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ABSTRACT: Stress-induced cardiomyopathy is usually described as syndrome with good prognosis. Although the QT prolongation is usually associated with this cardiomyopathy, the life threatening arrhythmias are less frequent than expected. We present middle age woman with torsade de pointes caused by significant QTc interval prolongation on the basis of tako-tsubo cardiomyopathy, which could suggest not always mild course of this syndrome.
Kardiologia polska 01/2012; 70(4):396-7. · 0.51 Impact Factor
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ABSTRACT: We describe a case of a patient with the history of a monomorphic postinfarction ventricular tachycardia that exhibited a right bundle branch block morphology and a superior axis. Because of electrical and hemodynamic instability of arrhythmia, classical mapping techniques were not applied. An electroanatomic voltage map during sinus rhythm was performed. A Purkinje potential (PP) preceding the QRS complex was recorded at posteroseptal area of a scar. Radiofrequency energy delivery at sites where a PP was detected resulted in a successful ablation.
Pacing and Clinical Electrophysiology 04/2011; 35(5):e124-6. · 1.35 Impact Factor
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ABSTRACT: We report a 47 year-old male patient with coexistence of left ventricular noncompaction and Brugada syndrome. He presented malignant ventricular arrhythmias followed by cardioverter- -defibrillator implantation, atrial fibrillation and flutter and progressive heart failure. This case could be an example of the coexistence of two rare diseases of various genetic patterns that only partially showed overlapping symptomatology and complications, particularly ventricular arrhythmias.
Cardiology journal 01/2011; 18(3):310-3. · 1.31 Impact Factor
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ABSTRACT: We report a case of tako-tsubo cardiomyopathy after an unintentional atrioventricular (AV) block during an ablation procedure in a 77 year-old woman. This intriguing case explores three possible reasons that could have triggered the disease: (1) slow pathway destruction; (2) AV nodal complete heart block; (3) the overall stress the patient had experienced.
Kardiologia polska 01/2011; 69(5):508-9. · 0.51 Impact Factor
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ABSTRACT: A case of a male patient with a history of supraventricular tachycardia confirmed by electrophysiological study and treated by RF ablation is presented. The features of multiple slow atrioventricular nodal pathways were found as well as the unusual induction mechanism of the slow-fast atrioventricular nodal reentry tachycardia - 1 : 2 AV conduction.
Kardiologia polska 07/2009; 67(6):695-9. · 0.51 Impact Factor
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ABSTRACT: The purpose of this study was to determine the rate and causes of inappropriate rhythm detection, and to compare adequacy of ventricular arrhythmia detection by single-chamber and dual-chamber cardioverter-defibrillators (ICD).
We evaluated 190 patients (age 57.2 +/- 11.2 years) with ICD. Follow-up: 34.3 +/- +/- 22 months. Dual-chamber ICD was used in 54 patients.
We evaluated 2244 arrhythmia events recognized as of ventricular origin, including ventricular tachycardia and ventricular fibrillation. 431 events (19.2%) were recognized erroneously and resulted in an inappropriate ICD discharge. Most cases of inappropriate therapies (182 events, 42.23%) were due to atrial fibrillation or flutter. Overall, inappropriate arrhythmia detection was found in 64 (33.6%) of 190 patients. In terms of the number of affected patients, the most common cause of inappropriate ICD discharge was sinus tachycardia - 23 (12.1%) patients, followed by atrial fibrillation - 16 (8.4%) patients. Among 54 patients with dual-chamber ICD, inappropriate therapy was noted in 21 (38.8%) patients, (T wave oversensing, sinus tachycardia and atrial fibrillation etc.). No significant difference was seen in the rate of inappropriate therapy due to a rapid supraventricular rhythm between patients with single-chamber versus dual-chamber ICD. In contrast, patients with single-chamber ICD more often experienced inappropriate therapy due to atrial fibrillation (155 vs. 28 patients) and sinus tachycardia (66 vs. 9 patients).
Despite of introduction of new generations of ICDs, the problem of inappropriate ICD discharge could not be eliminated. The major problem is distinction between supraventricular arrhythmia and ventricular tachyarrhythmia.
