An elderly female patient was brought to the Emergency Department due to loss of consciousness. The past medical history was remarkable for hypercholesterolemia and essential hypertension. The patient was not treated with any negative chronotropic drug. At the admission, the patient’s blood pressure was 90/60 mmHg, she had bradycardia (42/minute), and hypothermia (33ºC). Electrocardiogram (ECG) showed sinus bradycardia, 1st grade atrioventricular block, long corrected QT interval, and Osborn waves at the end of QRS complexes ( , arrowheads). Accordingly, these […]

Background: Cardioinhibitory carotid sinus hypersensitivity (CICSH) is defined as ventricular asystole ? 3 seconds in response to 5-10 seconds of carotid sinus massage (CSM). There is a common concern that a prolonged asystole episode could lead to death directly from bradycardia or as a consequence of serious trauma, brain injury or pause-dependent ventricular arrhythmias. Objective: To describe total mortality, cardiovascular mortality and trauma-related mortality of a cohort of CICSH patients, and to compare those mortalities with those found in a […]

Background: D-limonene (DL) is a monoterpene and is the major component in the essential oil of citrus fruit. It presents antihyperglycemic and vasodilatation activities. Objectives: This study evaluated the cardiovascular effects and potential antiarrhythmic of DL in rats. Methods: Hemodynamic and electrocardiographic (ECG) parameters were measured in male Wistar rats, which under anesthesia had been cannulated in the abdominal aorta and lower vena cava and had electrodes subcutaneously implanted. In the in vitro approach, the heart was removed and perfused […]

Neurally mediated syndrome (NMS) is the most common cause of and transient loss of consciousness and usually causes anxiety and concerns for patients and their families. Clinical investigation and explanations about benignity, in association to lifestyle modifications and teaching methods to abort the vagal reflex are the initial and effective approaches to manage the majority of patients.– However, in some cases, the loss of consciousness occurs suddenly, without prodromal symptoms and the patient does not have the opportunity to prevent […]

Abstract Background: Considering the potential deleterious effects of right ventricular (RV) pacing, the hypothesis of this study is that isolated left ventricular (LV) pacing through the coronary sinus is safe and may provide better clinical and echocardiographic benefits to patients with bradyarrhythmias and normal ventricular function requiring heart rate correction alone. Objective: To assess the safety, efficacy, and effects of LV pacing using an active-fixation coronary sinus lead in comparison with RV pacing, in patients eligible for conventional pacemaker (PM) […]

Arboviral diseases are an important public health problem, especially in tropical and subtropical countries, such as Brazil, where viruses of the family Flaviviridae, responsible for dengue fever, zika and yellow fever (YF), and of the family Togaviridae, which cause chikungunya, predominate. In recent years, the number of cases has increased because of several factors, of which environmental changes, such as deforestation and climate changes, disorderly occupation of cities with low hygiene-sanitary conditions, in addition to the increased mobility of international […]

Abnormal parasympathetic activity on the heart has been implicated in several forms of symptomatic bradycardia, especially in young and otherwise healthy individuals. Neurally mediated syncope, sinus arrest and advanced atrioventricular (AV) block have high risk of injury and serious implications on quality of life. Nonetheless, until recently, their clinical management, mainly based on behavioral measures and pacing, have often proved to be ineffective or inadequate. An alternative approach to treat this specific population, avoiding device implants and continuous drug therapy […]