The pathological features of 5 cases of subvalvular cardiac aneurysms occurring in Uganda over a 13-year period are described; 3 were subaortic and 2 were submitral. One of the latter was atypical in that the aneurysm arose at some distance below thefibrous mitral ring and was associated with endomyocardialfibrosis. In 2 cases where the coronary sinus and its ostium was examined, no abnormality was detected.Previous descriptions of the pathological aspects ofsubvalvular aneurysms are briefly reviewed.
For patients with persistent AF the use of a higher initial-energy monophasic shock of 360 J achieves a significantly greater success rate, with less skeletal muscle damage (and no cardiac muscle damage) as compared with the traditional starting energy of a 200 J DC shock.
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