Taquicardia recíproca de la unión auriculoventricular: características electrofisiológicas en un paciente con la variedad paroxística. Caso clínico / Paroxysmal tachycardia in a patient with a permanent form of junctional reciprocating tachycardia

Junctional reciprocating tachycardia is an atrioventricular reentrant tachycardia whose anterograde conduction occurs via the His Purkinje and the retrograde conduction via an accessory pathway with slow conduction. The most common form is incessant tachycardia but a paroxysmal form also exists. We report a 35 years old female with recurrent paroxysmal tachycardia, that underwent electrophysiological evaluation. A left posterolateral accessory pathway was documented. Reciprocating paroxysmal tachycardia was induced by electrical stimulation and a successful pathway ablation was performed (Rev MÚd Chile 2004; 132: 608-13).

Tratamiento crónico combinado con iloprost y sildenafil en un paciente con hipertensión pulmonar primaria / Aerosolized iloprost combined with a phosphodiesterase inhibitor in the treatment of primary pulmonary hypertension

Iloprost, a prostacyclin analogue administered by inhalation, improves hemodynamic and functional class variables in patients with primary pulmonary hypertension. However, repetitive inhalations are required due to its short term effects. One potential approach to prolong and increase the effects of aerosolized iloprost might be to combine its use with phosphodiesterase inhibitors. We report a 36 years old female patient with primary pulmonary hypertension treated with this combination. After 18 months of therapy the patient had an improvement in functional class and in the 6 min walk distance despite persistence of high pulmonary pressures. Our case is in agreement with the reported beneficial effect of the association of sildenafil and iloprost. We postulate that functional improvement in primary pulmonary hypertension is not always related to a decrease in pulmonary artery pressure (Rev MÚd Chile 2004; 132: 353-6).