Palliative needs for heart failure or chronic obstructive pulmonary disease: Results of a multicenter observational registry.

Background: Heart failure (HF) and chronic obstructive pulmonary disease (COPD) share a common organ failure trajectory marked by prognostic uncertainty, which is a barrier to appropriate provision of palliative care. We describe in a prospective cohort from specialist hospital services the epidemiology and late clinical course of these chronic diseases to trace criteria for transition to palliative care in the community.

Methods And Results: Seven centers enrolled 267 patients with advanced HF (n=174) or COPD (n=93) using common (multiple hospitalizations or severely impaired functional status or cachexia) and disease-specific (HF: systolic dysfunction, NYHA classes III-IV, end-organ hypoperfusion; COPD: very severe airflow obstruction, hypoxemia, hypercapnia, or long-term oxygen therapy) entry criteria.

Implantable loop recorders for assessment of syncope: increased diagnostic yield and less adverse outcomes with the latest generation devices.

Aim: Aim of the study was to compare the diagnostic yield of implantable loop recorders (ILR) of two successive generations for the assessment of syncope.

Methods: Data on patients who had undergone ILR implantation for unexplained syncope in four Italian public hospitals were retrospectively acquired from the Medtronic Clinical Service database. After implantation, routine follow-up examinations were performed every 90 days, while urgent examinations were carried out in the event of syncope recurrence.

[Dronedarone: a real innovation or a mere second-best choice? How to find the way among guidelines, regulatory agencies and daily clinical practice].

Dronedarone is the antiarrhythmic drug with the most complete and wide literature preceding its marketing. Most of these studies showed a good efficacy along with an excellent risk profile, especially in low- and medium-risk patients. Recently, updates of European, American and even Italian guidelines gave dronedarone its own spot into the antiarrhythmic armamentarium, recommending its use both for rhythm control and rate control in non-permanent atrial fibrillation.

Automatic adjustment of stimulation output in resynchronization therapy: impact and effectiveness in clinical practice.

Background: Algorithms for automatic pacing output adjustment have been implemented in pacemakers and implantable defibrillators (ICD) and recently in cardiac resynchronization therapy defibrillators (CRT-D). We assessed the impact and effectiveness of these automatic features.

Method And Results: We prospectively enrolled patients successfully implanted with the following Medtronic CRT-Ds: Concerto [with automatic left ventricular (LV) output management algorithm], Consulta [automatic management of atrial, right ventricular (RV) and LV voltage], and Sentry (only manual voltage adjustments).

A rare case of isolated left ventricular non-compaction. Importance of image technology and disease awareness for a correct diagnosis.

In 1999 a 50-year-old man with sustained monomorphic ventricular tachycardia came to our institution for investigation using fundamental echocardiographic imaging. A diagnosis of hypertrophic cardiomyopathy with dilatation and apical thrombus was made. In 2003, a new echocardiographic machine equipped with second harmonic imaging modality became available and after a second investigation the diagnosis was changed to isolated left ventricular non-compaction.