Structure and Conductivity in LISICON Analogues within the Li4GeO4-Li2MoO4 System.

New solid electrolytes are crucial for the development of all-solid-state lithium batteries with advantages in safety and energy densities over current liquid electrolyte systems. While some of the best solid-state Li+-ion conductors are based on sulfides, their air sensitivity makes them less commercially attractive, and attention is refocusing on air-stable oxide-based systems. Among these, the LISICON-structured systems, such as Li2+2xZn1-xGeO4 and Li3+xV1-xGexO4, have been relatively well studied. However, other systems such as the Li4GeO4-Li2MoO4 system, which also show LISICON-type structures, have been relatively little explored. In this work, the Li4-2xGe1-xMoxO4 solid solution is investigated systematically, including the solid solution limit, structural stability, local structure, and the corresponding electrical behavior. It is found that a γ-LISICON structured solution is formed in the range of 0.1 ≤ x < 0.4, differing in structure from the two end members, Li4GeO4 and Li2MoO4. With increasing Mo content, the ß-phase becomes increasingly more stable than the γ-phase, and at x = 0.5, a pure ß-phase (ß-Li3Ge0.5Mo0.5O4) is readily isolated. The structure of this previously unknown compound is presented, along with details of the defect structure of Li3.6Ge0.8Mo0.2O4 (x = 0.2) based on neutron diffraction data. Two basic types of defects are identified in Li3.6Ge0.8Mo0.2O4 involving interstitial Li+-ions in octahedral sites, with evidence for these coming together to form larger defect clusters. The x = 0.2 composition shows the highest conductivity of the series, with values of 1.11 × 10-7 S cm-1 at room temperature rising to 5.02 × 10-3 S cm-1 at 250 °C.

Left ventricular global longitudinal strain in predicting CRT response: one more J-shaped curve in medicine.

The aim of the study was: (1) to verify the hypothesis that left ventricular global longitudinal strain (LVGLS) may be of additive prognostic value in prediction CRT response and (2) to obtain such a LVGLS value that in the best optimal way enables to characterize potential CRT responders. Forty-nine HF patients (age 66.5 ± 10 years, LVEF 24.9 ± 6.4%, LBBB 71.4%, 57.1% ischemic aetiology of HF) underwent CRT implantation. Transthoracic echocardiography was performed prior to and 15 ± 7 months after CRT implantation. Speckle-tracking echocardiography was performed to assess longitudinal left ventricular function as LVGLS. The response to CRT was defined as a ≥ 15% reduction in the left ventricular end-systolic volume (∆LVESV). Thirty-six (73.5%) patients responded to CRT. There was no linear correlation between baseline LVGLS and ∆LVESV (r = 0.09; p = 0.56). The patients were divided according to the percentile of baseline LVGLS: above 80th percentile; between 80 and 40th percentile; below 40th percentile. Two peripheral groups (above 80th and below 40th percentile) formed "peripheral LVGLS" and the middle group was called "mid-range LVGLS". The absolute LVGLS cutoff values were - 6.07% (40th percentile) and - 8.67% (80th percentile). For the group of 20 (40.8%) "mid-range LVGLS" patients mean ΔLVESV was 33.3 ± 16.9% while for "peripheral LVGLS" ΔLVESV was 16.2 ± 18.8% (p < 0.001). Among non-ischemic HF etiology, all "mid-range LVGLS" patients (100%) responded positively to CRT (in "peripheral LVGLS"-55% responders; p = 0.015). Baseline LVGLS may have a potential prognostic value in prediction CRT response with relationship of inverted J-shaped pattern. "Mid-range LVGLS" values should help to select CRT responders, especially in non-ischemic HF etiology patients.

Left ventricular diverticulum mimicking cardiac tumor.

