Long-term results of visually guided left ventricular reconstruction as single therapy to treat ventricular tachycardia associated with postinfarction anteroseptal aneurysm.

Introduction: Postinfarction ventricular tachycardia (VT), anteroseptal aneurysm, and ventricular dysfunction are commonly associated and predict a poor long-term prognosis. Surgical left ventricular reconstruction, which includes double plication of the anterior and septal wall, can improve ventricular function. This article analyzes the long-term efficacy of such a procedure to control recurrence of VT in a group of 50 consecutive patients.

[Relationship between conduction persistence through the slow pathway after atrioventricular nodal reentry tachycardia radiofrequency ablation and its recurrence].

Purpose: The aim of this study is to verify whether the persistence of conduction over the slow pathway is related to an increased trend for recurrence.

Methods: Recurrence rate was retrospectively analyzed in 126 patients who underwent slow pathway radiofrequency (RF) catheter ablation during a follow-up of 20 +/- 12 months. The ablative procedure was interrupted when AVNRT was no longer induced by atrial stimulation after intravenous infusion of isoproterenol.

Endocardial and epicardial ablation guided by nonsurgical transthoracic epicardial mapping to treat recurrent ventricular tachycardia.

Introduction: An epicardial site of origin of ventricular tachycardia (VT) may explain unsuccessful endocardial radiofrequency (RF) catheter ablation. A new technique to map the epicardial surface of the heart through pericardial puncture was presented recently and opened the possibility of using epicardial mapping to guide endocardial ablation or epicardial catheter ablation. We report the efficacy and safety of these two approaches to treat 10 consecutive patients with VT and Chagas' disease.

Reduction of radiation exposure time during catheter ablation with the use of pulsed fluoroscopy.

Unlabelled: Prolonged exposure to radiation during radiofrequency catheter ablation implies a potential risk of radiodermatitis, neoplasm and genetic defects to the patient and to the operator-physician. The use of pulsed fluoroscopy is thought to reduce such a risk because the radiation dose decreases for the same period of time. The aim of the present study was to compare the radiation exposure time during pulse and continuous radiofrequency catheter ablation.

Bone mineral density in patients with pancreatic insufficiency and steatorrhea.

Objectives: Low bone mineral density (BMD) has been demonstrated in some patients with chronic intestinal disorders accompanied by diarrhea and malabsorption. However, very few studies have evaluated BMD in patients with pancreatic insufficiency due to cystic fibrosis. Our aim was to assess the prevalence and severity of bone loss in a cohort of patients with pancreatic insufficiency as a consequence of chronic pancreatitis.

Laparoscopic urologic surgery outcome assessment.

Laparoscopic surgery is an evolving technique that began to be applied widely in urology in the early 1990s. We have conducted an ongoing multicenter study of laparoscopic urologic surgery to identify any changes in utilization, complications, and short- and long-term outcomes. Laparoscopic urologic surgical procedures were assessed in three successive phases: retrospective initial experience [P1] (before 1991), and prospectively, an intermediate phase [P2] (1991-1992) and a late phase [P3] (1993-1994).

[Persistence of palpitations after successful radiofrequency catheter ablation].

Purpose: The aim of this study was to determine prevalence and the underlying mechanism of persistent palpitations after successful radiofrequency ablation of reentrant nodal tachycardia and atrioventricular tachycardia.

Methods: One hundred twenty consecutive patients (mean age of 36 +/- 16 years) who underwent radiofrequency catheter ablation of atrioventricular or reentrant nodal tachycardia constituted the analyzed group. Prevalence of palpitations was investigated during out-clinic visits and telephone interviews.

Electrocardiographic identification of mid-septal accessory pathways in close proximity to the atrioventricular conduction system.

In order to identify ECG characteristics of overt mid-septal accessory pathways (APs) predictive of close proximity to the AV conduction system we analyzed data from patients who underwent successful RF catheter ablation of a mid-septal AP. Mean patient age was 31 +/- 16 years, and 13 were male. The 40 degrees right anterior oblique view was used to divide the mid-septal area into 3 zones: 1 (anterior portion); 2 (intermediate); and 3 (posterior portion).

A new technique to perform epicardial mapping in the electrophysiology laboratory.

Introduction: A possible epicardial site of origin may be the reason for unsuccessful endocardial application of radiofrequency energy to control recurrent ventricular tachycardia. This study tests the feasibility and safety of a new epicardial mapping technique in patients with Chagas' disease and recurrent ventricular tachycardia.

Methods And Results: Epicardial mapping was performed through a pericardial puncture as an epidural introducer needle was advanced into the pericardial space under fluoroscopic guidance.

[Comparative study between verapamil and adenosine triphosphate in the treatment of paroxysmal supraventricular tachycardia].

Purpose: To evaluate the efficacy and safety of intravenous (IV) adenosine-triphosphate (ATP) and verapamil to convert acute episodes of paroxysmal supraventricular tachycardia (PSVT) to sinus rhythm.

