Clinical reliability of single-lead VDD pacing from evaluation of P-wave sensing under dynamic conditions.

In a group of 20 patients implanted with a single-lead VDD pacing system, a wide interindividual variability was found in P-wave amplitude changes occurring under dynamic conditions, even though they were of minor clinical relevance because constant atrial tracking was maintained.

[Clinical significance of a prolonged sinus-node recovery time as the only pathological finding: follow-up]. / Significato clinico di un tempo di recupero del nodo del seno allungato come unico dato patologico: follow-up.

The Authors report their experience related to clinical follow-up (F.U.) study of a 12 patients group who showed a prolonged sinus node recovery time (SNRT) as the only pathologic datum. F.U. study appears extremely useful for clinical arrangement of these patients. In 6 patients a gastric ulcer was associated, which is considered a morbid equivalent of vagotonia. Therefore SNRT could be a false positive. In 3 patients following controls allow to document an initial ischemic cardiopathy. Tachicardic phase of S.S.S. was documented in 3 patients.

[Malfunction of disc prostheses. Echocardiographic study of 5 cases (author's transl)]. / Malfunzionamento di protesi a disco. Studio ecocardiografico di cinque casi.

78 patients who underwent disc prostheses replacement, 36 in mitral area, 58 in aortic area were studied by echocardiography. The Authors found 5 cases of malfunction, 3 in mitral area and 2 in aortic area. Regarding mitral malfunctions in 1 case a valve thrombosis was found; in 2 cases there was a partial leak. Regarding aortic malfunctions there was paravalvular leak. In mitral area malfunctions the Authors found alterations of the disc morphology during diastolic opening time associated with alteration of opening time. An increased diastolic closure velocity in 2 cases of paraprosthetic leak was found. A diagnostic element in the case with thrombosis was variability of maximal disc escursion during the same recording, because opening time variability never got over 10 m. seconds. In aortic area malfunctions the Authors found a constant fluttering of anterior mitral leaflet, a sinergic septal motion with the posterior wall and in 1 case the presence of disc opening before the first component of the first sound. The Authors underline the importance of simultaneous eco-phonocardiographic examination and the check-ups for the time to be.

[Transitory malfunction of an L-Kaster mitral prosthesis. Echocardiographic and polygraphic study]. / Malfunzionamento transitorio di una L-Kaster in sede mitralica Studio ecocardiografico e poligrafico

An unusual instance of transient prosthesis breakdown in a 29-yr-old woman with two L-Kaster disk prostheses for mitro-aortic defect is reported. The ECHO and polygraphic traces observed during and after breakdown are examined. It is considered that the breakdown which occurred in one prostheis only, was attributable to a small, internal thrombosis with embolism of the right lower extremity.