Isolated tricuspid valve surgery after congenital versus left heart-disease surgery: mid-term outcomes.

Background: Left heart involvement might be a differential factor in the physiopathology and prognosis of severe tricuspid regurgitation (TR) following cardiac surgery. We aimed to compare the outcomes of isolated tricuspid valve surgery (ITVS) after congenital versus left heart-disease surgery.

Methods: We retrospectively studied and followed up 58 patients who underwent ITVS for TR following cardiac surgery in our center from January 2012 to December 2017.

Sutureless aortic valve and TAVI: pros and cons.

Aortic valve replacement (AVR) with biological heart valves remains the gold standard for treating operable older patients with symptomatic aortic stenosis. Over the last few years, transcatheter aortic valve implantation (TAVI) has been shown to be superior to medical treatment in high-risk patients with severe aortic stenosis. The transfemoral TAVI route has been also found in randomized controlled trials to be as good as, if not superior to, standard AVR at 5 years in high-risk patients.

Recurrences of symptoms after AV node re-entrant tachycardia ablation: a clinical arrhythmia risk score to assess putative underlying cause.

Purpose Of The Research: To identify clinical factors associated with the probability for each arrhythmic mechanism causing recurring symptoms after atrioventricular nodal re-entrant tachycardia (AVNRT) ablation. Slow pathway radiofrequency ablation is used to treat AVNRT. After ablation, recurrence of symptoms due to AVNRT or other arrhythmias can occur.

A case series of patients with poorly-tolerated arrhythmias related to a preexcitation syndrome and presenting with atypical ECG.

Unlabelled: The aim of study was to report different and unusual patterns of preexcitation syndrome (PS) noted in patients referred for studied for poorly-tolerated arrhythmias and their frequency. Electrophysiologic study (EPS) is an easy means to identify a patient with PS at risk of serious events. However the main basis for this diagnosis is the ECG which associates short PR interval and widening of QRS complex with a delta wave.

Incidence and prognostic significance of spontaneous and inducible antidromic tachycardia.

Aims: Orthodromic atrioventricular reentrant tachycardia (ORT) is the most common arrhythmia at electrophysiological study (EPS) in patients with pre-excitation. The purpose of the study was to determine the clinical significance and the electrophysiological characteristics of patients with inducible antidromic tachycardia (ADT).

Methods And Results: Electrophysiological study was performed in 807 patients with a pre-excitation syndrome in control state and after isoproterenol.

Is the measurement of accessory pathway refractory period reproducible?

Introduction: Short accessory pathway (AP) effective refractory period (ERP) is one of the risk factors in Wolff-Parkinson-White syndrome (WPW). The purpose of study was to evaluate the reproducibility of APERP measurement during a same electrophysiological study (EPS).

Methods: EPS consisted of 2 APERP measurements performed prospectively in 77 patients for a WPW in control state (CS) at a cycle length of 400 ms (n=76) and after isoproterenol (n=56).

Prevalence of atrial fibrillation in patients with history of paroxysmal supraventricular tachycardia.

Objectives: This study was performed to evaluate the prevalence of atrial fibrillation (AF) in patients seen for paroxysmal supraventricular tachycardia (PSVT) and to identify factors favoring AF. AF incidence is increased in patients with PSVT, but AF risk factors are unknown.

Population: 1187 patients, mean age 50 ± 19 years, were consecutively studied for spontaneous PSVT confirmed by electrophysiological study (EPS).

Missing diagnosis of preexcitation syndrome on ECG: clinical and electrophysiological significance.

Unlabelled: Electrocardiographic criteria of preexcitation syndrome are sometimes not visible on ECG in sinus rhythm (SR). The purpose of the study was to evaluate the significance of unapparent preexcitation syndrome in SR, when overt conduction through accessory pathway (AP) was noted at atrial pacing.

Methods: Anterograde conduction through atrioventricular AP was identified at electrophysiological study (EPS) in 712 patients, studied for tachycardia (n=316), syncope (n=89) or life-threatening arrhythmia (n=55) or asymptomatic preexcitation syndrome (n=252).

Risk of atrial fibrillation according to the initial presentation of a preexcitation syndrome.

Background: Atrioventricular reentrant tachycardia (AVRT) is frequent in Wolff-Parkinson-White syndrome (WPW). Atrial fibrillation (AF) is rare. The purpose of the study was to determine the factors of spontaneous AF in WPW according to the initial presentation.

Risk factors of adverse presentation as the first arrhythmia in Wolff-Parkinson-White syndrome.

Background: The aim of the study was the evaluation of the predictors of adverse presentation as first arrhythmia in Wolff-Parkinson-White syndrome; they usually affect young patients with septal or multiple accessory pathways (AP).

Methods: Our population comprised 645 patients with a preexcitation syndrome. Among them, adverse presentation (sudden death, hemodynamically not tolerated atrial fibrillation [AF]) occurred in 60 (9%) (group I).

Contrast-enhanced sonography of the renal transplant using triggered pulse-inversion imaging: preliminary results.

The purpose of our study was to quantify renal transplant parenchymal sonographic enhancement using pulse-inversion imaging (PII) and intermittent emission after contrast administration by means of bolus and infusion techniques, and to evaluate renal perfusion functional indices. A total of 34 patients, presenting with minor abnormalities (n = 14) and cortical perfusion changes due to parenchymal disorders (n = 12) or renal artery stenosis (n = 8) were included. Cardiac-triggered contrast-enhanced PII ultrasound (US) was performed after administration of SHU 508 A (Schering AG, Berlin, Germany), using a high mechanical index, a frame rate of one image every four cardiac cycles for bolus study, and a decreasing frame rate for infusion study.

Mechanism of QRS electrical alternans.

In patients with latent dual atrioventricular nodal pathways a 2:1 ventriculoatrial block often occurs during ventricular pacing and is generally associated with the concomitant appearance of QRS alternans. This type of QRS alternans is related to retrograde conduction, and a concealed retrograde conduction in the His Purkinje system could explain the QRS alternans. A case that confirms the hypothesis that electrical alternans is secondary to a 2:1 block in the activation of some part of the ventricles is reported.

Anaphylactic shock induced by paracetamol.

A 46 year old woman had adverse reactions to paracetamol. Oral challenge tests with the drug showed that the reactions were dose-dependent and they reproduced similar symptoms consisting of vomiting, diarrhoea, pruritus, skin rashes, facial oedema, dyspnoea and hypotension. There was a marked increase in blood histamine but the complement components C3 and C4 remained at normal levels.