Abstract Background Risk stratification for sudden cardiac death (SCD) in hypertrophic cardiomyopathy (HCM) is based on different algorithms proposed by the 2011 ACCF/AHA and 2014 ESC guidelines. Objective To analyze the 2014 ESC model for SCD risk stratification and primary prevention ICD (implantable cardioverter defibrillator) in HCM in comparison to the North American guideline. Methods An HCM cohort was evaluated and the ESC HCM-Risk SCD score was calculated. Agreement of ICD recommendations criteria between the two guidelines was analyzed with […]

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 […]

Abstract Background: Carotid sinus hypersensitivity (CSH) is a frequent finding in the evaluation of syncope. However, its significance in the clinical setting is still dubious. A new criterion was proposed by Solari et al. with a symptomatic systolic blood pressure (SBP) cut-off value of 85 mmHg to refine the vasodepressor (VD) response diagnosis. Objective: To determine and compare the response to carotid sinus massage (CSM) in patients with and without syncope according to standard and proposed criteria. Methods: CSM was […]

Abstract Background: The new European Society of Cardiology guidelines for hypertrophic cardiomyopathy (HCM) define the estimation of sudden cardiac death (SCD) risk as an integral part of clinical management. An implantable cardioverter defibrillator (ICD) is recommended (class IIa) when the risk is ≥ 6%. Objectives: To compare the SCD risk stratification according to the 2011 and 2014 recommendations for ICD implantation in patients with HCM. Methods: Retrospective study including 105 patients diagnosed with HCM. The indication for ICD was assessed […]

Clinical data Dyspnea on exertion for two years, progressing to low cardiac output and syncope lately, treated with dobutamine and usual drugs for congestive heart disease (currently using furosemide 40 mg, spironolactone 25 mg and losartan 12.5 mg). Physical examination: Good general condition, eupneic, acyanotic, normal pulse rate in the four limbs. Weight: 70 Kg, Height: 160 cm, blood pressure (right arm): 90/60 mmHg, HR: 94 bpm. […]

Introduction An abnormally short QT interval can be caused by several situations such as hypercalcemia, hyperkalemia, acidosis, hyperthermia, effects of drugs like digitalis or congenital short QT syndrome (SQTS). Primary hyperparathyroidism (PHPT) can ultimately cause short QT interval since overproduction of parathyroid hormone (PTH) causes hypercalcemia. However, cardiac arrhythmias are uncommon and electrical storm has been rarely described in patients with hypercalcemia. Secondary causes of short QT must be ruled out before considering the diagnosis of SQTS. First described in […]

Abstract Background: The prevalence of orthostatic hypotension (OH) increases with age and is associated with changes in autonomic regulation of blood pressure (BP) and heart rate (HR). Objective: to assess HR and HR variability (HRV) in elderly subjects with OH and determine OH predictors. Methods: a total of 105 patients aged ≥ 60 years, 39 with OH (case group) and 66 without OH (control group) (age-matched) were studied. Patients underwent clinical assessment, electrocardiogram, biochemistry tests and Holter monitoring for spectral […]