Prognostic significance of a low T/R ratio in Brugada syndrome.

Objectives: To determine the prognostic value of a low T/R ratio, defined as the amplitude ratio between the T waves and the R waves, in patients (pts) with a spontaneous type-1 Brugada pattern (SBT1).

Background: Abnormalities of myocardial repolarization may play a key role in the initiation of ventricular fibrillation (VF) in Brugada syndrome (BrS). Recent studies have shown that the height of the T waves and the T/R ratio are inversely proportional to sudden cardiac arrest (SCA) risk in early repolarization syndrome and hypertrophic cardiomyopathy.

Flecainide is a safe and effective treatment for pre-excited atrial fibrillation rapidly conducted to the ventricle in pregnant women: a case series.

Background: Pregnancy is associated with an increased incidence of cardiac arrhythmias likely due to hormonal, haemodynamic, and autonomic changes. Yet, there is little data available regarding the efficacy and safety of anti-arrhythmic agents to prevent pre-excited atrial fibrillation (AF) in pregnant women.

Case Summary: We report on three pregnant women who developed AF rapidly conducted to the ventricle through an overt accessory pathway as the first manifestation of Wolff-Parkinson-White syndrome.

Prediction of ventricular arrhythmias in patients with a spontaneous Brugada type 1 pattern: the key is in the electrocardiogram.

Aims: There is currently no reliable tool to quantify the risks of ventricular fibrillation or sudden cardiac arrest (VF/SCA) in patients with spontaneous Brugada type 1 pattern (BrT1). Previous studies showed that electrocardiographic (ECG) markers of depolarization or repolarization disorders might indicate elevated risk. We aimed to design a VF/SCA risk prediction model based on ECG analyses for adult patients with spontaneous BrT1.

Delayed diagnosis of Brugada syndrome in a patient with aborted sudden cardiac death and initial negative flecainide challenge.

A negative flecainide challenge does not rule out Brugada syndrome even in the presence of nonfatal cardiac arrest as the first manifestation of the disease. This should prompt clinicians to ensure long-term ECG follow-up and consider repeating a drug test with another sodium channel blocker.

Significance of atypical symptoms for the diagnosis and management of myocardial infarction in elderly patients admitted to emergency departments.

Background: Few recent studies have examined the characteristics of ST-segment elevation myocardial infarction (STEMI) among elderly patients managed in emergency departments (EDs).

Aims: To describe the clinical characteristics and management of elderly STEMI patients in EDs.

Methods: This retrospective, multicentre study involved STEMI patients aged ≥ 75 years admitted to four different EDs in the city of Lyon between 2004 and 2008.