Diagnosis and Treatment of Syncope

AbstractAccurate diagnosis of syncope is essential because it ranges from cardiac syncope with a very poor prognosis to neurally-mediated syncope (NMS) with a relatively favorable prognosis. Diagnosis of syncope, however, is difficult in many patients even by HUT, so a new loading method for HUT or implanted Holter ECG monitoring will be required in the future. The prognosis of NMS itself may be favorable, but it may cause the aggravation of complications

Effects of nicorandil, a potassium channel opener, on idiopathic ventricular tachycardia

AbstractObjectives. We assessed the effects of the adenosine triphosphate (ATP)–sensitive potassium channel opener, nicorandil, on ATP- and verapamil-responsive ventricular tachycardias (VTs).Background. Adenosine- or ATP-sensitive VTs are thought to be due to a nonreentrant mechanism, presumably delayed afterdepolarization. We suggest that this potassium channel opener may suppress ATP- and verapamil-sensitive VTs.Methods. The subjects included 13 patients with idiopathic VTs, 7 of whom had sustained VT and 6 of whom had nonsustained VT. We evaluated the effects of ATP, nicorandil and verapamil on VTs.Results. Sustained VT: Verapamil had preventive effects on seven VTs. Four VTs were terminated by ATP, and of these, nicorandil terminated two and prevented exercise-induced VT in the two others. Three ATP-insensitive VTs, which were determined to be due to a reentry by an electrophysiologic study, were not terminated by nicorandil. Nonsustained VT: All six VTs were inhibited by ATP, and five of these were suppressed by nicorandil. Verapamil inhibited four of the five VTs. QT intervals and the corrected QT intervals were significantly shortened by nicorandil.Conclusions. Nicorandil suppresses ATP- and verapamil-responsive VTs. One of the mechanisms of suppression by nicorandil might be related to a reduction of calcium in the myocardium, because it reduces the action potential duration

Novel Charge Ordering in the Trimer Iridium Oxide BaIrO3

We have prepared polycrystalline samples of the trimer Ir oxide BaIrO3 with face-shared Ir3O12 trimers, and have investigated the origin of the phase transition at 182 K by measuring resistivity, thermopower, magnetization and synchrotron x-ray diffraction. We propose a possible electronic model and transition mechanism, starting from a localized electron picture on the basis of the Rietveld refinement. Within this model, BaIrO3 can be basically regarded as a Mott insulator, when the Ir3O12 trimer is identified to one pseudo-atom or one lattice site. The transition can be viewed as a transition from the Mott insulator phase to a kind of charge ordered insulator phase.Comment: 8 pages 5 figures, Crystals (in press