Role of Surface Electrocardiography in Differentiation between Obstructive and Non-Obstructive Hypertrophic Cardiomyopathy.

Background: Electrocardiography (ECG), as an easily accessible modality, is usually helpful in hypertrophic cardiomyopathy (HCM) diagnosis. The purpose of this study was to evaluate the role of ECG in differentiating between obstructive (OHCM) and non-obstructive (NOHCM) HCM.

Methods: The present study is a cross-sectional analysis of HCM patients referred to our center between 2008 and 2017.

Coronary slow flow: Benign or ominous?

Objective: Coronary slow flow phenomenon has been arbitrarily defined as delayed coronary blood flow in the absence of obstructive coronary artery disease. The present study sought to investigate the clinical features, natural history, and outcomes of affected patients.

Methods: In this prospective cross-sectional study, 217 consecutive patients who had undergone coronary angiography and showed features of coronary slow flow phenomenon were evaluated for demographic and coronary risk factor profile, as well as clinical outcomes, at baseline and following treatment.

Short-term Changes in Aortic Regurgitation after Percutaneous Mitral Valvuloplasty.

Objectives: The aim of this study was to evaluate the short- term effects of percutaneous mitral valvuloplasty (PMV) on coexisting AR.

Methods: Clinical, echocardiographic and catheterization data from hospital records of a total of 327 patients with rheumatic mitral stenosis who underwent PMV at a tertiary centre were retrospectively reviewed and aortic regurgitation changes 48 hours post PMV was recorded.

Results: The study population consisted of 282 females and 45 males.

Ventricular tachyarrhythmia after coronary bypass surgery: incidence and outcome.

Background: Ventricular tachyarrhythmia after coronary artery bypass graft is common and the occurrence has been described, but the incidence and risk factors are not well defined.

Aim: To evaluate the incidence of arrhythmias and to detect high-risk populations.

Methods: In this prospective study, 856 consecutive patients undergoing coronary artery bypass graft were monitored for new-onset ventricular tachyarrhythmias: non-sustained monomorphic ventricular tachyarrhythmia, sustained monomorphic ventricular tachyarrhythmia, sustained polymorphic ventricular tachyarrhythmia, and ventricular fibrillation.

Left anterior descending coronary artery dissection after blunt chest trauma.

Coronary artery dissection is a well-known albeit unusual complication of blunt chest trauma. It is also an uncommon cause of myocardial infarction. Only a few such cases have been reported, probably due to the high rate of sudden death.

Efficacy and safety of different antitachycardia pacing sites in the termination of ventricular tachycardia in patients with biventricular implantable cardioverter-defibrillator.

Aims: We sought to evaluate the efficacy and safety of different antitachycardia pacing (ATP) sites in heart failure (HF) patients with a biventricular implantable cardioverter-defibrillator (ICD).

Methods And Results: Between January 2003 and December 2008, 89 consecutive patients with biventricular (BiV) ICDs (Medtronic Inc., St Paul, Minnesota, USA) were enrolled.

Electrical storm in patients with implantable cardioverter-defibrillators: can it be forecast?

The aim of this retrospective study was to determine the prevalence and predictors of electrical storm in 227 patients who had received implantable cardioverter-defibrillators (ICDs) and had been monitored for 31.7 +/- 15.6 months.

Free floating right atrial thrombus in two asymptomatic patients after electrophysiological study: role of routine echocardiography after ablation.

This report presents two patients with free floating right atrial and atrioventricular thrombi after electrophysiology study which were treated with thrombolysis in the first patient and surgical operation in the second patient without any complication.

Predictors of ventricular tachycardia induction in syncopal patients with mild to moderate left ventricular dysfunction.

Background: In patients with mild to moderate left ventricular dysfunction (LVD) (35% pound LVEF pound 50%) who present with syncope, demonstration of tachy and/or brady-arrhythmia has prognostic value. In this group of patients electrophysiological study (EPS) is often necessary.

