Torsades de pointes u bolesnice starije životne dobi s paroksizmalnom atrijskom fibrilacijom liječene kratkoročnom parenteralnom primjenom amiodarona

One of the drugs that are widely used in the treatment of atrial fibrillation is amiodarone. Despite considerable prolongation of the corrected QT interval and a substantial degree of bradycardia, amiodarone exhibits a remarkably low frequency of pro-arrhythmic events and <1.0% incidence of torsades de pointes, mostly after long-term usage. We present a case of an 80-year-old female with paroxysmal atrial fibrillation accompanied by acute heart failure treated by short-term parenteral amiodarone therapy and development of torsades de pointes.Jedan od lijekova koji se široko rabi u liječenju atrijske fibrilacije je amiodaron. Unatoč značajnom produljenju korigiranog QT intervala i usporavanju srčanog rada, amiodaron pokazuje iznimno nisku učestalost pro-aritmičkih događaja i <1,0% učestalosti torsades de pointes, uglavnom nakon dugotrajne uporabe. U radu je prikazan slučaj 80-godišnje žene s paroksizmalnom atrijskom fibrilacijom praćenom akutnim zatajenjem srca liječenom kratkotrajnom parenteralnom primjenom amiodarona i razvojem torsades de pointes

Heart Rate Variability after Off-Pump versus On-Pump Coronary Artery Bypass Graft Surgery

Background. It is known that after coronary artery bypass graft surgery (CABG) heart rate variability (HRV) becomes significantly decreased with a gradual recovery in a few months after surgery. However, literature data about the impact of the off-pump CABG on postoperative HRV are not complete. Therefore, the aim of this study was to analyze postoperative value of HRV in CABG patients operated on with off-pump versus on-pump coronary surgery. Methods. This study included 206 consecutive patients who underwent CABG. Sixty six patients (32%) were operated on off-pump while 140 patients (68%) were operated on using the machine for extracorporal circulation. HRV was analyzed from 24-hours Holter electrocardiogram recordings. Results. No significant differences in postoperative values of HRV variables were found between off-pump versus on-pump CABG patients (Mean RR interval 885 ± 106 versus 879 ± 125 ms, standard deviation of all normal R-R intervals 107 ± 30 versus 105 ± 34 ms, NS, total power 2298 ± 2472 versus 2156 ± 1913 ms2, NS). Conclusions. The results of the study showed that there are no differences in HRV few months after surgery between patients operated on with off-pump versus on-pump CABG