Skip to main content
Volume 2, No 2 - Spring 2001

Volume 2, No 2 - Spring 2001

Table of Contents

Implantable Cardioverter Defibrillator Shocks: A Troubleshooting Guide Treatment Update
Implantable cardioverter defibrillators deliver shocks in response to electrical signals that satisfy programmed criteria for detection of VT or VF. The first step in diagnosis of inappropriate shocks in patients with ICDs is to determine if the shock was delivered in response to a true tachyarrhythmia by inspecting data stored in the ICD. Shocks occur in the absence of tachyarrhythmias because nonarrhythmic physiologic or nonphysiologic signals are oversensed by the ICD and detected as arrhythmias. Diagnosis and causes of oversensing are reviewed. The second step in diagnosis is to determine if the tachyarrhythmia stored in the VT/VF episode log is VT/VF or SVT by analyzing stored electrograms. Frequent or repetitive shocks constitute an electrophysiologic emergency. The approach to this problem is reviewed. [Rev Cardiovasc Med. 2001;2(2):61–72]
Mitral Valve Prolapse: Time for a Fresh Look Cardiovascular Disorders
To what extent is prolapse of the mitral valve associated with mitral regurgitation and the risk of infective endocarditis, rupture of the chordae tendineae, and sudden death? Earlier studies used differing definitions and criteria, and reported prevalence of this deformity varied widely, especially between referral and general population studies. Advances in echocardiography have clarified the diagnosis, allowing classification of prolapse into subtypes associated with different degrees of risk and prognoses. [Rev Cardiovasc Med. 2001;(2)2:73–81]
The Role of Inflammation in Plaque Disruption and Thrombosis Coronary Syndromes
Most of the serious clinical manifestations (such as unstable angina, acute MI, and many cases of sudden death) of coronary atherosclerosis result from thrombosis, usually occurring on a disrupted atherosclerotic plaque. Plaques prone to disruption have large lipid-rich cores with evidence of cap-thinning and active inflammation. Inflammatory cells may contribute to both plaque disruption and subsequent thrombosis. Here we review the evidence for the involvement of inflammation in plaque disruption and thrombosis and the potential clinical implications of this pathophysiologic paradigm. [Rev Cardiovasc Med. 2001;2(2):82–91]
Current Issues in Vascular Disease 11th Annual Meeting of the Society for Vascular Medicine and Biology
Update on Inflammatory Markers XXII European Society of Cardiology Annual Congress
Percutaneous Transluminal Septal Myocardial Ablation: A Novel, Nonsurgical Treatment for Symptomatic Hypertrophic Cardiomyopathy
Patients with severely symptomatic hypertrophic obstructive cardiomyopathy (HOCM) have several alternatives when drugs do not help. Surgical septal myotomymyectomy, though effective, is an open-heart surgical procedure and can be associated with some complications. The less invasive dual chamber pacing has not lived up to its early promise. Percutaneous transluminal septal myocardial ablation (PTSMA) is a relatively simple, less complicated nonsurgical procedure that can provide an effective and sustained relief of left ventricular outflow tract (LVOT) obstruction. Should it gain wider acceptance? [Rev Cardiovasc Med. 2001;2(2):97–102]