Wide complex irregularly regular tachycardia with QRS alternation.

A 44-year-old white man was referred to our service because of a history of symptomatic rapid palpitations that had begun on January 2007. He had no previous history of syncope or family history of sudden cardiac death. The patient was otherwise well and had not been taking any medications.

Medium- and long-term survival after pacemaker implant: Improved survival with right ventricular outflow tract pacing.

Introduction: Long-term prognosis after pacemaker implant depends on numerous variables, particularly structural heart disease. There is evidence that apical stimulation could favor the development of heart failure and, therefore, influence mortality. Other right ventricular pacing sites have been studied, for example the outflow tract, but no reports regarding long-term clinical outcome are available.

Atrioventricular block during upright tilt table test.

Patients with a cardioinhibitory response (asystole or atrioventricular block [AVB]) during upright tilt table test (UTT) constitute a therapeutic challenge. Our present knowledge is partial and in those who experience AVB is absent. Furthermore, we ignore if there is any difference between both groups, particularly pacemaker indication.