Bifascicular block in unexplained syncope is underrecognized and under-evaluated: A single-center audit of ESC guidelines adherence.

Background: The presence of bifascicular block on electrocardiography suggests that otherwise-unexplained syncope may be due to complete heart block. European Society of Cardiology (ESC) recommends investigating it with electrophysiology study (EPS). PPM is indicated if high-degree atrioventricular block is inducible.

Transesophageal Echocardiography-Guided WATCHMAN Implantation Without Contrast Use: A Three-Year, Single-Center Experience.

Background It is unclear if the WATCHMAN device (Boston Scientific, St. Paul, Minnesota) can be implanted without contrast to prevent complications in patients with advanced chronic kidney disease (CKD) or contrast allergy. Objective The efficiency and safety of WATCHMAN implantation under transesophageal echocardiography (TEE)-guidance and fluoroscopy without contrast use.

Electrocardiographic changes in loperamide toxicity: Case report and review of literature.

Introduction: Loperamide, an antidiarrheal agent, is a µ-opioid receptor agonist increasingly abused to prevent opioid withdrawal or to produce euphoric effects. At supra-therapeutic doses, loperamide can cause cardiac toxicity due to blockade of Na and I channels, resulting in wide QRS rhythms, severe bradycardia, prolonged QTc, polymorphic ventricular tachycardia, cardiac arrest, and death. There are limited data on the cardiotoxic effects of high dose loperamide.