Cardiology journal 01/2009; 16(5):432-9. · 1.31 Impact Factor
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Łukasz Jodko,
Zdzisława Kornacewicz-Jach, Jarosław Kaźmierczak,
Ryszard Rzeuski,
Joanna Zielonka,
Robert Kaliszczak,
Krzysztof Safranow,
Klinika,
Kardiologii Pomorskiej,
Akademii Medycznej,
Szczecinie,
Zakład Biochemii Pomorskiej
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ABSTRACT: Streszczenie Wstęp: Jednym z ważniejszych problemów, jakie dotyczą pracy kardiowerterów-defibrylato-rów (ICD), są nieadekwatne terapie. Szczególnie dotyczy to pacjentów, u których występują tachyarytmie nadkomorowe. Celem pracy było określenie częstości i przyczyn występowania zaburzeń detekcji, a także porównanie adekwatności detekcji arytmii komorowych w ICD jedno-i dwujamowych, ze szczególnym uwzględnieniem współwystępowania arytmii nadko-morowych. Metody: Analizie poddano 190 osób (36 kobiet i 154 mężczyzn, w średnim wieku 57,2 ± 11,2 ro-ku), którym wszczepiono ICD. Średni czas obserwacji wyniósł 34,3 ± 22 miesiące. U 136 pa-cjentów implantowano ICD jednojamowy, u 54 — dwujamowy.
Cardiology Journal. 01/2009; 16(6):432-439.
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ABSTRACT: High-dose statins are used in acute coronary syndromes (ACS) to reduce inflammation. The aim of the study was the evaluation of the influence of low-dose atorvastatin (20 mg) on selected inflammatory parameters and clinical outcomes after ACS.
Seventy eight patients (pts) with ACS were randomly divided into group A (39 pts) taking atorvastatin, and group NA (39 pts) not taking any statin for the following six weeks. C-reactive protein (CRP), interleukin-6 (IL-6), monocyte chemoattractant protein-1 (MCP-1) and tumour necrosis factor alpha (TNFa) levels were measured on the first and the fifth days and six weeks after ACS.
There was no significant CRP and IL-6 level decrease in group A (CRP--62%; IL-6-73%) or group NA (CRP-44%; IL-6-62%). There was also no significant change in TNFa levels. The MCP-1 level finally reached the level of significant difference (p < 0.04). Cardiovascular events (MACE) and the restenosis rates did not differ between the groups.
Low-dose atorvastatin does not have a significant influence on cooling down inflammation in ACS, and MCP-1 can be used as an early indicator of statin anti-inflammatory activity. Furthermore, it does not reduce MACE or restenosis rates despite its influence on MCP-1 levels.
Cardiology journal 01/2008; 15(4):357-64. · 1.31 Impact Factor
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Maciej Sterliński,
Aleksander Maciag,
Oskar Kowalski,
Kinga Gościńska-Bis,
Mariusz Pytkowski,
Ilona Kowalik,
Ewa Lewicka-Nowak,
Przemysław Mitkowski, Jarosław Kaźmierczak,
Zbigniew Kalarus,
Włodzimierz Kargul,
Andrzej Lubiński,
Andrzej Cieśliński,
Zdzisława Kornacewicz-Jach,
Hanna Szwed,
Zygmunt Sadowski
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ABSTRACT: Benefits of cardiac resynchronisation therapy (CRT) for survival in selected congestive heart failure (CHF) patients have been acknowledged by the 2005 ESC guidelines. Aim: To analyse mortality in CRT pacing only (CRT-P) patients during at least one-year follow-up.
This was a prospective, multi-site, at least one-year observational study on mortality and mode of death in patients who received CRT-P due to commonly accepted indications. One-year follow-up data (or earlier death) were available for 105 patients (19 females, 86 males) aged 60.6+/-9.8 years (35-78). Baseline NYHA class was 3.2+/-0.4 (3-4). Coronary artery disease (CAD) was the underlying aetiology of CHF in 57 (54%) patients and 48 (46%) patients had CHF due to non-coronary factors.
