ABSTRACT
Scleromyositis is an autoimmune disease and an overlap syndrome of scleroderma and poly/dermatomyositis. It is characterized by frequent cardiovascular involvement including heart failure, arrhythmias and conduction disturbances. We present a case of a 73-year old female patient who required an upgrade from a DDD pacemaker to cardiac resynchronization therapy due left ventricular dysfunction and permanent ventricular pacing. Electroanatomical mapping (CARTO 3D) revealed extensive right atrial fibrosis which resulted in significant delay in intraatrial conduction. Interval from atrial paced stimulus to A signal in His bundle was 364â¯ms, while AH and HV intervals were within normal range.
Subject(s)
Cardiac Pacing, Artificial , Cardiac Resynchronization Therapy , Aged , Arrhythmias, Cardiac/therapy , Electrocardiography , Female , Fibrosis , Heart Atria , HumansABSTRACT
Each year a notable number of fatal intoxications with carbon monoxide (CO) is reported worldwide. Carbon monoxide binds with hemoglobin, decreases oxygen supply and leads to hypoxia and lactic acidosis. Myocardium, being particularly vulnerable to hypoxia, is one of the most damaged organs in course of CO intoxication. A CASE REPORT: We present a case report of severe CO poisoning in a 66-year old man, that led to significant repolarization abnormalities. Diffuse ST segment depression associated with significant QT interval prolongation up to QTcB 595ms was observed in the electrocardiogram at admission. Other potential causes of QT prolongation as hypothermia, dyselectrolitemia or QT prolonging drugs use were excluded. No regional neither global contractility dysfunction was observed on echocardiography. ECG recorded 6 hours after admission showed normalization of ST segment but only slight shortening of QTc to 550 ms.