Archives des maladies du coeur et des vaisseaux
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Arch Mal Coeur Vaiss · Jan 1990
[Carotid sinus hypersensitivity. Medium and long-term development in patients treated by ventricular pacing].
The problem of pacing patients with carotid sinus hypersensitivity (CSH) is the choice and criteria of selection of the pacing mode. The authors studied 29 patients with CSH treated by VVI pacing over a period of 10 years. The average follow-up was 34 months (range 6 to 96 months). ⋯ The patient had a mixed form of CSH (B. P. drop of 65 mmHg) associated with a "pace maker syndrome" (drop of 50 mmHg in systolic blood pressure at the onset of VVI pacing without any sino carotid massage). The authors conclude that the cases of CSH which, during their investigation, are best corrected by dual-chamber pacing or which are associated with a significant pacemaker effect or present retrograde ventriculo-atrial conduction, should receive dual-chamber pacemakers.
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Arch Mal Coeur Vaiss · Jan 1990
Case Reports[Myocardial infarction and massive biventricular thrombosis during thrombocytopenia induced by pentosan polysulfate and heparin].
Many cases of immuno-allergic thrombocytopenia complicated by serious thromboembolism induced by heparin or other heparinoids such as pentosan polysulphate have been reported. This case is of interest for two reasons: first of all, it was induced by pentosan polysulphate and then reactivated by secondary administration of heparin; secondly, it was complicated successively by an infero-apical myocardial infarction with probable spontaneous lysis of a coronary thrombosis because coronary arteriography performed one month later was normal, and then by massive biventricular thrombosis requiring surgical thrombectomy under cardiopulmonary bypass. Tests of platelet aggregation were positive to standard heparin and to several low molecular weight fractions. The outcome was favorable when the responsible substances were withdrawn.