Relation of N-terminal pro-B-type natriuretic peptide to symptoms, severity, and left ventricular remodeling in patients with organic mitral regurgitation.

Natriuretic peptides reflect cardiac stress and may therefore be useful in the management of patients with valvular heart disease. Data regarding these biomarkers in organic mitral regurgitation (MR) are sparse. In this study, 144 patients with moderate or severe organic MR were prospectively enrolled in an observational, multicenter study to analyze the relation of N-terminal-pro-B-type natriuretic peptide (NT-pro-BNP) to symptoms, severity of MR, and echocardiographic parameters.

Atrial fibrillation: estimated excess rate of stroke due to lacking adherence to guidelines.

Questions Under Study: Many patients with atrial fibrillation (AF), risk factors for stroke and no obvious contraindications do not receive oral anticoagulation. Estimations of the increased rate of stroke due to neglected anticoagulation, particularly in an elderly, non-selected population, are unknown.

Methods: Consecutive patients with paroxysmal or permanent atrial fibrillation admitted to the medical or surgical department of our hospital for any reason were studied.

Value of repeated cardiac magnetic resonance imaging in patients with suspected arrhythmogenic right ventricular cardiomyopathy.

Aim: Diagnosis of early stages of arrhythmogenic right ventricular cardiomyopathy (ARVC) with minimal structural abnormalities is challenging. The purpose of this study was to assess the value of repeated cardiac magnetic resonance imaging (CMR) in patients referred for right ventricular arrhythmias and clinical suspicion of ARVC.

Methods And Results: Prospective follow-up study of 18 patients (8 females) studied with CMR for suspected ARVC.

Prophylactic implantable cardioverter defibrillator therapy in dilated cardiomyopathy: impact of left ventricular function.

Background: The value of an implantable cardioverter defibrillator (ICD) for primary prevention in dilated cardiomyopathy (DCM) is unclear, as randomized trials could not show a survival benefit compared to drug therapy. It has not been investigated if patients with a very poor left ventricular function (LVEF) could profit from an ICD.

Methods: Consecutive patients with DCM who received an ICD between December 1996 and November 2003 were included in this analysis.

Evidence for left ventricular remodeling after percutaneous coronary intervention: effect of percutaneous coronary intervention on left ventricular ejection fraction and volumes.

Background: Post-stress ejection fraction (EF), end-diastolic (EDV) and end-systolic (ESV) volumes by gated myocardial perfusion SPECT (MPS) are well validated, reproducible and of prognostic significance. However, little is known about the impact of percutaneous coronary intervention (PCI) on left ventricular volumes and remodeling.

Methods: Thirty-eight patients who underwent MPS before and 6 months after PCI were evaluated.

Cardiac resynchronization in severe heart failure and left bundle branch block: a single center experience.

Objective: To assess the feasibility and longterm outcome of cardiac resynchronization therapy (CRT) in patients with impaired left ventricular function (LVEF <35%), left bundle branch block (QRS >120 ms) and dyspnoea NYHA 0 III at a single centre.

Methods And Results: Forty-seven patients were referred for implantation of a CRT device. In only 4 patients (9%) the device could not be implanted due to technical problems during the procedure.

Arrhythmogenic right ventricular cardiomyopathy: diagnostic and prognostic value of the cardiac MRI in relation to arrhythmia-free survival.

Arrhythmogenic right ventricular cardiomyopathy (ARVC) is a potentially fatal disease, which is often difficult to diagnose. As a non-invasive test cardiac magnetic resonance imaging (CMR) has become an important tool in establishing the diagnosis. The aim of this study was to evaluate the diagnostic and prognostic value of CMR in patients with suspected ARVC and to assess the long-term outcome of patients with CMR-diagnosed ARVC.

Rate response of a closed-loop stimulation pacing system to changing preload and afterload conditions.

Closed-loop stimulation (CLS) is a new sensor concept for rate adaptive pacing measuring changes in the unipolar right ventricular impedance, which correlates to changes of the right ventricular contractility and reflects the autonomic nervous innervation of the heart. Some patients do not tolerate the CLS mode because of inappropriate tachycardia, mainly related to postural changes. This study tested if the rate response of the CLS sensor is influenced not only by myocardial contractility but also by rapid changes in right ventricular filling.

Implantable cardioverter defibrillator proarrhythmia due to an interaction with "noncompetitive atrial pacing": an algorithm to prevent atrial arrhythmias.

An episode of device related proarrhythmia observed with a dual chamber ICD is reported. Ventricular tachycardia was induced due to an inappropriate interaction of programmed device settings with automatic algorithms, including noncompetitive atrial pacing (NCAP), an algorithm used to prevent atrial tachyarrhythmias.

Late potential analysis: is a mathematically-derived X,Y,Z lead system comparable to a true orthogonal X,Y,Z lead system?

Background: Analysis of ventricular late potentials (LP) with signal-averaged ECG (SAECG) using three bipolar, orthogonal X,Y, Z leads is a validated method of risk-stratification in patients prone to ventricular tachycardia. The aim of this study was to validate a ECG system, which allows LP analysis using X,Y, Z leads mathematically derived from the standard 12-lead ECG.

Methods And Results: In 36 patients (age 56 +/- 12 years, coronary artery disease 71%, LVEF 46 +/- 14%) with known or suspected ventricular tachyarrhythmia, two consecutive SAECGs were recorded, one with mathematically derived and another one with true X,Y, Z leads.

European clinical experience with a dual chamber single pass sensing and pacing defibrillation lead.

Dual chamber ICDs are increasingly implanted nowadays, mainly to improve discrimination between supraventricular and ventricular arrhythmias but also to maintain AV synchrony in patients with bradycardia. The aim of this study was to investigate a new single pass right ventricular defibrillation lead capable of true bipolar sensing and pacing in the right atrium and integrated bipolar sensing and pacing in the right ventricle. The performance of the lead was evaluated in 57 patients (age 61 +/- 12 years; New York Heart Association 1.