Giornale italiano di cardiologia
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Potentially lethal interactions between concomitantly implanted pacemaker and automatic first-generation cardioverter-defibrillator have been reported. We therefore evaluated the reliability and safety of simultaneous implantation of dual-chamber pacemakers with a fourth generation cardioverter-defibrillator incorporating an improved arrhythmia detection system. ⋯ These data suggest that concomitant implantation of a fourth-generation automatic cardioverter-defibrillator and a dual-chamber pacemaker using either unipolar or bipolar leads can be performed safely. Extreme caution and rigorous interactions testing is nevertheless advised when considering this device combination.
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Review Case Reports
Right bundle branch block, intermittent ST segment elevation and inducible ventricular tachycardia in an asymptomatic patient: an unusual presentation of the Brugada syndrome?
We describe the case of an asymptomatic 54-year-old female who underwent a routine electrocardiogram (ECG) in July 1997, which showed incomplete right bundle branch block and an important ST segment elevation with a coved fashion and the inversion of T waves in leads V1-V2. Her family and personal history was free of any cardiovascular pathology. She previously underwent a routine ECG in 1991 and 1995, showing an incomplete right bundle branch block with a moderate ST segment elevation in leads V1-V2. ⋯ The patient began therapy with sotalol 80 mg t.i.d. and the electrophysiologic study was repeated three days later. A non-sustained polymorphic ventricular tachycardia (cycle length 200 ms) was induced with triple extrastimulus during pacing at a cycle length of 370 ms from the outflow tract of the right ventricle. On the basis of these results and as also suggested by recent reports, we decided to implant an Automatic Implantable Cardioverter Defibrillator.