The implantable defibrillator and return to operation of vehicles study.

Aims: We sought to characterise driving habits of contemporary implantable cardioverter defibrillator (ICD) patients.

Methods And Results: We performed a multicentre prospective observational study of consecutive ICD recipients. Non-commercial drivers with a valid licence were eligible.

Usefulness of tissue doppler and color M-mode indexes of left ventricular diastolic function in predicting outcomes in systolic left ventricular heart failure (from the ADEPT study).

The prognostic values of tissue Doppler imaging and color M-mode diastolic indexes were studied in 225 patients who had symptomatic systolic heart failure in the ADEPT study. The primary end point of death, transplantation, or hospitalization due to heart failure occurred in 65 patients and was independently predicted by shorter deceleration time, lower ratio of pulmonary vein systolic to diastolic velocity, and increasing levels of the ratios of early transmitral velocity to early annular velocity or velocity of propagation. For the ratio of early transmitral velocity to early annular velocity, this prediction was additive to deceleration time.

Feasibility of valve repair for regurgitant bicuspid aortic valves--an echocardiographic study.

Background: There is increasing interest in the role of valve repair for patients with isolated severe aortic regurgitation. Those with bicuspid aortic valves are suggested as most suitable for repair. Morphologic features of these valves that suggest feasibility of repair are not well defined.

When death is the outcome of informed refusal: dilemma of rejecting ventricular assist device therapy.

Refusal of treatment can have fatal consequences for heart failure patients who could otherwise benefit from ventricular assist device therapy. Ethical dilemmas arise when treatment refusals seem based on unsound reasoning by patients. Using a clinical case from our medical center, we explored the complex ethical issues associated with patient refusal of ventricular assist device therapy due to the patient's perception of large device size as compared to other mechanical heart technologies.

Usefulness of real-time three-dimensional echocardiography for evaluation of myectomy in patients with hypertrophic cardiomyopathy.

Real-time 3-dimensional echocardiography was performed in 10 patients with obstructive hypertrophic cardiomyopathy (HC) before and after myectomy and in 6 controls. The exact location of systolic anterior motion of the mitral leaflet was shown in all patients with HC with a predominant involvement of the medial portion in 4 patients and the middle portion in 6 patients. The smallest area of the left ventricular outflow tract was significantly smaller in patients with HC than in controls (1.

Salvage of nondiagnostic transthoracic echocardiograms on patients in intensive care units with intravenous ultrasound contrast.

Transthoracic echocardiography (TTE) is often technically difficult on patients in intensive care units. Contrast echocardiography can improve left ventricular wall visualization and the assessment of regional and global left ventricular wall motion. Our study undertook to determine what proportion of nondiagnostic TTE studies on patients in intensive care units could be salvaged (i.

Encephalitis owing to human herpesvirus-6 after cardiac transplant.

Human herpesvirus-6 (HHV-6), a beta herpesvirus closely related to cytomegalovirus (CMV), infects the majority of the population in childhood. Human herpesvirus-6 can be reactivated in the immunosuppressed patient. After bone marrow and orthotopic liver transplant, it has been linked to various clinical syndromes, including undifferentiated febrile illness, encephalitis, pneumonitis and bone marrow suppression.

Safety of stress testing in patients with hypertrophic cardiomyopathy.

Two hundred sixty-three consecutive patients with hypertrophic cardiomyopathy underwent stress testing. Major complications occurred in 0.04% of patients and minor events occurred in 23%.