Ventricular and supraventricular arrhythmias and heart failure in a patient with left ventricular noncompaction and Brugada syndrome

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. (Cardiol J 2011; 18, 3: 310–313

Kardiomiopatia stresowa - czy zawsze łagodna? Wydłużenie QT i częstoskurcz torsade de pointes u pacjentki z zespołem balotującego koniuszka

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.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

Inappropriate cardioverter-defibrillator discharge continues to be a major problem in clinical practice

Background: 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). Methods: 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. Results: 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). Conclusions: 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

Comparison of the antioxidant potential of some herbal teas produced from ecological and traditional crops

The growing public awareness of the dangers regarding chemicals used in traditional agriculture has led to consumers seeking valuable and contaminant-free products. Ecological agriculture has become synonymous with high health value and product safety. The aim of this study was to evaluate the antioxidant activity and the total polyphenolic content of infusions of herbal tea bags and loose teas from traditional crops, as well as infusions of loose teas from ecological crops. Raw material comprised dried flowers of Matricaria chamomilla and Tilia cordata, as well as dried leaves of Urtica dioica, Melissa officinalis and Mentha piperita. Herbal infusions were prepared using three brewing times: 5, 10 and 20 min. The analysis of antioxidant potential was performed using in vitro methods such as DPPH, ABTS and FRAP. The polyphenolic content was determined using the Folin-Ciocalteu method. The antioxidant activity of the studied tea infusion depended on the method by which the plants were cultivated and the brewing time. The ecological agriculture conditions seem not to stimulate the synthesis of antioxidants. However, the possibility to obtain other beneficial properties of the studied plants is an indication to carry out ecological cultivation

The value of the initial electrocardiogram in the evaluation of an acutely ischaemic area in anterior myocardial infarction

Background: The aim of the study was to evaluate the importance of admission electrocardiography (ECG) in predicting the extent of acute ischaemia in anterior acute myocardial infarction (AMI). Methods: In 56 patients with anterior AMI electrocardiographic, echocardiographic and angiographic images, troponin I concentration and CK-MB activity were analysed. Results: In 55 cases the artery responsible for infarction was the left anterior descendent (LAD). In the group with proximal occlusions the number of leads with ST elevation was greater (6.6 ± 1.4 vs. 5.3 ± 1.8; p = 0.02) and the level of ST elevations in all leads was higher (18.3 ± 9.9 vs. 11.6 ± 7.2; p = 0.01). The mean height of ST elevation in I, aVL, V3 and V5, ST-segment depression in inferior leads and CK-MB activity, was higher in proximal LAD disease. The height of ST elevation in I and aVL correlated with a low ejection fraction and high CK-MB activity. The higher the total ST-segment elevation in all leads, the higher CK-MB activity level. Conclusions: ECG is useful in identifying the site of a LAD occlusion in an anterior AMI. The total ST-segment elevation correlates with the AMI size measured as the maximal CK-MB activity. The height of the ST-segment elevation in leads I and aVL reflects the degree of left ventricle dysfunction. The traditional terminology used to define the localisation of ST-segment shifts in ECG does not take account of the regional wall motion abnormalities observed in echocardiographic examination in an anterior AMI

The influence of low dose atorvastatin on inflammatory marker levels in patients with acute coronary syndrome and its potential clinical value

Background: 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. Methods: 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. Results: 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. Conclusions: 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

Częstoskurcz komorowy pęczkowy u pacjenta z chorobą niedokrwienną serca w starszym wieku

Częstoskurcz pęczkowy to rzadka postać częstoskurczu komorowego pochodzącego z lewej komory, która występuje najczęściej u młodych osób bez strukturalnej choroby serca. Ma morfologię bloku prawej odnogi pęczka Hisa z lewogramem. W pracy przedstawiono przypadek starszego pacjenta z chorobą wieńcową, u którego wystąpił częstoskurcz komorowy o elektrokardiograficznych i klinicznych cechach częstoskurczu pęczkowego. W przerywaniu napadów skuteczny okazał się werapamil. Rewaskularyzacja przezskórna wykonana z powodu istotnych zwężeń prawej tętnicy wieńcowej i tętnicy diagonalnej pierwszej nie spowodowała wytłumienia arytmii. U pacjenta wykonano ablację prądem o wysokiej częstotliwości podłoża arytmii w okolicy tylno-dolnej lewej komory. Po ablacji nie indukowano częstoskurczu komorowego, nawet przy wlewie izoprenaliny, nie obserwowano również nawrotów w 24-miesięcznej obserwacji. W pracy podjęto także temat diagnostyki różnicowej częstoskurczu &#8222;idiopatycznego&#8221; z częstoskurczem na tle choroby niedokrwiennej serca. (Folia Cardiol. 2004; 11: 57&#8211;60

Częstoskurcz komorowy pęczkowy u pacjenta z chorobą niedokrwienną serca w starszym wieku

Częstoskurcz pęczkowy to rzadka postać częstoskurczu komorowego pochodzącego z lewej komory, która występuje najczęściej u młodych osób bez strukturalnej choroby serca. Ma morfologię bloku prawej odnogi pęczka Hisa z lewogramem. W pracy przedstawiono przypadek starszego pacjenta z chorobą wieńcową, u którego wystąpił częstoskurcz komorowy o elektrokardiograficznych i klinicznych cechach częstoskurczu pęczkowego. W przerywaniu napadów skuteczny okazał się werapamil. Rewaskularyzacja przezskórna wykonana z powodu istotnych zwężeń prawej tętnicy wieńcowej i tętnicy diagonalnej pierwszej nie spowodowała wytłumienia arytmii. U pacjenta wykonano ablację prądem o wysokiej częstotliwości podłoża arytmii w okolicy tylno-dolnej lewej komory. Po ablacji nie indukowano częstoskurczu komorowego, nawet przy wlewie izoprenaliny, nie obserwowano również nawrotów w 24-miesięcznej obserwacji. W pracy podjęto także temat diagnostyki różnicowej częstoskurczu &#8222;idiopatycznego&#8221; z częstoskurczem na tle choroby niedokrwiennej serca. (Folia Cardiol. 2004; 11: 57&#8211;60