Cardiology Journal 2012, tom 19, nr 2

Fragmentation of QRS (fQRS) complex is an easily evaluated non-invasive electrocardiographic parameter. Fragmentation of narrow QRS is defined as presence of an additional R wave (R′) or notching in the nadir of the S wave, or the presence of > 1 R′ in 2 contiguous leads, corresponding to a major coronary artery territory on the resting 12-lead ECG. Fragmentation of wide complex QRS consists of various RSR patterns, with more than 2 R waves (R′′) or more than 2 notches in the R wave, or more than 2 notches in the downstroke or upstroke of the S wave.

Present day 24-h Holter monitors have been shown to miss many arrhythmias that may occur infrequently or under specific circumstances. The advancement in electronic and adhesive technologies have enabled the development of first generation wearable long-term 14-day patch ECG monitors that attach directly to the skin and require no electrodes and wires to operate. 

This report describes paradoxical atrial undersensing by a dual chamber pacemaker in a patient with paroxysmal atrial fibrillation. Atrial undersensing was present only when the device was programmed to a high sensitivity but sensing normalized when a lower sensitivity was programmed. This unusual response should be differentiated from the recently documented lock-in behavior of pacemakers delivering managed ventricular pacing. (Cardiol J 2012; 19, 2: 207–209)

In October 2010, a 64 year-old lady with history of well controlled hypertension, previous stroke with no residual weakness and psoriasis attended for a routine tooth extraction. 

A 22 year-old woman presented with dyspnea, central cyanosis and a pulsatile mass on her left neck.

Coarctation of the aorta (CoA) is a common congenital anomaly that is usually treated in infancy or childhood. Adult patients with coarctation have a high incidence of associated cardiac disorders, including valve diseases, atrial fibrillation and ischemic heart disease. Most patients with uncorrected CoA die before reaching the age of 50 from complications such as myocardial infarction, intracranial hemorrhage, congestive heart failure (HF), infective endocarditis or aortic dissection. 

Left internal mammary artery (LIMA) is the most commonly used graft during coronary bypass surgery. LIMA side branches are clipped during surgery in order to prevent coronary steal. In cases of patent LIMA side branches, there are differingapproaches. 

In this study, we present the case of the extraction of a non-functioning, abandoned, chronically implanted nine year-old lead with proximal extended frayed ending, displaced spontaneously into the subclavian vein. 

Although pericardial cysts are generally benign structures and detected incidentally, they may be associated with life-threatening complications. We present the case of a 24 year-old man with a giant hemorrhagic pericardial cyst diagnosed after evaluation for recurrent syncope which caused compression of the right ventricle. 

Pulmonary hypertension is caused by a heterogenous group of disorders with diverse pathophysiological mechanisms, with ultimate structural changes in the pulmonary vascular bed. Platelet activation plays an important role in the development of pulmonary arterial hypertension, while it is unknown whether it contributes to pathogenesis in other conditions. We aimed to investigate platelet activation in different causes of pulmonary hypertension by means of mean platelet volume measurement.