Left ventricular (LV) diverticulum represents a rare and frequently asymptomatic congenital anomaly, which is incidentally discovered during routine transthoracic echocardiography. We present a case of a 66-year-old female patient who was admitted to the cardiology department due to incidental finding of a tumor-like mass associated with the posterior mitral leaflet. Preliminary echocardiographic evaluation revealed a solid structure, suspected of mitral annulus calcification or LV malignancy. However, cardiac contrast-enhanced computed tomography confirmed the presence of LV diverticulum, partially filled with calcified thrombus. Conservative management was recommended. This case underscores the importance of multimodality imaging for differentiation of LV tumor-like structures.

Decarbonatization of Energy Sector by CO2 Sequestration in Waste Incineration Fly Ash and Its Utilization as Raw Material for Alkali Activation.

In this study, municipal solid waste incineration (MSWI) fly ash was subjected to mineral carbonation with the aim of investigating CO2 sequestration in waste material. The conducted study follows the trend of searching for alternatives to natural mineral materials with the ability to sequestrate CO2. The mineral carbonation of MSWI fly ash allowed for the storage of up to 0.25 mmol CO2 g-1. Next, both carbonated and uncarbonated MSWI fly ashes were activated using an alkaline activation method by means of two different activation agents, namely potassium hydroxide and potassium silicate or sodium hydroxide and sodium silicate. Mineral carbonation caused a drop in the compressive strength of alkali-activated materials, probably due to the formation of sodium and/or potassium carbonates. The maximum compressive strength obtained was 3.93 MPa after 28 days for uncarbonated fly ash activated using 8 mol dm-3 KOH and potassium hydroxide (ratio 3:1). The relative ratio of hydroxide:silicate also influenced the mechanical properties of the materials. Both carbonated and uncarbonated fly ashes, as well as their alkali-activated derivatives, were characterized in detail by means of XRD, XRF, and FTIR. Both uncarbonated and carbonated fly ashes were subjected to TG analysis. The obtained results have proved the importance of further research in terms of high-calcium fly ash (HCFA) utilization.

Clinical Characteristics of Atrial Flutter and Its Response to Pharmacological Cardioversion with Amiodarone in Comparison to Atrial Fibrillation.

BACKGROUND: Unlike atrial fibrillation (AF), atrial flutter (AFl) is thought to be relatively refractory to pharmacological cardioversion (PC), but the evidence is scarce. The aim of this study was to evaluate the clinical characteristics and efficacy of the PC of AFl with amiodarone in comparison to AF. MATERIALS AND METHODS: This retrospective study covered 727 patients with urgent consult for AF/AFl in a high-volume emergency department between 2015 and 2018. AFl was diagnosed in 222 (30.5%; median age: 68 (62; 75) years; 65.3% men). In a nested case-control study, 59 control patients with AF, matched in terms of age and sex with 60 AFl patients, were subject to PC with amiodarone. The primary endpoint was return of sinus rhythm confirmed using a 12-lead ECG. RESULTS: The AFl population had a median CHA2DS2-VASc score of 3 (2; 4) and episode duration of 72 h (16; 120). In the AFl cohort, 36% of patients were initially subject to PC, 33.3% to electrical cardioversion (EC) and 40.5% to catheter ablation. In comparison to the AF group, the AFl patients required a longer hospitalization time, had a higher rate of EC (p < 0.001) and less frequent use of PC (p < 0.001) and, lower left ventricular ejection fraction (p < 0.001) and more pronounced cardiovascular risk factors. The efficacy of PC with amiodarone was significantly lower in AFl than AF group (39% vs. 65%, relative risk (RR) 0.60, p = 0.007). CONCLUSIONS: AFl patients shared a greater burden of comorbidities than AF patients, while the efficacy of PC in AFl was low. Patients should be initially managed with primary electrical cardioversion.

Antiarrhythmic drugs for pharmacological cardioversion of atrial fibrillation and sex differences: Insights from the CANT II Study.