Methods: A total of 53 consecutive patients with mild to moderate LVD and history of undetermined syncope underwent EPS.

Delayed cardiac perforation by one small body diameter defibrillator lead.

We report a 37-year-old man who presented with continuous chest pain 6 weeks after implantable cardioverter-defibrillator implantation. Implantable cardioverter-defibrillator interrogation indicated complete loss of capture even with maximum output. Chest radiography and echocardiography confirmed extracardiac location of lead tip.

Predictors of syncope in patients with hypertrophic cardiomyopathy.

Background: Approximately 30% of patients with hypertrophic cardiomyopathy (HCM) suffer syncope and syncope was the only symptom associated with sudden death. However, no systematic studies in large cohorts looking at predictors of syncope are available in the literature. Therefore, we sought to determine predictors of syncope in patients with HCM.

Inappropriate Shock delivered by Implantable Cardioverter Defibrillator--Cardiac Resynchronization Therapy (ICD-CRT) due to myopotential oversensing.

The clinical efficacy of ICD-CRT therapy depends on accurate sensing of intracardiac signals and sensing algorithms. We report the occurrence of sensing abnormality in a patient with ICD-CRT. In this patient, oversensing of myopotentials during strenuous muscular activity resulted in an inappropriate ICD-CRT discharge.

ST-segment depression as a risk factor in hypertrophic cardiomyopathy.

Aims: From the spectrum of electrocardiogram (ECG) changes that may occur in hypertrophic cardiomyopathy (HCM), there is no criterion reported to be useful for risk stratification. We sought to determine whether there was a relationship between the resting ECG findings and prognosis in patients with HCM.

Methods And Results: We retrospectively analysed data on 173 consecutive patients admitted to our centre with a diagnosis of HCM.

Effect of right ventricular lead location on response to cardiac resynchronization therapy in patients with end-stage heart failure.

Aims: It is currently recommended to implant the left ventricular (LV) pacing lead at the lateral wall. However, the optimal right ventricular (RV) pacing lead location for cardiac resynchronization therapy (CRT) remains controversial. We sought to investigate whether optimizing the site for placement of the RV lead could further improve the long-term response to CRT in patients with advanced heart failure.

Electrophysiological characteristics of orthodromic reentrant tachycardia in patients with Wolf-Parkinson-White syndrome and atrial fibrillation.

The aim of this study was to evaluate differences in the electrophysiological features of atrioventricular reentrant tachycardia (AVRT) in patients with Wolf-Parkinson-White syndrome (WPW) associated with or without atrial fibrillation (AF). We included 119 patients with WPW and orthodromic AVRT during electrophysiological study. The patients were divided into two groups; group I with documented episodes of AF (n=39, mean age 33.

A Randomized Trial Oral Propranolol versus Metroprolol in Treatment of Neurally Medicated Cyncope.

Background: Beta-blockers has been claimed to be useful in chronic prophylaxis of neurally mediated syncope with frequent recurrences. However, efficacy of cardioselective and non-cardioselective beta-blockers has never been compared in a randomized study.

Methods: From October 2003 to December 2004, 62 patients (32 men, mean age 44.

Can prodromal symptoms predict recurrence of vasovagal syncope?

Background: Vasovagal syncope (VVS) is a common symptom with empirical therapy and high recurrence rate. Our goal was to determine whether the pattern of presyncopal prodromal symptoms can predict the recurrence probability of vasovagal syncope.

Methods: Seventy-nine consecutive patients (male/female: 53/26) with history of VVS and positive tilt table test (TTT) were enrolled in the study and completed the follow-up time for one year.

Relationship between QRS complex notch and ventricular dyssynchrony in patients with heart failure and prolonged QRS duration.

Background: Cardiac resynchronization therapy (CRT) has been accepted as an established therapy for advanced systolic heart failure. Electrical and mechanical dyssynchrony are usually evaluated to increase the percentage of CRT responders. We postulated that QRS notch can increase mechanical LV dyssynchrony independently of other known predictors such as left ventricular ejection fraction and QRS duration.

