Kardiol Pol
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In order to achieve optimal outcomes when treating ventricular tachyarrhythmias with implantable devices, it is extremely important to identify parameters predisposing to arrhythmia. In view of current restrictions in healthcare funding, there is a growing demand for additional predictors of arrhythmia that would allow better patient selection for implantable cardioverter-defibrillator (ICD) use for primary prevention of sudden cardiac death (SCD). ⋯ Factors associated with a significantly increased risk of ventricular tachyarrhythmia/appropriate ICD intervention included reduced LVEF, increased resting HR, NYHA class II or higher heart failure, and wide QRS. Patients with low LVEF (< 31%) are at particular risk of SCD due to ventricular arrhythmia and this parameter alone can influence the decision regarding ICD implantation. No effect of ICD interventions on total mortality was observed, although more ICD interventions were observed in patients who died due to heart failure.
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New generation cardiac troponin assays have sufficient precision to detect and quantify plasma troponin concentrations below the lower threshold of detection of the currently employed troponin tests. However, diagnostic performance of the newer generation assays in daily clinical practice is not well established. ⋯ The newer generation sensitive cardiac troponin assay presented superior diagnostic accuracy in the diagnosis of AMI compared to the standard troponin test in a single reading at admission with improved sensitivity and specificity. The sensitive troponin assay has the potential to improve early detection and/or exclusion of AMI.
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Systemic lupus erythematosus (SLE) is an autoimmune disorder resulting in multiorgan inflammatory damage. The heart is frequently involved in SLE. ⋯ Severe valvular impairment is rather rare and occurs in few years and in advanced stage of the disease. In this study we report a case of a young women with SLE and heart failure due to mitral regurgitation as the first manifestation of the disease.
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Case Reports
[Additional mass on the intracardiac lead - diagnostic doubts and the optimal choice of treatment].
We describe a case of a 30 year-old female with implantable cardioverter-defibrillator. One and a half year later the patient suffered from endocarditis und undevent surgery. The factor V Leiden mutation was diagnosed. Diagnosis and treatment of device-related interactive complications is discussed.