Successful surgical removal of long-term implantable cardioverter defibrillator lead infection caused by methicillin-resistant in patients with dilated cardiomyopathy.

The patient was a 67-year-old male who received implantable cardioverter defibrillator (ICD) due to dilated cardiomyopathy and ventricular tachycardia 10 years previously. In September 2007, he was admitted to our hospital for dilated cardiomyopathy accompanied by congestive heart failure. Since he suffered from pneumonia and respiratory insufficiency, he was treated with steroid, long-term artificial respirator, and central venous catheter placement.

Listeria endocarditis with acute thoracoabdominal aortic dissection.

The patient was 71-year-old male under treatment at a clinic for hypertension, aortic regurgitation, alcoholic hepatitis and dental treatment. He mainly complained fever and anorexia. Since blood culture examination revealed Listeria monocytogenes and echocardiography exhibited vegetation at the mitral leaflet, the patient was diagnosed as infective endocarditis.

Discrimination of Brugada syndrome patients from individuals with the saddle-back type ST-segment elevation using a marker of the standard 12-lead electrocardiography.

Background: In the clinical situation, the saddle-back (S-B) type is more frequently detected than the coved type. In the present study, the discrimination of Brugada syndrome from the S-B type individuals using a marker of the standard 12-lead electrocardiography (ECG) was attempted.

Methods And Results: The study group consisted of 55 individuals with the S-B type in whom pilsicainide provocation test (PLC test) was carried out.

Clinical significance of electrocardiography recordings from a higher intercostal space for detection of the brugada sign.

Background: The significance of higher intercostal space electrocardiography (HICS ECG) for the detection of the Brugada sign was investigated.

Methods And Results: The subjects consisted of 113 cases (108 males, 5 females; mean age, 57+/-17 years) with incomplete right bundle branch block type QRS morphology and ST-segment elevation (>0.10 mV) in the right precordial leads.

Brugada syndrome-like ST-segment elevation increase exacerbated by vomiting.

The patient was a 53 year-old male who had 3 syncopal episodes over a 6-month period. In the electrophysiological study, ventricular fibrillation (VF) was repeatedly induced by the ventricular extrastimulus method. Intravenous pilsicainide was administered, and the J-point and ST-segment in the right precordial leads became slightly elevated just following drug administration.

Autonomic imbalance as a property of symptomatic Brugada syndrome.

The autonomic properties in 27 patients with the electrocardiographic morphology of Brugada syndrome were investigated using 24-h Holter monitoring: 10 patients had a history of ventricular fibrillation (VF; Br-VF group) and 17 did not (Br-N group); there were 26 healthy subjects enrolled in this study. All subjects underwent normal Holter data monitoring and power spectral analysis. Few extrasystoles were observed in either group, and the mean heart rate (HR), maximum HR, and total heart beats over 24 h were obtained.

Experimental study on the effectiveness and safety of radiofrequency catheter ablation with the cooled ablation system.

Experimental in vitro and in vivo studies were performed to assess the effectiveness and safety of the cooled-tip catheter and the Cooled Ablation System, which enables the creation of deeper and wider burn lesions in the myocardial tissue using radiofrequency current. This system was confirmed to consistently create large burns by cooling the catheter tip with circulating water within the catheter, even under unfavorable conditions. On the other hand, unfavorable effects, as a result of over burning, such as explosive vaporization within the tissue (the 'pop' phenomenon), tissue carbonization, coronary artery injury and lung injury were identified.

Clinical significance of the dispersion of the activation--recovery interval and recovery time as markers for ventricular fibrillation susceptibility in patients with Brugada syndrome.

Brugada syndrome (BS) is associated with sudden cardiac death and the markers for ventricular fibrillation (VF) remain unclear, so the activation-recovery interval (ARI) dispersion and recovery time (RT) dispersion were investigated as possible markers in 20 subjects with BS (BS group) and 22 healthy individuals (H group). The 20 BS subjects were divided into 8 cases with documented VF (BS-VF group), 3 of which had recurrences, and 12 without (BS-N group). The corrected dispersion measurements from the standard 12-lead ECG of the QT interval (QTcd), ARI (ARIcd) and RT (RTcd) were compared among the groups.