Mean follow-up duration was 730 days (360-1780), median 625. There were 21 (20%) deaths: 5 (24%) sudden cardiac deaths (SCD), 13 (62%) deaths due to heart failure (HFD) and 3 (14%) other deaths. Thirteen (62%) patients died within the first year of observation. All SCD occurred in this period. Mean time to death was 303+/-277 days (19-960) to HFD - 339+/-313 days (19-960) and to SCD - 208+/-127 days (31-343). There were no significant differences between survivors and non-survivors with respect to left ventricular ejection fraction (LVEF) (25+/-10 vs. 20+/-8%), 6-minute walk test (6 min WT) (276+/-166 vs. 285+/-163 m) and LV diastolic diameter (LVEDD) (71+/-9 vs. 78+/-10 mm) (all NS). The SCD and HFD patients had similar age (62.0+/-5.4 vs. 56.6+/-13.2 years), gender (80 vs. 83% males), NYHA class (3.1+/-0.2 vs. 3.5+/-0.3), LVEF (22+/-9 vs. 17+/-5%), LVEDD (86+/-10 vs. 79+/-9 mm), 6 min WT (270+/-142 vs. 292+/-188 m) (NS). In 4 patients from the SCD group CHF was of non-coronary aetiology and only in 1 patient from the HFD group (p=0.003). The values of LVEF, LVEDD and NYHA class in HFD patients who died during the first year after implantation, compared with those who died later, were similar.
Sudden cardiac death probability in the studied CRT-P population was the highest during the first year after implantation. Afterwards, the risk of HFD started to increase. Thus, in all patients eligible for CRT prophylactic defibrillation function should be considered.
Kardiologia polska 12/2007; 65(11):1287-93; discussion 1294-5. · 0.51 Impact Factor
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ABSTRACT: The presented case report describes a male patient with an implanted cardioverter-defibrillator (ICD) in whom a coadministration of ciprofloxacin and azimilide caused QT interval prolongation and multiple episodes of torsades de pointes (TdP) followed by ICD shocks (arrhythmic storm). The case highlights a not described drug interaction between azimilide and ciprofloxacin, which is believed to be the safest member of fluoroquinolones class.
Pacing and Clinical Electrophysiology 09/2007; 30(8):1043-6. · 1.35 Impact Factor
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ABSTRACT: We describe a case of defibrillation lead damage which was detected only during an upgrade procedure from single-chamber ICD to dual-chamber ICD with biventricular pacing. The damage was not detected during routine checks in the ICD clinic.
Europace 11/2006; 8(10):870-2. · 1.98 Impact Factor
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ABSTRACT: Hospital readmissions are one of the important problems of patients with implantable cardioverter-defibrillators (ICD). Detailed analysis of the causes of re-hospitalizations may lead to improved management of ICD patients and eventually limit the number of hospital readmissions.
Prospective analysis of repeat hospitalisations, their causes and time from discharge to first hospital readmission in a group of patients after ICD implantation. A search for predictors of rehospitalisation was also performed.
Analysis involved 133 consecutive patients who underwent ICD implantation in the Department of Cardiology, PAM. Readmission causes were split into cardiac and non-cardiac. An index of repeat hospitalisation was calculated and parameters with a direct impact on rehospitalisation necessity were also evaluated.
One hundred and sixty-seven hospital readmissions of 72 (54%) patients were noted at mean 22+/-15 months after the primary hospitalisation. Rehospitalisation index per patient for the total follow-up period was 1.26, while for the first year of follow-up it was 0.69. In the case of 42 (32%) patients, 91 (54.5%) hospital readmissions were associated with arrhythmia. In 34 (25.6%) patients, 54 (32.3%) re-hospitalizations were not related to arrhythmia, while 20 (15%) patients were hospitalised 22 times (13.2%) for non-cardiac reasons. Mean time to the first readmission, regardless of the reason, was 9+/-9 months. Predominant causes of repeat hospitalisation were ventricular arrhythmias and worsening of heart failure. Patients with left ventricular ejection fraction (LVEF) below 30% and in functional NYHA class III were readmitted to hospital more frequently for reasons not related to arrhythmia.
Hospital readmissions for cardiac causes in patients after ICD implantation are still frequent. Most of them are caused by ventricular arrhythmia and heart failure. Low LVEF (<30%) and NYHA functional class > or =III are risk factors predicting repeat hospitalisations unrelated to arrhythmia.
