Comparison of the amplitude of the P-wave from intracardiac electrocardiogram obtained by means of a central venous catheter filled with saline solution to that obtained via esophageal electrocardiogram.

Recognition of the P wave is important for the correct characterization of atrial and ventricular arrhythmias. When the P wave is difficult to identify on standard electrocardiography (SECG), either esophageal electrocardiography (EECG) or intracardiac electrocardiography (IC-ECG), central venous catheter may be used. The feasibility of these methods has already been demonstrated, but there is no published study comparing them. This study compared the amplitude of the P wave obtained by IC-ECG with those of the P waves obtained by EECG and SECG. SECG, EECG, and IC-ECG were performed on each patient. IC-ECG and EECG made it possible to register P waves larger than registered by SECG (p <0.00001). The difference between the largest P waves obtained with IC-ECG (5.93 +/- 3.56 mm) and EECG (4.67 +/- 2.16 mm) was not statistically significant (p = 0.1953). In conclusion, IC-ECG is easy to perform and magnifies the P wave at least as effectively as EECG.

Is early anticoagulation necessary after biological aortic valve replacement?

Early antithrombotic therapy after biological aortic valve replacement (AVR) is controversial. The aim of this study was to determine the rate of thromboembolic events (TE) without anticoagulation treatment during the first 3 months after surgery. Out of 143 consecutive patients who underwent biological AVR from January 1998 to December 2004, 127 patients who did not receive anticoagulation were included (89%). Events during the first 3 months after surgery included: 2 strokes (1.5%), 2 major bleedings (1.5%) and 9 deaths (7%) (none of them due to TE). In conclusion, the management of patients without antithrombotic treatment after biological AVR seems to be safe due to a low rate of TE.