Therapeutic inertia in rhythm control strategies in hospitalized patients with fibrillation: Insights from Hellenic Cardiorenal Morbidity Snapshot (HECMOS) study.

Background: Current guidelines recommend a rhythm control strategy in patients with symptomatic atrial fibrillation (AF) while catheter ablation has been shown to be a safer and more efficacious approach than antiarrhythmic medications.

Methods: HECMOS was a nationwide snapshot survey of cardiorenal morbidity in hospitalized cardiology patients. In this sub-study, we included 276 cases who had a history of AF, particularly on the rhythm strategy, and catheter ablation procedures had been performed before the index admission.

Acute myocardial infarction after a European hornet sting--a case report.

The authors briefly describe an 87-year-old man who experienced an acute ST-elevation myocardial infarction in the context of an anaphylactic reaction caused by a European hornet (Vespa cabro linnaeus) envenomation. This unusual case highlights the potential cardiovascular complications associated with common insect stings such as those caused by hymenoptera. Thus, a thorough cardiovascular evaluation is essential in such cases since the vasoactive, inflammatory, and thrombogenic mediators of anaphylactic reactions may provoke myocardial ischemia.

Acute non-ST-elevation myocardial infarction presented as occipital headache with impaired level of consciousness--a case report.

Headache represents a rare manifestation of myocardial ischemic pain. It is believed that this clinical symptom results from convergence of heart autonomic fibers with somatic inputs originating from the head. The authors describe for the first time the case of a 73-year-old woman who experienced an acute non-ST-elevation myocardial infarction that manifested solely with intense occipital headache associated with vomiting and impaired level of consciousness.

Oral vitamin C administration reduces early recurrence rates after electrical cardioversion of persistent atrial fibrillation and attenuates associated inflammation.

Background: Inflammation and oxidative stress have been recently implicated in the pathophysiology of atrial fibrillation (AF). The aim of this study was to examine the potential benefit of vitamin C on the early recurrence rates and on inflammatory indices after successful cardioversion of persistent AF, as well as to investigate the time course of changes in these indices post-cardioversion.

Methods: We prospectively studied 44 consecutive patients after successful electrical cardioversion of persistent AF.

Kearns-Sayre syndrome associated with trifascicular block and QT prolongation.

Patients suffering from Kearns-Sayre syndrome (KSS) often develop conduction defects that may lead to syncope or sudden cardiac death. The association of conduction abnormalities with prolonged QT interval in these patients is very rare. We describe a patient with KSS and diabetes mellitus who suffered a torsades de pointes-induced syncopal attack, in the presence of trifascicular block and QT prolongation (QTc: 574 ms).