Arrhythmic Mitral Valve Prolapse: New Menaces of the Known Disease

Mitral  valve prolapse  (MVP) has  long  been  the subject  of intense  discussions regarding the prognosis and  follow-up tactics.  In most  cases,  this condition has a benign prognosis. However, recent autopsy and follow-up studies have shown risks of developing  sudden cardiac death (SCD) in some subgroups of patients who have this clinical phenomenon. The proposed  literature review uses the population  of patients with MVP with the highest probability  of developing  life-threatening ventricular tachyarrhythmias. Patients with the presence of a complex  of changes, including  bicuspid  MVP, negative T waves in the inferior and lateral leads on a standard  12-lead electrocardiogram (ECG), and a special anatomical  phenomenon called mitral annular  disjunction  (MAD), are at high  risk of developing  ventricular  ectopias  and VSS.  A reflection  of the high  risk of SCD  in such patients  is the increase of ventricular ectopy according to Holter monitoring. The presence of a bicuspid  MVP and the MAD  phenomenon, which is a separation  of the line of attachment  of the posterior mitral leaflet from the basal inferior wall segment  towards  the atrial wall, determines the presence of a special form of MVP,  the so-called  arrhythmogenic MVP.  Hence,  in most cases MVP has a benign  prognosis. However, patients with the aforementioned ar- rhythmic  MVP  signs  must  be given  particular  attention  and  annual  follow-up including  ECG  control,  Holter  monitoring and  echocardiographic examination of the heart to reduce the risk of ventricular tachyarrhythmias and SCD development

SAFETY OF AMIODARONE USAGE IN PATIENTS WITH WOLFF-PARKINSON-WHITE SYNDROME AND ATRIAL FIBRILLATION

Amiodarone is one of the basic antiarrhytmic drugs for atrial fibrillation treatment. However application of amiodarone in patients with atrial fibrillation and Wolff-Parkinson-White syndrome can induce ventricular fibrillation. Amiodarone usage in these patients should be accompanied by readiness for performance of resuscitation. This is confirmed by clinical case presentation

PROGNOSTIC VALUE OF PATHOLOGIC Q-WAVE AND TIME OF ITS APPEARANCE IN PATIENTS WITH MYOCARDIAL INFARCTION: COMPARISON STUDY

Aim. To evaluate short- and long-term prognosis of myocardial infarction (MI) depending on occurrence of pathologic Q-wave on ECG and time of its appearance.Material and methods. 616 patients with initial ST-elevated MI were included into the study — 254 women and 362 men, aged 62.1±11.2. All patients were split up three groups depending on occurrence of pathologic Q-wave on ECG and time of its appearance. First group consisted of 311 patients with early Q-wave (during first 6 hours from onset of MI symptoms). Second group consisted of 120 patients with late Q-wave (from 6 to 24 hours from onset of MI symptoms). Third group consisted of 185 patients with non-Q-wave MI.Results. The hospital lethality in the patients with early Q-wave was significantly higher than this in patients of the second and the third groups. However, we didn’t reveal significant differences between patients with late Q-wave and patients without Q-wave on ECG. The incidences of cardiac death (sudden death and fatal MI), non-fatal MI and hospitalization because of unstable angina was assessed during next two years. During the follow-up period patients of three groups had similar incidences of the non-fatal MI and hospitalization because of unstable angina. However, incidence of cardiac death was significantly higher in early Q-wave group in comparison with non-Q-wave group.Conclusion. Occurrence of pathologic Q-wave on ECG and time of its appearance should be taken into account to assessed short- and long-term prognosis of MI

Projektowanie rozmieszczenia jednostek straży pożarnej na obszarach zamieszkanych z wykorzystaniem Systemu Informacji Geograficznej

The mathematical model to determine the required number of operational fire departments to protect settlements from fires was described. The authors of the study describe the results of automated GIS design, which is aimed at planning of activities and resource equipment for operational fire departments in settlements. The structure and functionality of the system were presentedW artykule opisano model matematyczny służący do określenia niezbędnej liczby jednostek operacyjnych służby pożarniczej potrzebnych do skutecznej ochrony przeciwpożarowej obszarów zamieszkanych. Przedstawione zostały wyniki zautomatyzowanego Systemu Informacji Geograficznej do planowania działań i określania wyposażenia jednostek operacyjnych służby pożarniczej chroniących obszary zamieszkane. W artykule autorzy prezentują strukturę systemu i jego funkcjonalne możliwości

DIAGNOSTICS AND TREATMENT OF MITRAL VALVE PROLAPSE

The mitral valve prolapse (MVP) is one of the most inconsistent diagnose. In the most cases patients with MVP have the good long-term prognosis, and therapy is aimed at reduction in psychovegetative dysfunction. Careful follow-up and timely cardiosurgical correction should be performed, if necessary, in patients with classical MPV. The choice method in these cases is the mitral valve plasty

EFFECT OF GENDER DIFFERENCES ON THE EFFICACY AND SAFETY OF REPERFUSION THERAPY OF ST-SEGMENT ELEVATION MYOCARDIAL INFARCTION (DATA OF RETROSPECTIVE SINGLE-CENTER STUDY – HOSPITAL PERIOD)

Gender differences can significantly affect mortality in ST-segment elevation myocardial infarction (STEMI) in real practice. Aim. To evaluate the effect of gender on mortality in STEMI. Material and methods. Outcomes of in-hospital stage of treatment of 553 men (67.7%) and 263 women (32.3%) were analyzed in single-center retrospective study. Primary percutaneous coronary intervention (pPCI) and pharmacoinvasive strategy (PIS) were used in 160 (60.8%) and 103 (39.2%) women, respectively, as well as in 295 (53.3%) and 258 (46.7%) men, respectively. Patients with time ″primary medical contact (PMC) – balloon″ less than 60 min and ″symptom - PMC″ more than 6 hours were excluded. The majority of patients were in a time interval ″PMC - balloon″ about 120 minutes. Results. Mortality in women was significantly higher than this in men regardless of the reperfusion strategy – 15.3% in whole (18.1% at pPCI and 10.9% at PIS), and 3.1% in whole (5.1% at pPCI and 0.8% at FIS), respectively (p<0.001). The probability of lethal outcome in women was 4 times higher than this in men (odds ratio 4.4; 95% confidence interval 2.7-7.1). Conclusion. Clinical characteristics of the patients due to gender differences make a significant contribution to the course of STEMI. Women more often have severe complications and a worse in-hospital prognosis