Persistent Left Superior Vena Cava in Patients Undergoing Cardiac Device Implantation: Clinical and Long-Term Data.

Background: Persistent left superior vena cava (LSVC) is a rare congenital venous anomaly that may be found at the time of cardiac device lead insertion.

Methods: In this case series, we present clinical and long-term data of five patients with LSVC who underwent pacemaker (PM) or cardioverter defibrillator (ICD) implantation during the period of 10 years.

Results: Left-sided venous approach was used for device implantation in 3 patients with standard PM indications, whereas a right-sided venous approach and an epicardial approach had to be used in 2 patients who needed an ICD and biventricular PM, respectively.

Electrophysiological predictors of propafenone efficacy in prevention of atrioventricular nodal re-entrant and atrioventricular re-entrant tachycardia.

Aim: To assess the efficacy of propafenone in prevention of atrioventricular nodal reentrant tachycardia (AVNRT) and orthodromic atrioventricular tachycardia (AVRT) based on the clinical results of arrhythmia recurrence and find the electrophysiological predictor of propafenone effectiveness.

Methods: This retrospective study included 44 participants in a 12-month period, who were divided in two groups: group A - in which propafenone caused complete ventriculo-atrial block and group B - in which propafenone did not cause complete ventriculo-atrial block.

Results: Group A had significantly lower incidence of tachycardia than group B (95% vs 70.

Persistent atrial fibrillation is associated with a poor prognosis in patients with atrioventricular block and dual-chamber pacemaker.

Background: The prognostic significance of development of persistent atrial fibrillation (AF) in patients with atrioventricular (AV) block and dual chamber (DDD) pacemakers has not been separately investigated. We sought to determine whether persistent AF influences clinical outcome in these patients.

Methods: Three hundred-eight consecutive patients with second- or third-degree AV block and implanted a DDD pacemaker were followed for 36 ± 20 months and retrospectively divided into two groups.

Incidence and predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular block and dual chamber pacemaker implantation.

Aim: To evaluate predictors of asymptomatic atrial fibrillation in patients older than 70 years with complete atrioventricular (AV) block, normal left ventricular systolic function, and implanted dual chamber (DDD) pacemaker.

Methods: Hundred and eighty six patients with complete AV block were admitted over one year to the Sisters of Mercy University Hospital. The study recruited patients older than 70 years, with no history of atrial fibrillation, heart failure, or reduced left ventricular systolic function.

Differential relationship of recent self-reported stress and acute anxiety with divided attention performance.

There have been relatively few studies on the relationship between recent perceived environmental stress and cognitive performance, and the existing studies do not control for state anxiety during the cognitive testing. The current study addressed this need by examining recent self-reported environmental stress and divided attention performance, while controlling for state anxiety. Fifty-four university undergraduates who self-reported a wide range of perceived recent stress (10-item perceived stress scale) completed both single and dual (simultaneous auditory and visual stimuli) continuous performance tests.

Chronic self-perceived stress and set-shifting performance in undergraduate students.

Given recent findings on the potential for detrimental effects of chronic stress on the prefrontal cortex, additional research on the relationship between chronic stress and performance on executive functioning tasks (dependent on prefrontal functioning) is needed. Eighty-one undergraduate students completed a self-report measure of stress over the previous month (perceived stress scale--PSS) and the comprehensive trail-making test (CTMT, Trials 3 and 5). Results revealed a statistically significant positive correlation between PSS score and time needed to complete Trial 5 of the CTMT, which places demands on the set-shifting component of executive functioning.

Impact of atrioventricular node ablation and pacing therapy on clinical course in patients with permanent atrial fibrillation and unstable ventricular tachycardia induced by rapid ventricular response: follow-up study.

Aim: To evaluate prospectively the impact of atrioventricular (AV) node ablation and consequent pacing therapy on clinical course in patients with permanent atrial fibrillation and unstable ventricular tachycardia induced by rapid ventricular response.

