RESUMO
Objective: To find out the indication and frequency of permanent pacemaker implantation in complete heart block patients [CHB]
Study Design: Prospective cohort study
Place and Duration of Study: Rawalpindi Institute of Cardiology, Rawalpindi for a period of six months from Mar 2016 to Sep 2016
Material and Methods: Total 153 patients of both genders coming to Rawalpindi Institute of Cardiology with complete heart block were included in the study. The patients fulfilling the inclusion criteria were evaluated for the etiology of complete heart block by history, physical examination, electrocardiography, blood tests, chest x-ray and echocardiography. Later their outcome [pacemaker implantation/medical treatment/death] was determined
Results: Myocardial infarction was found out to be the cause for CHB in 32.1 percent patients. Out of 153 patients, 12 patients died. In the remaining 141 patients, 77 were implanted with a pacemaker
Conclusions: Myocardial infarction accounted for 32.1 percent cases of complete heart block and a significant number of patients were implanted with a permanent pacemaker. Hence the trend of pacemaker use is on a rise
RESUMO
Valproate-induced encephalopathy is a rare syndrome that may manifest in otherwise normal epileptic individuals. It may even present in patients who have tolerated this medicine well in the past. It is usually but not necessarily associated with hyperammonemia. The EEG shows characteristic triphasic waves in most patients with this complication. A case of valproate-induced encephalopathy is presented. The problems in diagnosing this condition are subsequently discussed