[Relationship between late ventricular potentials and ventricular arrhythmias in patients in chronic dialysis treatment].

Background: Arrhythmias are frequent pathology in patients with chronic hemodialysis. We evaluated whether a relatively new technique, signal averaging, could be useful in predicting the development of complex arrhythmias in these patients.

Methods: Thirty-three patients, 18 male and 15 female, subjected to thrice weekly chronic hemodialytic treatment with various dialysis techniques, were studied.

[Pseudoaneurysm of the left ventricle: a report of 2 cases].

Two cases of left ventricular pseudoaneurysm following myocardial infarction are presented. In the first patient a two-dimensional echocardiography study revealed a small posterior echo-free space that appeared to communicate with the left ventricle through a small defect in the left ventricular posterior wall. Conventional Doppler echocardiography and colour flow imaging demonstrated flow between the left ventricle and the paraventricular chamber.

[Atrial natriuretic factor in patients with cardiac decompensation before and after chronic therapy with an angiotensin-converting enzyme inhibitor].

Background: Patients with severe congestive heart failure often have high plasma Atrial Natriuretic Factor (ANF) and neurohormonal activation. Ace inhibitors give clinical and hemodynamic benefits and lower plasma angiotensin and norepinephrine levels. The interactions between ANF and the Ace inhibitors are mainly modulated via the renin angiotensin system.

[Study of the arrhythmia in patients with chronic uremia in periodic hemodialysis with Holter dynamic electrocardiography].

For the purpose of evaluating cause, frequency, type and seriousness of arrhythmias in dialysis patients, 14 chronic uremics, 8 on bicarbonate-dialysis, 6 on acetate-dialysis underwent a basal ECG, echocardiography and a Holter dynamic electrocardiography (ECGD) for a duration of 96 hours. Before and after dialysis PAO, body weight, serum electrolytes and arterial pH were controlled. In 11 patients (78%) supraventricular and ventricular arrhythmias were discovered of equal frequency and seriousness both in the inter and intra dialytic phase, even if more frequent in ventricular hypertrophic patients (IVSn) the complex ventricular arrhythmias (Lown greater than 2).

Reduction of complex ventricular arrhythmias after enalapril treatment in patients with advanced stable heart failure.

We studied, by 48-hour Holter monitoring, 33 patients with chronic stable heart failure (radionuclide ejection fraction less than 35%), complex ventricular arrhythmias and no electrolyte abnormalities, after a period during which they were treated with digoxin and diuretics. Before Holter monitoring blood samples were analyzed for serum concentration of sodium, potassium, magnesium, urea, creatinine, digoxin, aldosterone and for plasmatic renin activity in addition to urinary aldosterone and catecholamines determination. After these investigations in 23 patients, 5-20 mg of enalapril were progressively added to the conventional therapy, while 10 patients continued the previous therapy.