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Successful Radiofrequency Catheter Ablation of Idiopathic Ventricular Fibrillation Presented as Recurrent Syncope and Diagnosed by an Implanted Loop Recorde

title: Successful Radiofrequency Catheter Ablation of Idiopathic Ventricular Fibrillation Presented as Recurrent Syncope and Diagnosed by an Implanted Loop Recorde abstract: As a palliative therapy, an implantable cardioverter- defibrillator (ICD) could not prevent the occurrence of ventricular tachycardia or fibrillation (VT, VF), but only suppress it by overdrive pacing or direct current shocks. Recurrent VT or VF followed by frequent ICD shocks might thus put patients in a painful disaster. We presented a case of recurrent syncope diagnosed as recurrent VF by an implanted loop recorder (ILR). The VF was eliminated by radiofrequency catheter ablation (RFCA) of triggering ventricular premature complexes (VPCs). (c) 2005 Elsevier Ireland Ltd. All rights reserved.

Septal Pacing Preserving Better Left Ventricular Mechanical Performance and Contractile Synchronism Than Apical Pacing in Patients Implanted with an Atrioventricular Sequential Dual Chamber Pacemaker.

title: Septal Pacing Preserving Better Left Ventricular Mechanical Performance and Contractile Synchronism Than Apical Pacing in Patients Implanted with an Atrioventricular Sequential Dual Chamber Pacemaker. abstract: BACKGROUND: Permanent pacing is the treatment for chronotropically incompetent hearts. However, the right ventricular (RV) apical pacing- induced asynchrony, even maintaining the atrioventricular (AV) sequential activation, has depressed left ventricular contractility. Whether RV septal pacing would less compromise the electromechanical performance of the left ventricle and the chronotropic effect on myocardial contractility , is unknown. METHODS: We prospectively studied 42 patients without structural heart diseases and with symptomatic bradycardia. There were 10 patients receiving atrial pacing (AAI) pacemakers, 18 patients having AV sequential pacing at RV apex (DDDapx) and 14 patients being AV sequentially paced at septum (DDDspt). Echocardiography was performed before and within 72 h after the pacemaker implantation. The ventricular mechanical performance and asynchrony was compared in conditions of programmed rates of 60, 80 and 100/min. RESULTS: Myocardial performance index was significantly better in DDDspt than in DDDapx patients (p=0.003) . With faster programmed rate, the QRS/RR increased (p<0.05) in DDDapx patients with more inter- and intraventricular asynchrony, implicating the disadvantage of prolonged depolarization time. The DDDspt group demonstrated comparable parameters of diastolic function to AAI patients and preserved mechanical performance during accelerated pacing. CONCLUSIONS: RV septal pacing showed the advantages of shorter depolarization time, less ventricular contractile asynchrony , better mechanical performance and preserved chronotropic response on myocardial contractility in comparison with apical pacing. patients having AV sequential pacing at RV apex (DDDapx) and 14 patients being AV sequentially paced at septum (DDDspt).

Influence of Hepatitis C Virus Infection on Soluble Cellular Adhesion Molecules in Hemodialysis Patients

title: Influence of Hepatitis C Virus Infection on Soluble Cellular Adhesion Molecules in Hemodialysis Patients abstract: Background/Aims: Higher levels of soluble cellular adhesion molecules have been found to be a strong indicator of endothelial dysfunction and atherosclerosis in the general population. In hemodialysis patients, soluble cellular adhesion molecules have been found at higher levels as well. Such an increase has been considered as a sign of chronic inflammation. Chronic viral hepatitis C (HCV) infection, highly prevalent in hemodialysis patients, is also a disease that can induce chronic inflammation. We conducted a cross- sectional association study of soluble cellular adhesion molecules and hepatitis C in maintenance hemodialysis patients. Methods: A total of 87 stable hemodialysis patients were included in this study, mean age was 60.0 ±13.7 years. Anti-HCV antibody and HCV RNA assay were done. Patients were divided into anti-HCV-positive and anti-HCV- negative groups. Predialytic serum soluble intercellular adhesion molecules-1 (sICAM-1), soluble vascular cellular adhesion molecules-1 (sVCAM-1), and soluble E-selectin were assayed by commercially available enzyme-linked immunosorbent assay (ELISA) kits. The results were correlated with other hematological and biochemical results. Results: In the anti-HCV-positive group, the time on hemodialysis was longer (105.5 ± 65.7 vs. 49.2 ± 44.0 months, p = 0.001). The sICAM-1, sVCAM-1 and E- selectin levels were higher in the anti-HCV-positive group. HCV infection was determined as an independent determinant of sICAM-1 and sVCAM-1 by multiple linear regression analysis. Conclusion:Elevated serum soluble cellular adhesion molecules are multifactorial in hemodialysis patients. The role of HCV infection must be considered. The clinical significance and implications of soluble cellular adhesion molecules remains to be elucidated.Copyright © 2005 S. Karger AG, Basel

The Association of Higher Depressive Symptoms and Sexual Dysfunction in Male Haemodialysis Patients

title: The Association of Higher Depressive Symptoms and Sexual Dysfunction in Male Haemodialysis Patients abstract: Background. The prevalence of sexual dysfunction among male haemodialysis patients is high. Sexual dysfunction is composed of both physiological and psychological factors. However, the role of pyschological depression is still obscure. Methods. A multicentre cross-sectional study of 411 male haemodialysis patients was conducted to define the determinants of sexual dysfunction. Mid-week pre-dialytic biochemical and haematological parameters were obtained. All patients were required to complete three questionnaires by themselves: (i) the International Index of Erectile Function (IIEF, Chinese version); (ii) the Beck Depression Inventory( BDI, Chinese version) and (iii) the 36-item Short Form Health Survey Questionnaire (SF-36, Taiwan Standard Version 1.0). Results. In total, 154 male patients completed the IIEF questionnaire. Their mean age was 50.2 + /- 10.7 years. A linear multivariable regression analysis demonstrated advanced age, diabetes and the presence of depressive symptoms to be independently associated with sexual dysfunction. Subjects with sexual dysfunction had significantly lower quality of life scores. Conclusions. The presence of depressive symptoms, highly prevalent in haemodialysis patients, is an independent factor of sexual dysfunction in male haemodialysis patients. In a comprehensive approach to the management of sexual dysfunction, a thorough evaluation of psychological depression must be included.