BACKGROUND: Data on sex differences in terms of action of antiarrhythmic agents (AADs) are limited. This study aimed to evaluate the clinical profile of patients with atrial fibrillation (AF), and efficacy and safety of AADs used for pharmacological cardioversion (PCV) of AF. METHODS: This research was a sub-analysis of the retrospective multicenter Cardioversion with ANTazoline II (CANT) registry, which comprised 1365 patients with short-duration AF referred for urgent PCV with the use of AAD. Patients were categorized according to and compared in terms of clinical parameters and PCV outcomes. The primary endpoint was return of sinus rhythm within 12 hours after drug infusion, and the composite safety endpoint involved bradycardia <45 bpm, hypotension, syncope, or death. RESULTS: The sex distribution of patients qualified for PCV was even (men, n = 725; 53.1%). Females were older and more symptomatic and had higher CHA2DS2-VASc scores, higher prevalence of tachyarrhythmia, and higher use of chronic anticoagulation. The overall efficacy (71.4% vs. 70.1%; P = 0.59) and safety (5.2% vs. 4.6%; P = 0.60) of PCV was comparable in men and women. Amiodarone (68.3% vs. 65.9%; P = 0.66) and antazoline (77.1% vs. 80.0%; P = 0.19) had similar efficacy in men and women, but propafenone had a lower rate of rhythm conversion in men (64.7% vs. 79.3%; P = 0.046). None of the assessed AADs differed in terms of safety profile in both sexes. CONCLUSION: Female patients with AF have different clinical profiles but similar efficacy and safety of AADs as compared to male participants. Propafenone has significantly lower efficacy in men, which requires further investigation.

Percutaneous closure of the left atrial appendage to prevent ischaemic stroke in patients with atrial fibrillation who require but have contraindications to oral anticoagulation.

Atrial fibrillation (AF) is associated with a five-fold increased risk for stroke due to cardioembolic events. Most strokes in patients with AF arise from thrombus formation in the left atrial appendage (LAA). Oral anticoagulation is a standard treatment of AF patients with high risk of stroke. However, the main drawbacks of oral anticoagulation are high risk of major bleeding and imperfect effectiveness dependent on a very narrow therapeutic range. In this article, based on two case reports, we describe a method of percutaneous closure of the LAA. We discuss indications, describe the procedure and mention possible complications. LAA closure seems to be a promising tool to prevent AF-related strokes in a selected group of patients.

Fabrication and Characterization of a Composite Ni-SDC Fuel Cell Cathode Reinforced by Ni Foam.

High-temperature fuel cells (namely, molten carbonate and solid oxide; MCFCs and SOFCs) require the cathode to be designed to maximize oxygen catalytic reduction, oxygen ion transport, electrical conductivity, and gas transport. This then leads to the optimization of the volume fraction and morphology of phases, as they are a pathway for electrons, ions, and gases to be continuous and self-interpenetrating. Apart from the functional properties, the cathode must be mechanically stable to prevent cracking during fuel cell assembly and operation. The manufacturing process of the composite cathode was optimized to meet such requirements in this research work. The tape casting technique and further firing process were used to fabricate the cathodes. The slurry for the green tape was composed of nickel (Ni), cerium oxide doped with samarium oxide (SDC), water (solvent), and an organic binder (which becomes pore space after firing). Each of these elements is necessary for the effective transport of specific species: electrons, oxygen, ions, and gas particles, respectively. Moreover, the nickel foam was embedded into the powder-based structure to improve mechanical strength. The study involved many technological issues, such as the effect of the SDC fraction on the cathode microstructure, mechanical strength, and chemical stability at high temperatures, and also involved environmental issues.

The usefulness of telemedicine devices in patients with severe heart failure with an implanted cardiac resynchronization therapy system during two years of observation.