Kardiologia polska 07/2006; 64(7):684-91; discussion 692-3. · 0.51 Impact Factor
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ABSTRACT: Endurance sports are associated with structural and functional changes in the myocardium. Physiologic changes representing cardiac adaptation to training are termed "athletic heart".
We compared the incidence of arrhythmias and conduction abnormalities in athletes of static and dynamic sports using resting and 24 hour electrocardiography. We also studied the effect of physiologic left ventricular hypertrophy on the incidence of arrhythmias and conduction abnormalities in athletes, as well as of training duration on electrocardiographic parameters.
We enrolled 40 male athletes of static and 40 of dynamic sports, as well as 30 normally active males. A 12-lead resting ECG, 24 hour ECG, and echocardiography were done.
The resting heart reate in athletes was significantly slower (p < 0.0001). No intervals longer than 3s, bundle branch or atrioventricular blocks were disclosed. The finding of left ventricular bypertrophy and training duration had no significant effect on the presence and number of supraventricular and ventricular arrhythmias or blocks.
Resting ECG, echocardiography, and 24 hour ECG provide valuable cardiologic information in athletes. The heart rate was slower in all athletes and the PQ interval was longer as compared with controls. No serious arrhythmias or conduction abnormalities were noted. The duration of training and the presence of myocardial hypertrophy had no effect on electrocardiographic parameters.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 04/2006; 20(118):390-4.
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ABSTRACT: Left ventricular (LV) diastolic dysfunction is responsible for most clinical symptoms in hypertrophic cardiomyopathy. The left ventricular outflow tract (LVOT) obstruction has additional negative haemodynamic influence. Alcohol septal ablation reduces the LVOT gradient. CEL The aim of our study was the evaluation of acute and long-term changes of LV diastolic function after successful alcohol septal ablation.
In 15 patients with successful reducing of LVOT gradient the LV diastolic function was assessed using Doppler echocardiography before ablation and in short and long-term follow-up.
Before ablation IVRT and DT were prolonged in comparison to normal values. In acute phase after ablation E/A ratio decreased from 1.19 +/- 0.36 to 0.89 +/- 0.27 (p < 0.01), but returned to baseline by the first week. In long-term follow-up there was again a significant reducing of E/A ratio (mainly due to E wave changes). IVRT was significantly shortened from 98 +/- 20 ms at baseline to 80.5 +/- 17 ms at day 7 and later. This change was stable to the end of follow-up. DT did not change significantly just after the ablation and during follow-up.
In the acute period after alcohol septal ablation there is an increase of LV relaxation disorders. Changes observed during long-term follow-up are difficult to interpret, but significant shortening of IVRT shows on improvement of the LV diastolic function.
Polski merkuriusz lekarski: organ Polskiego Towarzystwa Lekarskiego 07/2002; 13(73):25-8.
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ABSTRACT: A 31-year-old woman presented with a 3-month history of progressing fatigue and effort dyspnea. Echocardiography depicted a tumor within the free wall of the right ventricle and right atrium, located on both sides of the tricuspid annulus. Computed tomography showed disseminated circular shadows sized up to 7 mm--most likely metastatic lesions--in both lungs. The diagnosis of low-grade mesothelioma bifasicum was confirmed with histopathologic and immunohistochemical studies of the samples taken by thoracoscopy from parietal pleura, lung tumor, and diaphragm region. Chemotherapy, which included gemcitabine and carboplatin, resulted in transient improvement of the clinical status of the patient and reduction of the tumor mass lasting several months followed by progression of the disease. Significant amounts of pleural fluid and huge tumors within both pleural cavities emerged. The patient died due to respiratory and circulatory insufficiency 11 months following the diagnosis.
Angiology 58(2):255-8. · 1.51 Impact Factor
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ABSTRACT: The presented case report describes a female patient suffering from systemic lupus erythematosus, in whom dilated cardiomyopathy with progressive heart failure was a very first symptom of the disease. The advanced invasive treatment method, cardiac resynchronization therapy, was successfully applied to improve the quality of life, clinical symptoms, and exercise tolerance.
Angiology 58(2):238-41. · 1.51 Impact Factor
