Late sensing due to extremely delayed right ventricular activation in arrhythmogenic right ventricular cardiomyopathy.

A patient with arrhythmogenic right ventricular cardiomyopathy/dysplasia, implanted with a dual-chamber implantable cardioverter-defibrillator programmed in DDD mode, showed an unexpected ventricular sensing dysfunction: despite a very long (320 ms) programmed atrioventricular (AV) interval, ventricular stimuli were delivered in the ST segment after each spontaneous conducted QRS complex. This suggested the presence of ventricular undersensing. When, however, the system was programmed in VVI mode, spontaneous QRS complexes were normally sensed, although electrogram (ECM) analysis revealed that ventricular sensing occurred 160 ms after the beginning of QRS complex.

Double superior and inferior vena cava: unusual venous anomaly.

We report the case of a 56-year-old woman affected by recurrent paroxysmal atrial fibrillation and sick sinus syndrome. Before pacemaker implantation, a diagnosis of left superior vena cava persistency was made. After some years, at pacemaker replacement, an inferior vena cava anomaly was suspected because of the difficult progression of the lead for temporary pacing from the right femoral vein.

Hypertrophic cardiomyopathy mimicking acute myocardial infarction: diagnostic role of cardiac magnetic resonance.

Rarely, hypertrophic cardiomyopathy can be associated with ST elevation on electrocardiogram. We report a rare case of anterior hypertrophic cardiomyopathy mimicking an acute myocardial infarction where the diagnosis of myocardial hypertrophy was made by cardiac magnetic resonance. The method was able to identify the myocardial hypertrophy located in basal segments of anterior wall respect to echocardiography.

Ibutilide for cardioversion of atrial flutter: efficacy of a single dose in recent-onset arrhythmias.

Aim: Ibutilide is particularly effective in rapid termination of atrial flutter (AFL) with few adverse effects. Despite the recommendation of 2 infusions, cardioversion may occur up to 70 minutes after a single dose. We investigated the feasibility, efficacy and safety of a single dose ibutilide treatment of AFL in a single-center, observational study.