BACKGROUND: Heart failure (HF) remains a disease with a poor prognosis. Telemonitoring is a medical service aimed at remote monitoring of patients. AIM: The study aimed to identify the clinical relevance of non-invasive telemonitoring devices in HF patients. METHODS: Sixty patients aged 66.1 (11) years, with left ventricular ejection fraction (LVEF) 26.3 (6.8)% underwent cardiac resynchronization therapy (CRT) implantation. They were randomly allocated to the control (standard medical care) or study (standard medical care + telemonitoring device) groups. During the follow-up (24 months), the patients in the study group provided body mass and blood pressure, along with electrocardiogram on a daily basis. The data were transferred to themonitoring center and consulted with a cardiologist. Transthoracic echocardiography and a 6-minute walk test were performed before and 24 months after CRT implantation. RESULTS: During the two-year observation, the composite endpoint (death or HF hospitalization) occurred in 21 patients, more often in the control group (46.8% vs. 21.4%; P = 0.026). Inunivariate analysis: the use of telemetry (hazard ratio [HR], 0.2; 95% confidence interval [CI], 0.07-0.7; P=0.004), thepresence of coronary heart disease (HR, 41.4; 95% CI, 3.1-567.7; P=0.005), hypertension (HR, 0.24; 95% CI, 0.07-0.90; P = 0.035), and patient's body mass (HR, 0.36; 95% CI, 0.14-0.92; P = 0.03) were related to the occurrence of the composite endpoint. CONCLUSIONS: The use of a telemonitoring device in CRT recipients improved theprognosis in2-year observation and contributed to the reduction of HF hospitalization.

Efficacy and safety of antazoline for cardioversion of atrial fibrillation: propensity score matching analysis of a multicenter registry (CANT II Study).

INTRODUCTION: Due to safety concerns about available antiarrhythmic drugs (AADs), reliable agents for termination of atrial fibrillation (AF) are requisite. OBJECTIVES: The aim of the study was to evaluate the efficacy and safety of antazoline, a first­generation antihistamine, for cardioversion of recent­onset AF in the setting of an emergency department. PATIENTS AND METHODS: This multicenter, retrospective registry covered 1365 patients (median [interquartile range] age, 69.0 [61.0-76.0] years, 53.1% men) with new­onset AF submitted to urgent pharmacological cardioversion. AAD allocation was performed by the attending physician: antazoline alone was utilized in 600 patients (44%), amiodarone in 287 (21%), propafenone in 150 (11%), and ≥2 AADs in 328 patients (24%). Antazoline in monotherapy or combination was administered to 897 patients (65.7%). Matched antazoline and nonantazoline groups were identified using propensity score matching (PSM, n = 330). The primary end point was return to sinus rhythm within 12 hours after initiation of the treatment. RESULTS: Before PSM, antazoline alone was superior to amiodarone (78.3% vs 66.9%; relative risk [RR], 1.17; 95% CI, 1.07-1.28; P <0.001) and comparable to propafenone (78.3% vs 72.7%; RR, 1.08; 95% CI, 0.97-1.20; P = 0.14) in terms of rhythm conversion rate. In the post­PSM population, the rhythm conversion rate was higher among patients receiving antazoline alone than in the nonantazoline group (84.2% vs 66.7%; RR, 1.26; 95% CI, 1.11-1.43; P <0.001), and the risk of adverse events was comparable (P = 0.2). CONCLUSIONS: Antazoline appears to be an efficacious agent for termination of AF in real­world setting. Randomized controlled trials are required to evaluate its safety in specific patient populations.

Pharmacological Cardioversion in Patients with Recent-Onset Atrial Fibrillation and Chronic Kidney Disease Subanalysis of the CANT II Study.

Pharmacological cardioversion (PCV) is commonly a primary option for termination of recent-onset atrial fibrillation (AF) in emergency departments (ED). This is a subanalysis of the CANT II study, evaluating the effectiveness and safety of antazoline in patients (n = 777) at three stages of chronic kidney disease (CKD): Group I > 60 mL/min (n = 531), Group II 45−59 mL/min (n = 149), and Group III < 45 mL/min (n = 97). Patients in Group III were older and with a higher prevalence of co-morbidities; however, we did not find statistically significant differences in the overall effectiveness of PCV in comparison with the other groups. In patients receiving amiodarone, the PCV success rate was similar in all the studied groups, but along with a renal function decline, it decreased in patients receiving antazoline (79.1 vs. 35%; p < 0.001), and it increased almost significantly in patients receiving propafenone (69.9 vs. 100%; p = 0.067). In patients in Group I, antazoline restored a sinus rhythm as effectively as propafenone and amiodarone; however, in patients in Group III, both antazoline and amiodarone became less effective in restoring a sinus rhythm than propafenone (p = 0.002 and p = 0.034, respectively). The rate of safety endpoint was the highest in patients in Group III (eGFR < 45 mL/min), and it was significantly higher than in patients in Groups I and II (p = 0.008 and p = 0.036, respectively). We did not observe antazoline-related adverse events in any of the studied groups of patients. This real-world registry analysis revealed a different influence of CKD on the effectiveness of individual drugs, and while propafenone and amiodarone maintained their AF termination efficacy, antazoline became significantly less effective in restoring sinus rhythm.

