Use of transthoracic impedance cardiography and tissue Doppler echocardiography in the cardiovascular assessment of atrial fibrillation patients subjected to electroversion.

BACKGROUND: Atrial fibrillation (AF) is the commonest complex cardiac arrhythmia, affecting approximately 2% of the general population. AIM: To describe cardiovascular changes in tissue Doppler echocardiography (TDE) and impedance cardiography (ICG) in AF patients subjected to cardioversion. METHODS: Forty-one patients (22 males and 19 females) with acute or persistent AF were examined by means of TDE and transthoracic ICG before electroversion, and then one week following the restoration of sinus rhythm. Additionally, the preand post-cardioversion serum levels of B-type natriuretic peptide (BNP) were determined. RESULTS: The restoration of sinus rhythm was reflected by a significant increase in the following ICG parameters (average changes are presented): stroke volume (+25 mL), stroke volume index (+11.8 m/m²), contractility index (+12.6/s), end-diastolic index (+12.3 mL/m²), acceleration index (+6/s²), and left ventricular ejection time (+56 ms). These changes were accompanied by a significant increase in the TDE parameters of tricuspid annular systolic velocity and mitral annular systolic velocities. Moreover, a significant decrease in early diastolic velocities was also observed following the restoration of sinus rhythm, along with significantly lower levels of BNP. CONCLUSIONS: Both TDE and ICG are modern, valuable diagnostic methods that complementarily explain changes occurring in the cardiovascular system of AF patients subjected to electroversion.

[Polymorphic ventricular tachycardia of torsade de pointes type in patient with schizophrenia treated with thioridazine]. / Wieloksztaltny czestoskurcz komorowy typu torsade de pointes u pacjentki ze schizofrenia leczonej tiorydazyna.

A case of 82 year-old female with schizophrenia treated with thioridazine with a long QT syndrome and polymorphic ventricular tachycardia of torsade de pointes type was presented. Additional predisposing factor for cardiac arrhythmia was diarrhea with subsequent hypokalemia. Infusion of magnesium sulphate, potassium supplementation and thioridazine discontinuation was effective management of the pathient.