Methods: Fifty patients with PSVT were randomized in two groups: A) 25 treated with IV bolus of ATP (10 or 20mg), and V) 25 treated with IV verapamil, up to 15mg, during 3min. We evaluated the time delay necessary to convert the arrhytmia, doses, and side-effects.

In vivo detection of Trypanosoma cruzi antigens in hearts of patients with chronic Chagas' heart disease.

The heart is the most commonly affected organ in chronic Chagas' disease, and lymphocytic myocarditis is often observed. However, the pathogenesis of chronic Chagas' heart disease is controversial. The purpose of this study was to determine whether in vivo T.

A fast and reliable algorithm to localize accessory pathways based on the polarity of the QRS complex on the surface ECG during sinus rhythm.

Background: Many criteria have been published to localize accessory pathways from the 12-lead ECG during sinus rhythm. This study analyzed whether the localization of an accessory pathway could be predicted by using the polarity of the QRS complex during sinus rhythm on the surface ECG, instead of the delta wave polarity as used in many reports.

Methods: The ECGs of 140 patients with an overt and single accessory pathway were evaluated.

Signal-averaged electrocardiogram in chronic Chagas' heart disease.

Unlabelled: The aim of the study was to register the prevalence of late potentials (LP) in patients with chronic Chagas' heart disease (CCD) and the relationship with sustained ventricular tachycardia (SVT). 192 patients (96 males), mean age 42.9 years, with CCD were studied through a Signal Averaged ECG using time domain analysis.

Electrophysiologic study in chronic Chagas' heart disease.

Cardiac arrhythmias are common in chagasic patients. Electrophysiologic study is an invasive procedure for the investigation of sinus node function, atrioventricular node conduction and intraventricular (His-Purkinje) conduction and the mechanism of tachycardias. It is useful in elucidating syncope, dizziness and tachycardiac palpitations that remain unexplained by non-invasive diagnostic methods.

[Acute atrial fibrillation in the emergency room. Which is the best drug for a rapid sinus rhythm conversion?].

Purpose: To evaluate differences between amiodarone, procainamide and quinidine in the time delay necessary to convert acute atrial fibrillation (AF) to sinus rhythm.

Methods: Sixty patients with acute AF were randomized in three groups (G) and treated with: quinidine (QG)-(21 patients) i.v.

Arrhythmias and sudden death after dynamic cardiomyoplasty.

Background: The main causes of death in patients with severe cardiomyopathy are progressive heart failure and sudden death. The influence of cardiomyoplasty on the incidence of sudden death and arrhythmias in patients with cardiomyopathy remains unclear. The aim of this study was to investigate the occurrence of arrhythmias and sudden death after cardiomyoplasty.

[Radiofrequency catheter ablation of type I atrial flutter].

Purpose: To verify the efficacy and safety of the creation of a barrier with radiofrequency (RF) in the tricuspid annulus and the vena cava ostium (TA-IVC).

Methods: Nine consecutive patients, 7 males, with age ranging from 36 to 76 years, with paroxysmal (7 patients) or permanent (2) type I atrial flutter (negative P wave in lead II, III and F) were submitted to RF ablation of TA-IVC istmo. One deflectable catheter with 4mm size tip was introduced into the right ventricle apex and pulled back to the inferior vena cava.

[The pseudo-pacemaker syndrome].

We describe three cases of the pseudo-pacemaker syndrome. One of them due to selective fast pathway fulguration of atrioventricular nodal reentrant tachycardia and two others have occurred in spontaneous form. All cases were related with the presence of first-degree atrioventricular block and sinus node tachycardia.

Clinical and electrophysiologic features of syncope in chronic chagasic heart disease.

Introduction: Syncope in patients with chronic Chagasic heart disease (CCHD) is a frequent but poorly studied problem.

Methods And Results: Fifty-three patients with CCHD and recurrent syncope were followed for 2 to 127 months. They were classified into the following groups: G-I (n = 15) without inducible ventricular tachycardia (VT) and normal HV interval; G-II (n = 17) with only inducible VT; G-III (n = 11) with only an abnormal HV interval; and G-IV (n = 10) with both an inducible VT and an abnormal HV interval.

[Arrhythmias following orthotopic heart transplantation].

Purpose: To correlate the incidence of arrhythmias to the degree of allograft rejection on endomyocardial biopsy.

Methods: Seventeen patients who underwent orthotopic heart transplantation were submitted to ambulatory Holter monitoring 24h prior to endomyocardial biopsy. The biopsy results were compared to Holter monitoring results.

[Reproducibility of head-up tilt test in patients with neurocardiogenic syncope].

Purpose: In order to identify the reproducibility of head-up tilt test, a second test one week later in 22 patients with a positive first test, was performed.

Methods: The test was performed in a fasting state during the morning. The heart rate and blood pressure were monitored during 20 minutes in the supine position and then at 60 degrees for up to 40 minutes.