Influence of the maximum heart rate attained during exercise testing on subsequent heart rate recovery.

Background: Abnormal heart rate recovery (HRR) following exercise testing has been shown to be a predictor for adverse cardiovascular events. The actual maximum heart rate (MHR) attained during the exercise test does not however have a distinct significance in traditional HRR assessment. The objective of this study was to investigate the role of MHR in HRR.

Sudden death in an Emery-Dreifuss muscular dystrophy patient with an implantable defibrillator.

We report the first case of witnessed sudden death of an Emery-Dreifuss muscular dystrophy (EDMD) patient with a properly functioning implantable cardioverter-defibrillator (ICD). This 38-yr-old woman with normal left ventricular function had a history of recurrent syncope and nonsustained ventricular tachycardia, for which a single-chamber ventricular ICD was implanted. She later collapsed suddenly and unexpectedly while at home, with witnesses present, and was found cyanotic with pulseless electrical activity by the emergency squad.

Massive arm edema following arteriovenous dialysis shunt creation in a patient with ipsilateral permanent pacemaker.

Asymptomatic subclavian vein occlusion following insertion of a permanent pacemaker (PPM) or implantable cardioverter-defibrillator (ICD) is not uncommon. We report a case of a dual-chamber PPM in a patient with an unrecognized left subclavian vein occlusion who developed massive left arm edema following ipsilateral implantation of an arteriovenous (AV) hemodialysis graft. We recommend that patients with pre-existing PPM or ICD leads who are in need of vascular access for hemodialysis should have the AV shunts placed in the contralateral arm.