Sudden death in hypertrophic cardiomyopathy: old risk factors re-assessed in a new model of maximalized follow-up.

AIMS: in hypertrophic cardiomyopathy (HCM), the following five risk factors have a major role in the primary prevention of sudden death (SD): family history of SD (FHSD), syncope, massive wall thickness (MWTh) >30 mm, non-sustained ventricular tachycardia (nsVT) in Holter monitoring of electrocardiography, and abnormal blood pressure response to exercise (aBPRE). In HCM, as a genetic cardiac disease, the risk for SD may also exist from birth. The aim of the study was to compare the survival curves constructed for each of the five risk factors in a traditional follow-up model (started at the first presentation of a patient at the institution) and in a novel follow-up model (started at the date of birth). In an additional analysis, we compared the survival rate in three subgroups (without FHSD, with one SD, and with two or more SDs in a family). METHODS AND RESULTS: a total of 1306 consecutive HCM patients (705 males, 601 females, mean age of 47 years, and 193 patients were <18 years) evaluated at 15 referral centres in Poland were enrolled in the study. In a novel method of follow-up, all the five risk factors confirmed its prognostic power (FHSD: P = 0.0007; nsVT: P < 0.0001; aBPRE: P = 0.0081; syncope: P < 0.0001; MWTh P> 0.0001), whereas in a traditional method, only four factors predicted SD (except aBPRE). In a novel model of follow-up, FHSD in a single episode starts to influence the prognosis with a delay to the fifth decade of life (P = 0.0007). Multiple FHSD appears to be a very powerful risk factor (P < 0.0001), predicting frequent SDs in childhood and adolescence. CONCLUSION: the proposed concept of a lifelong calculated follow-up is a useful strategy in the risk stratification of SD. Multiple FHSD is a very ominous risk factor with strong impact, predicting frequent SD episodes in the early period of life.

Regional Strain Pattern Index-A Novel Technique to Predict CRT Response.

BACKGROUND: Cardiac resynchronization therapy (CRT) improves outcome in patients with heart failure (HF) however approximately 30% of patients still remain non-responsive. We propose a novel index-Regional Strain Pattern Index (RSPI)-to prospectively evaluate response to CRT. METHODS: Echocardiography was performed in 49 patients with HF (66.5 ± 10 years, LVEF 24.9 ± 6.4%, QRS width 173.1 ± 19.1 ms) two times: before CRT implantation and 15 ± 7 months after. At baseline, dyssynchrony was assessed including RSPI and strain pattern. RSPI was calculated from all three apical views across 12 segments as the sum of dyssynchronous components. From every apical view, presence of four components were assessed: (1) contraction of the early-activated wall; (2) prestretching of the late activated wall; (3) contraction of the early-activated wall in the first 70% of the systolic ejection phase; (4) peak contraction of the late-activated wall after aortic valve closure. Each component scored 1 point, thus the maximum was 12 points. RESULTS: Responders reached higher mean RSPI values than non-responders (5.86 ± 2.9 vs. 4.08 ± 2.4; p = 0.044). In logistic regression analysis value of RSPI ≥ 7 points was a predictor of favorable CRT effect (OR: 12; 95% CI = 1.33-108.17; p = 0.004). CONCLUSIONS: RSPI could be a valuable predictor of positive outcome in HF patients treated with CRT.

Oral versus intravenous hydration and renal function in diabetic patients undergoing percutaneous coronary interventions.

