Reel syndrome, a diagnostic conundrum: a case report.

Background: Pacemaker lead dislodgement and failure, related to device manipulation, is a rare complication of permanent pacemaker (PPM) insertion. Reel's, Twiddler's, and Ratchet syndrome are rare causes of pacemaker failure with varying mechanisms, defined by their classical lead and generator findings on chest X-ray imaging. Misleading patient presentations may be attributed to lead stimulation of surrounding structures.

Primary percutaneous coronary intervention for refractory cardiac arrest.

The identification and treatment of reversible causes is paramount to the success of resuscitation in cardiac arrest, particularly when standard therapy has failed. Acute coronary occlusion is one such cause, and the introduction of primary percutaneous coronary intervention services may provide an opportunity for emergency revascularization in this setting. This article describes 2 patients with cardiac arrest as a result of coronary occlusion, in which standard therapeutic measures proved futile.

Comparison of bivalirudin with heparin versus abciximab with heparin for primary percutaneous coronary intervention in "Real World" practice.

Objective: We aimed to carry out a "real world" comparison of bivalirudin plus unfractionated heparin (UFH) versus abciximab plus UFH in patients undergoing primary percutaneous coronary intervention (PPCI) for ST elevation myocardial infarction (STEMI).

Methods: We included patients who had abciximab or bivalirudin during their PPCI in our unit between Sept 2009 and Nov 2011.

Results: The study included 516 and 484 patients in the bivalirudin and abciximab group respectively.

First time and repeat cardioversion of atrial tachyarrhythmias - a comparison of outcomes.

Introduction: Repeat cardioversion may be necessary in over 50% of patients with persistent atrial fibrillation (AF), but identifying responders remains challenging. This study evaluates the long-term success of direct current cardioversion (DCCV) and the clinical and echocardiographical parameters that influence them, in over 1000 sedation-cardioversion procedures undertaken at Eastbourne General Hospital between 1996 and 2006.

Methods: A total of 770 patients of mean age (SD) 70.

Validating optimal function of the closed loop stimulation sensor with high right septal ventricular electrode placement in 'ablate and pace' patients.

Purpose: The study aim was to validate the closed loop stimulation (CLS) vs. accelerometer (ACC) rate-responsive sensors with electrodes placed in the right ventricular high septal (RVHS) or right ventricular apical (RVA) lead positions in patients following 'ablate and pace' therapy for persistent atrial fibrillation.

Methods: 'Ablate and pace' patients were randomised to either RVHS or RVA electrode placement with a dual sensor device.

A randomised controlled trial comparing StarClose and AngioSeal vascular closure devices in a district general hospital--the SCOAST study.

Aims: AngioSeal and StarClose are vascular closure devices (VCDs) that can be used following cardiac catheterisation via the femoral artery to achieve haemostasis. Both devices have been demonstrated to be superior to conventional manual pressure, which reduce time to haemostasis and time to patient ambulation. We sought to compare these devices in a prospective, randomised trial.

A cardiac sonographer led follow up clinic for heart valve disease.

Introduction: This study describes the effect of introducing a cardiac sonographer led follow up clinic for patients with stable heart valve disease. The 2 years before and after the instigation of the valve clinic were audited.

Materials And Methods: The clinic was conducted in a single centre and undertaken in the cardiology department of a district general hospital.

Treating cardiovascular disease in women.

Cardiovascular disease (CVD) is the most common cause of death in women but some of the challenges of management differ from those in men. This article addresses the gender-specific issues of cardiovascular management, with emphasis on ischaemic heart disease and modification of coronary risk factors. Women with ischaemic heart disease present later than men, and are therefore older and more likely to suffer from co-morbidities such as diabetes and hypertension.

Management of acute atrial fibrillation.

Atrial fibrillation (AF) is the most common cardiac arrhythmia; despite many available guidelines the optimal management strategy remains elusive. The most common presentations of acute AF are palpitations, breathlessness, syncope, dizziness, chest pain, transient ischaemic attack (TIA) and stroke. Patients may need urgent electrical cardioversion (ECV) or pharmacological cardioversion (PCV) and long term anticoagulation therapy.