Extended monitoring by impedance cardiography and plasma catecholamine measurements during tilt-table testing gave further insight into different hemodynamic and neurohumoral presyncopal patterns among the various types of neurocardiogenic syncope and may thereby help to develop individualized therapeutic concepts.

Twenty coronary patients with a median age of 76 years were treated in the coronary care unit with tiapamil, a new Ca2+ antagonist, by intravenous infusion (until December, 1979, the generic name was dimeditiapramine). The following arrhythmias were identified: atrial fibrillation with ventricular rate >95 beats/min (5 patients); supraventricular premature complexes (SVPC) (4 patients); and ventricular premature complexes (VPC), Lown grades 2-4 (1 5 patients). Electrocardiograms and hemodynamic parameters were continuously monitored prior to, during, and after the therapy. In patients with atrial fibrillation, sinus rhythm was not restored, but tiapamil decreased the ventricular rate by 54%.In patients with VPC, the median frequency of VPC decreased from 310.5 before tiapamil to 32.5 beats/h at the fourth hour of therapy (p

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Summary:Twenty coronary patients with a median age of 76 years were treated in the coronary care unit with tiapamil, a new Ca2+ antagonist, by intravenous infusion (until December, 1979, the generic name was dimeditiapramine). The following arrhythmias were identified: atrial fibrillation with ventricular rate >95 beats/min (5 patients); supraventricular premature complexes (SVPC) (4 patients); and ventricular premature complexes (VPC), Lown grades 2-4 (1 5 patients). Electrocardiograms and hemodynamic parameters were continuously monitored prior to, during, and after the therapy. In patients with atrial fibrillation, sinus rhythm was not restored, but tiapamil decreased the ventricular rate by 54%.In patients with VPC, the median frequency of VPC decreased from 310.5 before tiapamil to 32.5 beats/h at the fourth hour of therapy (p

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A 78-year-old woman with transient ischemic attacks and a 2-day history of dyspnea was admitted to our hospital on artificial ventilation 2 weeks after surgical removal of a malignant uterine tumor. Echocardiography showed a dilated right ventricle with moderate tricuspid insufficiency and a floating thrombus in the right and left atria. A spiral CT scan demonstrated the presence of a pulmonary embolism in the left lung. Transesophageal echocardiography revealed a patent foramen ovale penetrated by a vermiform thrombus (Figure 1). The patient then underwent emergency heart surgery. Under conditions of extracorporeal circulation the right atrium was found to contain a large thrombus that was wedged in the patent foramen ovale (Figures 2a and 2b). The thrombus, measuring 16 cm in length, was removed in toto (Figure 3), and the patent foramen ovale was closed directly without a patch. Following an uncomplicated recovery the patient was discharged several days later to a cardiac rehabilitation center.