BACKGROUND: Contrast-induced nephropathy (CIN) is a serious complication of percutenous coronary interventions (PCI). Proper hydration reduces the risk of PCI. Wheter oral hydration is as effective as intravenous one has not been well established. AIM: To determine the effects of oral hydration with mineral water versus intravenous hydration with isotonic solution (0.9% NaCl) on renal function in diabetic patients undergoing coronary angiography and angioplasty. METHODS: The study included 102 patients (age 67 ± 7.8 years, 44 female/58 male). Eligible patients (group 1 - 52 pts) were hydrated intravenously (1 mL/kg/h) 6 hours before and during 12 hours following PCI with isotonic solution (0.9% NaCl). Fifty patients (group 2) were randomised to receive oral mineral water (1 mL/kg/h) 6-12 hours before and during 12 hours following angiography or angioplasty. All patients during the procedure received contrast medium ioversol. Primary endpoint of the study was the evaluation of renal function before and 72 hours after contrast medium administration. RESULTS: Baseline creatinine clearance was 70.3 ± 21.22 mL/min in group 1 and 78.69 ± 19.92 mL/min in group 2 (NS). The mean volume of contrast medium was 101.1 ± 36.7 mL in group 1 and 110.4 ± 45.3 mL in group 2 (NS). At 72 hours after the procedure, creatinine clearance was 65.3 ± 23.39 mL/min in group 1 and 73.5 ± 21.94 mL/min in group 2 (NS). CONCLUSIONS: Our study demonstrates that the oral hydration with mineral water and intravenous hydration with 0.9% NaCl have similar effects on renal function in diabetic patients undergoing coronary angiography and angioplasty.

Prediction of long-term outcome after primary percutaneous coronary intervention for acute anterior myocardial infarction.

BACKGROUND: Despite the widespread use of reperfusion methods, the long-term outcome after primary percutaneous coronary intervention (PCI) is variable, and accurate risk stratification is of clinical importance. AIM: To assess the predictors of long term outcome after PCI for acute anterior myocardial infarction (AMI). METHODS: One hundred and twenty-seven consecutive patients undergoing PCI within 12 hours from the onset of the first AMI were enrolled. Troponin I, CK-MB, creatinine, NT-proBNP, echocardiographic left ventricular (LV) function, myocardial contrast perfusion, results of coronary angiography, ECG, 24-hour Holter ECG, and T-wave alternans (TWA) were analysed as predictors of major adverse cardiac events (MACE), defined as death, non-fatal reinfarction, sustained ventricular tachycardia, and rehospitalisation for decompensated heart failure. Patients were followed up for two years. RESULTS: Twenty-seven patients developed MACE. The best predictive model for MACE consisted of impaired perfusion (MCE, myocardial contrast echocardiography), higher CK-MB at 24 hours, discharge NT-proBNP, and non-negative TWA. The combination of elevated creatinine level, decreased LV ejection fraction, and a non-negative TWA proved the best for identification of patients at risk of cardiac death. The best multivariate model for predicting heart failure hospitalisation consisted of higher 24-hour CK-MB, discharge NT-proBNP, impaired perfusion and prolonged duration of ST elevation. CONCLUSIONS: Our study showed that the rate of MACE in patients with anterior ST-segment elevation myocardial infarction undergoing primary PCI at two years follow-up is low. A combined assessment of myocardial contrast perfusion, TWA, CK-MB and discharge NT-proBNP seems to optimally predict patients at risk of MACE.

Defect structure in δ-Bi5PbY2O11.5.

A detailed study of the defect structure in a di-substituted δ-Bi2O3 type phase, δ-Bi5PbY2O11.5, is presented. Using a combination of conventional Rietveld analysis of neutron diffraction data, reverse Monte Carlo (RMC) analysis of total neutron scattering data and ab initio molecular dynamics (MD) simulations, both average and local structures have been characterized. δ-Bi5PbY2O11.5 represents a model system for the highly conducting δ-Bi2O3 type phases, in which there is a higher nominal vacancy concentration than in the unsubstituted parent compound. Uniquely, the methodology developed in this study has afforded the opportunity to study both oxide-ion vacancy ordering as well as specific cation-cation interactions. Oxide-ion vacancies in this system have been found to show a preference for association with Pb2+ cations, with some evidence for clustering of these cations. The system shows a non-random distribution of vacancy pair alignments, with a preference for 〈100〉 ordering, the extent of which shows thermal variation. MD simulations indicate a predominance of oxide-ion jumps in the 〈100〉 direction.

