Efficacy of propafenone for maintaining sinus rhythm in patients with recent onset or persistent atrial fibrillation after conversion: a randomized, placebo-controlled study

Objective -The aim of this study was to investigate the efficacy and safety of propafenone in the prevention of atrial fibrillation (AF) relapse after restoration of sinus rhythm

Catheter-induced vasospasm in the right external iliac and femoral arteries during a cardiac diagnostic procedure

Catheter-induced vasospasm of small caliber arteries, such as the coronary arteries, is frequently observed during cardiac catheterization, but obstruction of the large caliber arteries has not previously been reported. Here we present two cases in which femoral and external iliac arteries were totally obstructed due to spasm during diagnostic coronary angiography

Effect of trimetazidine on exercise performance in patients with coronary artery ectasia

Coronary artery ectasia (CAE) is a rare form of coronary artery disease. It has previously been shown that nitrate derivatives induce exertional angina in patients with CAE. Furthermore, there is limited data about the effects of other anti-ischemic agents in CAE. The aim of this study was to investigate the effect of trimetazidine on exercise performance in patients with CAE. The study population consisted of 56 patients with isolated CAE (32 males, mean age: 58 9 years). The presence of myocardial ischemia was evaluated by treadmill exercise test. The exercise test was positive in 49 patients at baseline and in 27 patients during trimetazidine therapy (P < 0.01). The exercise test induced angina in all of the patients who have had a positive test result. Significant ST depressions were observed in 42 and 23 patients before and after the treatment, respectively (P < 0.01). The extent of ST depression at peak exercise was significantly lower on trimetazidine (0.9 +/- 0.5 vs 1.5 +/- 0.6 mm, P < 0.01). With trimetazidine, the exercise duration increased from 7.8 +/- 2.1 to 8.7 +/- 2.4 min (P = 0.04) and cardiac work-load also increased from 8.9 +/- 2.3 to 10.4 +/- 2.1 mets (P < 0.01). The results suggest that trimetazidine can relieve exercise-induced angina and improve exercise performance in patients with CAE

Use of intraventricular dispersion of the peak diastolic flow velocity as a marker of left ventricular diastolic dysfunction in patients with atrial fibrillation

The aim of this study was to evaluate the use of intraventricular dispersion of the peak diastolic Row velocity as a marker of left ventricular diastolic dysfunction in patients with atrial fibrillation. Regional diastolic Row velocity patterns at 1, 2, and 3 cm away from the mitral tip toward the apex were simultaneously recorded with the mitral flow velocity pattern by using pulsed Doppler echocardiography in 24 patients with atrial fibrillation before electrical or medical cardioversion. Echocardiographic examination was repeated after 10 to 30 days (ie, at the time of recovery of left atrial mechanical functions) after cardioversion of atrial fibrillation in all patients. Thirteen patients were found to have diastolic dysfunction; the remaining 11 patients with a normal E/A ratio constituted the control group. Afterward, the data recorded before the cardioversion were analyzed for each patient. in subjects with normal diastolic function, the peak diastolic flow velocity ((PDFV) at the mitral tips also was maintained at the positions 1 to 3 cm away from the tip In the left ventricular cavity (PDFV at the mitral tips: 0.84 m/s, PDFV at 3 cm: 0.85 m/s; P = .34). In contrast, the regional PDFV progressively decreased toward the apex- in patients with diastolic dysfunction (PDFV at the mitral tips: 0.82 m/s, PDFV at 3 cm: 0.63 m/s: p = .0004). Only 77% of the initial velocity was maintained at 3 cm away from the mitral tips in patients with diastolic dysfunction, whereas almost 100% of the: Initial velocity was preserved In patients with normal diastolic function (P < .001). These findings suggest that the assessment of the intraventricular decrease in mitral PDFV may be used as a reliable marker of diastolic dysfunction in patients with atrial fibrillation

Does impaired left ventricular relaxation affect P wave dispersion in patients with hypertension?

Objective: P wave dispersion (PD) is considered to reflect the heterogeneous conduction in atria. We investigated whether there was a correlation between the left ventricular (LV) relaxation and PD

Time interval from the initiation of the electrocardiographic P wave to the start of left atrial appendage ejection flow: A novel method for predicting atrial fibrillation recurrence

Objective: The incidence of paroxysmal and persistent atrial fibrillation (AF) recurrence is high and unpredictable. in this study, a novel noninvasive method that was thought to reflect the interatrial. conduction time was investigated to predict AF recurrence. This method was on the basis of the measurement of time interval from initiation of the electrocardiographic P wave to the start of left atrial (LA) appendage (LAA) ejection How (P-LAA)

Predictors of exercise induced myocardial ischemia in patients with isolated coronary artery ectasia

The aim of this study was to investigate the angiographic predictors of exercise induced ischemia in patients with isolated coronary ectasia. We have prospectively analysed coronary angiograms of 1521 consecutive patients undergoing cardiac catheterisation. The overall incidence of coronary ectasia was 6.7% (102 patients). Forty-six patients (3%) with non-obstructive, diffuse or segmental coronary ectasia (i.e. isolated coronary ectasia) constituted the main study group. Coronary angiograms were reviewed for stigmata of an impaired coronary blood flow such as 'slow flow', 'segmental backflow phenomenon' and stasis. 'Slow flow' was quantified with frame counting. An ectasia-jeopardy score was also described in order to assess the effect of the extent of coronary ectasia on exercise induced ischemia. Exercise induced ischemia was observed in 24 patients (52%). Exercise test was abnormal in 70% of the patients with diffuse ectasia and 26% of patients with segmental ectasia (p = 0.003). The frame count of the arteries of the study group was higher than the control group but the correlation between the frame count of the ectatic vessels and exercise induced ischemia was not significant. Stasis of the dye also did not correlate with ischemia. There was a significant correlation between exercise induced ischemia and backflow phenomenon in left anterior descending artery (LAD) (r = 0.56, p = 0.0001). Exercise induced ischemia was best correlated with the ectasia-jeopardy score (r = 0.77, p = 0.0001) and a score of greater than or equal to4 identified the patients at risk with 90% sensitivity and 80% specificity. In conclusion, the extent of the ectasia within the coronary tree, diffuse ectasia and backflow-phenomenon in LAD were identified as the most important predictors of exercise induced ischemia