Pacing and clinical electrophysiology : PACE
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Pacing Clin Electrophysiol · Aug 2011
Intrathoracic impedance and ultrasound lung comets in heart failure deterioration monitoring.
Echographic examination of the lung surface may reveal multiple ultrasound lung comets (ULCs) originating from water-thickened interlobular septa. These images were demonstrated to be useful for noninvasive assessment of interstitial pulmonary edema. Similarly, the correlation between implantable defibrillator-measured intrathoracic impedance and pulmonary capillary wedge pressure (PCWP) was demonstrated in heart failure (HF) patients. The aims of this analysis were to assess the agreement between defibrillator-detected impedance decrease and the presence of ULCs, as well as to compare the performance of the impedance-detection algorithm and the ULCs assessment in predicting HF worsening. ⋯ These data demonstrate the correlation between intrathoracic impedance and the number of ULCs at chest ultrasound, and a good agreement between the defibrillator warning for fluid index and the detection of multiple ULCs.
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Pacing Clin Electrophysiol · Aug 2011
Prevalence of preexcitation in a young population of male Swiss conscripts.
Sudden cardiac death can be the first clinical presentation of asymptomatic ventricular preexcitation. Recent data about prevalence of preexcitation in the electrocardiograms (ECG) of the general population are scarce. ⋯ The prevalence of preexcitation in young, predominantly male conscripts is 0.13%. This is comparable with previous findings in children.
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Pacing Clin Electrophysiol · Jul 2011
No increased bleeding events with continuation of oral anticoagulation therapy for patients undergoing cardiac device procedure.
Switching warfarin for heparin has been a practice for managing periprocedural anticoagulation in high-risk patients undergoing device-related procedures. We sought to investigate whether continuation of warfarin sodium therapy without heparin bridging is safe and, when it is continued, the optimal international normalized ratio (INR) without increased bleeding risk at time of device-related procedure. ⋯ Continuation of oral anticoagulation therapy with an INR level of <2.5 does not impose increased risk of bleeding for device-related procedures, although precaution is necessary to avoid supratherapeutic anticoagulation levels.
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Pacing Clin Electrophysiol · Mar 2011
Case ReportsProarrhythmic ECG deterioration caused by myocardial ischemia of the conus branch artery in patients with a Brugada ECG pattern.
The Brugada-type electrocardiogram (ECG) is characterized by ST-segment elevation in the right precordial ECG leads and has been reported to have the potential of sudden death. Right ventricular outflow tract supplied from the conus branch of the coronary artery (CB) is considered as the anatomopathologic substrate of Brugada syndrome. We experienced two asymptomatic patients with a saddleback Brugada-type ECG who exhibited a dynamic ECG conversion to a coved type following a ventricular fibrillation/ventricular tachycardia (VT/VF) episode when myocardial ischemia occurred exclusively at the CB. Some types of Brugada syndrome might be caused VT/VF by selective myocardial ischemia at the CB.