Pharmacological Cardioversion With Antazoline in Atrial Fibrillation: The Results of the CANT Study.

Background Antazoline mesylate represents an antihistamine capable of rapid and safe cardioversion of atrial fibrillation, yet evidence concerning its efficacy in comparison to other medications is insufficient. The study aimed to evaluate the success rate and safety of pharmacological cardioversion of atrial fibrillation with intravenous antazoline ( CANT [Cardioversion With Antazoline Mesylate] study) in the setting of the emergency department. Methods and Results After reviewing 1984 medical records, 450 eligible patients (22.7%) with short-duration atrial fibrillation subject to pharmacological cardioversion were enrolled in a retrospective observational analysis. The choice of antiarrhythmic drug was left to the discretion of the attending physician. The primary end point was successful cardioversion in the emergency department. The safety end point comprised bradycardia <45 bpm, hypotension, syncope, or death. The study population (mean age, 65.5±11.9 years; 52.9% females) was characterized by a median atrial fibrillation episode duration of 10 hours. Antazoline, alone or in combination, was administered in 24.2% (n=109) and 40% (n=180), respectively; amiodarone was administered in 46.7% and propafenone in 9.3%, while ≥2 antiarrhythmic drugs were administered in 19.8% of patients. Antazoline had the highest success rate of pharmacological cardioversion among all drugs (85.3%), which was comparable with propafenone (78.6%; relative risk, 1.09, 95% confidence interval, 0.91-1.30; P=0.317) and higher than amiodarone treatment (66.7%; relative risk, 1.28, 95% confidence interval, 1.13-1.45; P<0.001; number needed to treat, 5.4). The rate of cardioversion with antazoline alone was higher than combined amiodarone and/or propafenone (68.1%; relative risk, 1.25; 95% confidence interval, 1.12-1.40, P=0.0001). No safety end points were reported in the antazoline group, while 5 incidents occurred in the non-antazoline cohort ( P=0.075). Conclusions Antazoline represents an efficacious and safe method of pharmacological cardioversion in a real-life setting.

Correlation between electrical and mechanical properties of the left ventricle in patients with postinfarction ventricular tachycardia.

BACKGROUND: Electroanatomical mapping allows differentiation between viable and scarred myocardium. Echocardiography is widely used to assess myocardial contractility. The relationship between electrophysiological and echocardiographic assessment of left ventricular function has not yet been well established. AIM: To correlate mechanical and electrical function of the left ventricle in patients with postinfarction ventricular tachycardia and to assess clinical, echocardiographic and angiographic parameters affecting regional electrical function. METHODS: In 32 patients (25 males, 64+/-9 years old) mean unipolar (UP) and bipolar (BP) voltages were obtained with electroanatomical mapping (CARTO system) for a 12-segment model and compared with segmental wall motion function scored as normal, hypokinetic and a- or dyskinetic. UP voltage in individual groups of segments was: 7.8+/-4.2 mV, 6.5+/-4.2 mV, 4.7+/-2.5 mV, p <0.01 and for BP voltage 2.1+/-1.5 mV, 1.9+/-1.9 mV, 1.1+/-1.0 mV, p < 0.01, respectively. Left ventricular ejection fraction < or =30%, end-diastolic diameter >56 mm, previous inferior or anterior myocardial infarction (MI), MI < or =5 years and open infarct-related artery were associated with lower voltage in normokinetic segments. CONCLUSIONS: Segments with advanced systolic dysfunction had significantly lower uni- and bipolar voltage than normo- and hypokinetic segments. However, preserved local electrical function could be found in a/dyskinetic regions. Left ventricular remodelling, time and location of MI and patency of infarct-related artery influenced voltage in normokinetic segments.