International journal of cardiology
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Coronary vasospasm-induced electrical and mechanical complications in patients with acute coronary syndrome and no hemodynamically significant coronary artery disease are rarely reported. ⋯ Coronary vasospasm can be a cause of life-threatening cardiac arrhythmias in patients with acute coronary syndrome and no hemodynamically significant coronary artery disease. Coronary angiography with/without intra-coronary ergonovine testing is necessary in acute coronary syndrome patients to identify the underlying pathology and establish appropriate treatment in these cases.
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Letter Case Reports
Permanent pacemaker lead implantation via azygous vein in a patient with silent superior vena cava syndrome.
Occlusion of the superior vena cava is a rare but serious complication of transvenous endocardial pacing. We describe an unusual approach for permanent pacemaker implantation using the azygous vein in a patient with occlusion of the bilateral total subclavian and innominate veins after previous bilateral pectoral pacemaker implantation. Endocardial pacing using the azygous vein with minimal invasive thoracotomy may be a good option for patients with inaccessible subclavian route.
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We studied three patients who had orthodromic atrioventricular reentrant tachycardia (AVRT) using left lateral accessory pathway (AP), with difficulty in identifying the earliest site of retrograde atrial activation. ⋯ In AVRT that has a long VA interval and difficulty in identifying the earliest site of retrograde atrial activation, two different mechanisms existed (mitral isthmus block and conduction through CS musculature). Careful mapping of double atrial potentials and continuous VA activation at the left lateral mitral annulus is essential for determination of a successful ablation site.
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Letter Case Reports
Intra-aortic balloon counterpulsation for complex aortic stenosis in hybrid strategy.
Intra-aortic balloon pumping (IABP) has been considered to be relatively contraindicated in patients with complex aortic stenosis (AS). In this report, we describe the successful implementation of IABP counterpulsation in a patient with severe coronary artery disease and left ventricular dysfunction complicating significant aortic AS. It is shown that adjuvant IABP is a safe and effective method to bridge the unstable hemodynamic condition in the initial percutaneous phase of a hybrid approach. One year after second stage valve surgery, the clinical course remains uneventful.