Methods: One hundred four patients with permanent atrial fibrillation and uncontrolled ventricular rate resistant to drug therapy underwent radiofrequency catheter ablation of the AV node and permanent pacemaker implantation. At baseline examination, 14 of them had unstable ventricular tachycardia induced by rapid ventricular response of atrial fibrillation (ventricular tachycardia group).

Ventricular pacing vs dual chamber pacing in patients with persistent atrial fibrillation after atrioventricular node ablation: open randomized study.

Aim: To compare ventricular rate responsive (VVIR) pacing with dual chamber rate responsive (DDDR) pacing and antiarrhythmic drugs for the treatment of patients with persistent atrial fibrillation after atrioventricular node ablation.

Methods: One hundred two patients with persistent atrial fibrillation eligible for the atrioventricular node ablation were randomly assigned to the therapy with either VVIR pacemaker (n=52) or DDDR pacemaker and antiarrhythmic drugs (n=50). After ablation, patients in both pacing groups were assigned to take anticoagulant therapy.

Late clinical outcome after radiofrequency catheter ablation of idiopathic ventricular tachycardia: follow-up study.

Aim: To prospectively evaluate long-term clinical outcome in patients who underwent radiofrequency catheter ablation for the treatment of idiopathic ventricular tachycardia (VT).

Methods: Twenty consecutive patients with idiopathic VT resistant to drugs were treated by temperature-controlled radiofrequency ablation. The site of VT origin was localized by pace mapping and endocardial activation mapping during VT.

Radiofrequency catheter ablation of the bundle branch reentrant ventricular tachycardia.

Bundle branch reentrant ventricular tachycardia (BBRVT) has a suitable anatomic substrate for radiofrequency catheter ablation. However, the experience with this treatment is still small. In the current study, we examined the safety and the long-term efficacy of radiofrequency ablation in the cure of patients with BBRVT.

Prospective evaluation of infrahisal second-degree AV block induced by atrial pacing in the presence of chronic bundle branch block and syncope.

Unlabelled: The value of nonfunctional infrahisal second-degree atrioventricular (AV) block induced by incremental atrial pacing was prospectively examined in 192 patients with chronic bundle branch block (BBB) and syncope. We compared 174 (91%) patients with normal response to atrial pacing (Group I) to 18 (9%) patients with atrial pacing induced nonfunctional infrashisal second-degree AV block (Group II). Patients in group I had higher incidence of organic heart disease, ventricular tachycardia induction, and retrograde ventriculoatrial conduction (P < 0.

[Risk factors for the onset of ventricular tachycardia in patients with mitral valve prolapse].

Non-invasive diagnostic methods (history, ECG, phonocardiography, exercise testing, Holter monitoring and Doppler echocardiography) were done in 48 persons with mitral valve prolapse (MVP). The aim was to establish possible risk factors for occurrence of ventricular tachycardia (VT) in persons with MVP and to find a possible difference between these risk factors. The possible risk factors for VT are: syncope, negative T wave in the inferolateral ECG leads, longer duration of QT interval, ST devalvation and duration of the ST devalvation, reduction of oxygen consumption evaluated by exercise testing, left ventricular function impairment, polymorphic premature ventricular contractions (PVC's), paired PVC's, larger dimensions of left cardiac chambers, larger surface and thickness of anterior mitral leaflet, extent of mitral regurgitation and higher mitral valve prolapse score.

[Non-pharmacologic therapy of supraventricular tachyarrhythmias].

In the last ten years different forms of nonpharmacological therapy of supraventricular tachyarrhythmias were developed. One of the major advances is the catheter fulguration, which has reduced significantly need for surgical procedures in the treatment of atrial or junctional tachyarrhythmias. Operative treatment for dissection or ablation of accessory atrioventricular pathways is currently highly successful with minimal morbidity in any pathway location.

Daily administration of furosemide in dilated cardiomyopathy--yes or no?

Seventeen patients with dilated cardiomyopathy (mean ejection fraction 22%) in the NYHA state III or IV were investigated. All patients fulfilled the criteria of an indication for administration of furosemide, since left ventricular filling pressure (LVFP, measured as pulmonary capillary pressure) was 20 or more mm Hg in all. This study investigates the effects of an acute (40 mg i.