness of primary prevention implantable cardioverter defibrillator (ICD) therapy is under debate. The EUropean Comparative Effectiveness Research to Assess the Use of Primary ProphylacTic Implantable Cardioverter Defibrillators (EU-CERT-ICD) aims to assess its current clinical value.

Methods And Results: The EU-CERT-ICD is a prospective investigator-initiated non-randomized, controlled, multicentre observational cohort study performed in 44 centres across 15 European Union countries.

Who needs a permanent pacemaker after transcatheter aortic valve implantation?

Introduction: We aimed to identify predictive factors for pacemaker requirement and determine the rate of pacemaker dependency in a single centre patient group.

Methods And Reults: Out of 116 patients, who underwent transcatheter aortic valve implantation at our institution. Absence of atrial fibrillation at time of procedure, pulmonary hypertension, obesity and severity of aortic valve stenosis were predictive for the need of permanent pacemaker implantation after transcatheter aortic valve implantation.

The OPTI-MIND study: a prospective, observational study of pacemaker patients according to pacing modality and primary indications.

Aims: The OPTI-MIND study aims to collect 2-year clinical outcomes of pacemaker patients in real-world clinical practice, overall and according to patient characteristics and pacemaker settings.

Methods And Results: The present analysis of the OPTI-MIND study describes the programmed device settings after discharge from the pacemaker implant. The objective was to determine whether these settings fit recent guidelines for device-programmed physiological pacing based on the preservation of atrioventricular synchrony, avoiding unnecessary pacing, ensuring rate increase during exercise or preventing neurally mediated symptoms.

Prevalence of metabolic syndrome, insulin resistance, and microvascular angina pectoris in 500 consecutive patients referred to coronarography.

Objective: This work was aimed to evaluate the prevalence of insulin resistance (IR) and metabolic syndrome in a large cohort of 40-60 years old patients with cardiovascular symptoms.

Methods: A total of 500 consecutive males and females referred to coronarography and coronary catheterization, because of spontaneous or after load precordial pain plus denivelisation of ST segment by electrocardiography, were included. Besides standard clinical examinations, ergometry, echocardiography, fundamental laboratory tests, and several other laboratory examinations were also performed, including oral glucose toleration test (OGTT), total and high-density lipoprotein (HDL) cholesterol, triglycerides, apoprotein A1 and B, apolipoprotein (a), uric acid, fibrinogen, plasminogen activator inhibitor-1 (PAI-1), cytokines (tumor necrosis factor α, TNFα, interleukin-1, IL-1, interleukin-6, IL-6), endothelin-1, as well as hormones (insulin, C peptide, leptin, growth hormone, cortisol).

[Metastatic involvement of the heart and pericardium--MR case reports].

Secondary metastatic tumors of the heart and pericardium are in comparison with primary cardiac tumors more common, but their overall prognosis is very poor. Metastases can occur in every part of the heart and pericardium. The most common source are tumors--lung cancer, breast cancer, melanoma and lymphoma.

Case report of out-of-hospital heat dissipation of an implantable cardioverter-defibrillator.

The implantable cardioverter-defibrillator (ICD) has revolutionized the treatment of patients at risk of sudden cardiac death due to ventricular arrhythmias. Repeated studies have shown them to increase overall survival rates in patients with congestive heart failure or previous myocardial infarction and left ventricular dysfunction. We present a rare case of out-of-hospital ICD heat dissipation due to rapid battery discharge preceded by an audible popping noise.

[Management of ventricular tachycardia after acute myocardial infarct].

Background: Risk stratification of malignant ventricular tachyarrhythmias and sudden cardiac death after myocardial infarction is essentially important for high risk patients identification, who require specific therapeutic procedures. Non-invasive risk markers--LVEF, late potentials LP, Q-T dispersion, decreased heart rate variability (HRV) and baroreflex sensitivity (BRS)--and ventricular tachycardia inducibility have low positive predictive value. The appropriate combination and consecutiveness which will provide most precise identification of patients threatened by sudden arrhythmic death, applicable to all patients after myocardial infarction, is being analysed.

[Radiofrequency ablation of type I atrial flutter. Personal experience].

