[Chronic beta-stimulant therapy: a possible etiopathogenic factor for hypertrophic cardiomyopathy]. / Terapia cronica con beta-stimolanti: un possibile fattore etiopatogenetico per la cardiomiopatia ipertrofica.

We herein report the case of a 37-year-old woman, referred to our Unit because of atypical chest pain, negative T waves in leads V1-6 and medio-apical hypertrophic cardiomyopathy, diagnosed by two-dimensional echocardiography. The patient suffered from status asthmaticus and consequently had been treated for a twenty year period with beta-adrenoceptor stimulating agents, corticosteroids, theophylline. No coronary stenosis was revealed by coronary angiography. The results of electrocardiographic and two-dimensional echocardiographic investigations, performed after interruption of beta-stimulations, showed a regression of hypertrophic cardiomyopathy. We suggest that hypertrophic cardiomyopathy could be induced by beta-adrenergic stimulation.

[Use of the thoraco-acromialis vein for implantation of a permanent transvenous PMK (author's transl)]. / Use della vena toraco-acromiale nell'impianto di un elettrostimolatore definitivo.

In order to implant a permanent PMK in 35 patients with total heart block the thoraco-acromialis vein has been investigated. The vein was easily found in the groove between the clavicular and sternal part of the musculus pectoralis major and used to implant a permanent pacing lead in 32 patients (91.5%). Following the satisfactory results and taking into account that the complications had reduced to a very low rate (in 2 cases lead tip displacement and pouch haematoma occurred respectively), the Authors consider the adopted method an useful approach for PMK implantation particularly when the use of the vena cephalica is deemed impossible.

[Syncopal attacks due to ventricular tachyarrhythmias ("torsade de pointe type") in a patient with a PM of hysteresis type (author's transl)]. / Episodi sincopali da tachiaritmie ventricolari con "torsade de pointe" in portatore di segnapassi artificiale.

The authors report on a patient with artificial ventricular pacemaker with hysteresis, who suffered from ventricular fibrillation known as "torsade de pointe" and ventricular flutter, often accompanied by lipothymias, with hypokalemia. The following points are considered: the pacemaker responsibility to produce arrhythmia; the pacemaker behaviour during ventricular tachyarrhythmias; the modifications of stimulation threshold and R-wave sensitivity after PM removal and the following hours.