A patient with sick sinus syndrome, atrial flutter and bidirectional ventricular tachycardia: Coincident or concomitant presentations?

Channelopathies are among the major causes of syncope or sudden cardiac death in patients with structurally normal hearts. In these patients, the atrium, ventricle or both could be affected and reveal different presentations. In this case, we present a patient with an apparently structurally normal heart and recurrent syncope, presented as sick sinus syndrome with atrial flutter and bidirectional ventricular tachycardia.

Early septal activation, successful lateral ablation.

The coronary sinus activation pattern is an important clue for the detection of arrhythmia mechanisms and/or localization of accessory pathways. Any change in this pattern during radiofrequency ablation should be evaluated carefully to recognize the presence of another accessory pathway or innocence of the accessory pathway during arrhythmia. Intra-atrial conduction block can change the coronary sinus activation pattern.

Significance of QRS morphology in determining the prevalence of mechanical dyssynchrony in heart failure patients eligible for cardiac resynchronization: particular focus on patients with right bundle branch block with and without coexistent left-sided conduction defects.

Aims: The aim of this study was to assess the significance of QRS morphology in determining the prevalence of mechanical dyssynchrony in heart failure (HF) patients considered eligible for cardiac resynchronization.

Methods And Results: A total of 200 consecutive HF patients (158 males, mean age 56 +/- 13.5 years) with standard indications for cardiac resynchronization therapy (CRT) were evaluated prospectively.

Brugada syndrome manifested by the typical electrocardiographic pattern both in the right precordial and the high lateral leads.

We identified a patient with the Brugada syndrome and frequent episodes of the traumatic syncope. This patient presented with alternating ST-segment elevation in the right precordial and the high lateral leads. The signal-averaged ECG was positive for the late potentials and electrophysiology study revealed no inducible supraventricular or ventricular tachycardias.

Predictors of postoperative atrial fibrillation after coronary artery bypass graft surgery.

Objectives: The present study was aimed to identify the preoperative, intraoperative, and postoperative predictors of AF in a pure cohort of the patients with coronary artery disease who underwent CABG surgery.

Methods: Between November 2005 and May 2006, 302 consecutive patients were included in this prospective study. All the relevant clinical, electrocardiographic, echocardiographic, and laboratory data were gathered in the included patients and they were also monitored for development of post-CABG AF.

Predictors and frequency of conduction disturbances after open-heart surgery.

Introduction: The risk of developing conduction disturbances after coronary bypass grafting (CABG) or valvular surgery has been well established in previous studies, leading to permanent pacemaker implantation in about 2% to 3% of patients, and in 10% of patients undergoing repeat cardiac surgery. We sought to determine the incidence, features and predictors of conduction disorders in the immediate post-operative period of patients subjected to open-heart surgery, and the need for permanent pacemaker implantation.

Material And Method: We prospectively studied 374 consecutive patients who underwent open-heart surgery in our institution: coronary artery bypass (CABG) (n=128), Mitral valve replacement(MVR)(n=18), aortic valve replacement(AVR) (n=21), MVR and AVR(n=56), repair of ventricular septal defect (VSD) (n=51), repair of tetralogy of Fallot (TOF) (n=57),CABG and valvular surgery (n=6), others (n=37).

Electrocardiographic and electrophysiologic predictors of successful ablation site in patients with manifest posteroseptal accessory pathway.

Background: Prediction of accessory pathway (AP) location before radiofrequency ablation has become increasingly important for patients with AP; this is especially true for posteroseptal (PS) APs.

Objective: To identify electrocardiographic and electrophysiologic predictors of pathway location in patients with manifest posteroseptal AP.

Methods: A detailed electrocardiographic analysis, electrophysiologic study, and ablation were performed in 94 patients with single manifest posteroseptal AP (mean age 35.