Outpatient treatment of recent-onset atrial fibrillation with the "pill-in-the-pocket" approach.

Background: In-hospital administration of flecainide and propafenone in a single oral loading dose has been shown to be effective and superior to placebo in terminating atrial fibrillation. We evaluated the feasibility and the safety of self-administered oral loading of flecainide and propafenone in terminating atrial fibrillation of recent onset outside the hospital.

Methods: We administered either flecainide or propafenone orally to restore sinus rhythm in 268 patients with mild heart disease or none who came to the emergency room with atrial fibrillation of recent onset that was hemodynamically well tolerated.

[Reciprocal supraventricular paroxysmal tachycardia in pregnancy. Apropos of a case].

The authors report a case of paroxysmal supraventricular reciprocal tachycardia, associated with transient Wolff-Parkinson-White syndrome in a 25-year-old woman, without heart disease, at 31 weeks gestation. The arrhythmia was successfully converted to sinus rhythm by intravenous flecainide. After delivery the arrhythmia and pre-excitation syndrome spontaneously disappeared and were not observed yet during the 6 months follow-up.

[Myocardial infarction caused by accidental electrocution. Apropos of a case with an 8-year follow-up].

We report on a case of non-fatal myocardial infarction (MI) after electrocution. The diagnosis was made on the basis of electrocardiographic and enzymatic changes and was supported by the results of two-dimensional echocardiogram and radio-nuclide scans, showing segmental hypoperfusion and wall motion abnormalities. The patient was followed for over 8 years, evaluating the evolution of cardiac damage with the above tests.

[Determination of myocardial risk on basis of the outcome of previous myocardial infarcts. Advantages of myocardial tomoscintigraphy using thallium with dipyridamole].

Exercise stress test, 24-hour-ambulatory electrocardiographic monitoring and myocardial perfusion 201-Thallium single photon emission computerized tomography (SPECT) with dipyridamole pharmacological stress probably have different sensitivities and specificities for the identification of residual ischemia after an acute myocardial infarction. Their clinical value is still a matter of debate. To comparatively evaluate various non-invasive methods, we studied 63 patients with previous myocardial infarction consecutively referred to our Nuclear Medicine Department to undergo myocardial dipyridamole (0.

[Ventricular fibrillation during stress test on a treadmill. Apropos of a case].

A case of ventricular fibrillation occurring in the recovery phase of treadmill exercise test is described. A 64-year-old man was admitted to the hospital because of chest pain. The resting electrocardiogram was normal, but during a stress test (Bruce protocol) ventricular ectopic beats and ischemic S-T depression were observed.