The cause of Afl-I is macroentry in the right atrium. The critical site of reentry is the narrow anatomical space in the isthmic region between the posterior part of the annulus of the tricuspid valve and the vena cava inferior (isthmus TA-IVC). Radiofrequency ablation (RF) of the isthmus TA-IVC is successful on average in 90% of patients.

[Risk factors and prevention of sudden cardiac death in patients with ventricular tachycardia after myocardial infarct].

Unlabelled: The optimal therapeutic procedure for prevention of sudden cardiac death (SCD) after myocardial infarction involves identification of the patients with a high risk of malignant ventricular arrhythmias using non-invasive risk markers, invasive electrophysiological evaluation of high risk patients, selection of treatment (ICD, RFTA, antiarrhythmics) and evaluation of the effectiveness of treatment. The objective of this work is retrospective evaluation of the incidence of risk markers of sudden cardiac death and the importance of programmed ventricular stimulation for the prognosis of patients with malignant ventricular arrhythmias after myocardial infarction.

Results: 1.

[The head-up tilt test with nitroglycerin provocation in the diagnosis of vasovagal syncope].

The study compares the diagnostical values of "head-up tilt" tests both with or without nitroglycerin the provocation. On the basis of the comparison of a group of 60 patients and 20 healthy people we can state that the "head-up tilt" test with the provocation by nitroglycerin is appropriate for the statement of diagnosis of the cardioinhibitory type of vasovagal syncopes. (Tab.

[Treatment of paroxysmal ventricular tachycardia].

The authors present a retrospective evaluation of the risk stratification and therapy of 53 patients with ventricular tachycardia. They present the diagnostical algorithm used for the detection of risk of sudden death. The most frequently used drug in the set of patients was amiodarone in monotherapy or in combination with other drugs.

[Dispersion of the Q-T interval after myocardial infarct].

Non-homogenity of ventricular myocardial repolarization is a substrate for the reentry mechanism of ventricular arrhythmias. It is manifestant by dispersion of Q-T and Q-Tc intervals on the standard ECG curve. The authors studied the possibility of using the dispersity of Q-T and Q-Tc intervals in clinical practice.

[Autonomic nervous system tests in the classification of patients at risk for sudden cardiac death].

The authors present an insight into the role of the nervous system in relation to the risk of sudden cardiac death. They present the basic diagnostic possibilities provided by examination of the autonomous nervous system, namely heart rate variability and baroreflex sensitivity. Reduced heart rate variability and the depression of baroreflex sensitivity represent independent risk markers of sudden heart death.

[Prevention of polymorphous ventricular tachycardia in patients with congenital long QT interval syndrome].

Patients with the Romano-Ward long QT interval syndrome run a high risk of sudden cardiac death. Beta-blockers of the sympathetic nerve are effective treatment. Some patients die suddenly despite this treatment.

[Microvascular angina pectoris and insulin resistance].

The authors examined 29 patients with the syndrome of microvascular angina pectoris. In 12 patients (41.4%) they recorded hyperinsulinaemia as a manifestation of insulin resistance.

[Corneal endothelium after radical keratotomy].

Corneal endothelium was examined in 37 patients with a contact endothelial specular microscope before and after radial keratotomy. The mean percent of cell loss was 0.9% one month and 2.

[Use of transconjunctival cryoapplication in chronic pars planitis with involvement of peripheral retina and choroid].

The transconjunctival cryoapplication was performed in 8 patients (13 eyes) with the recurrent pars planitis and the simultaneous involvement of peripheral retina and choroid. Before the surgery, the peripheral fundus of the eye was examined with the Goldmann three-mirror lens and afterwards, the cryoapplication of lesions was performed. The topical treatment, dexamethasone and indomethacin drops, followed the surgery only.

[Critical evaluation of the treatment of diabetic retinopathy based on personal experience].

The authors present the results of analysis of the treatment of 184 patients (360 eyes) with diabetic retinopathy; it comprises as well the out-patients as the in-patients divided into 4 groups in dependence on the changes and the treatment applied (laser focused photocoagulation, panretinal photocoagulation, cryopexy) the majority of patients reported to the hospital with an advanced proliferative diabetic retinopathy and this allowed only the performance of a panretinal photocoagulation and in a part of cases only cryopexy. The attention is called to the necessity of an early detection of pathological changes and of an early treatment.