[ECG pearl: Valsalva maneuver terminated ventricular tachycardia]. / EKG-gyöngyszem: Valsalva-manover terminálta kamrai tachycardia.

Összefoglaló. Egy 78 éves férfi széles-QRS-tachycardiás esetét mutatjuk be. A betegnél a pitvar-kamrai disszociáció igazolta a ritmuszavar kamrai eredetét, amelyet a Valsalva-manoverrel több alkalommal is átmenetileg meg lehetett szüntetni. A szerzok ismertetik a manover lehetséges patomechanizmusait, illetve felhívják a figyelmet arra, hogy a vagusmanoverre megszuno reguláris tachycardia nem jelent feltétlenül supraventricularis eredetet. Orv Hetil. 2021; 162(12): 468-470. Summary. A 78-year-old man is presented with wide QRS tachycardia (WQRST). The ventricular origin of WQRST was confirmed by atrioventricular dissociation. The Valsalva maneuver terminated the tachycardia repeatedly. The authors discuss the possible mechanisms of Valsalva maneuver in the arrhythmia termination. This case highlights that Valsalva maneuver or carotid massage terminated tachycardia are not necessarily supraventricular tachycardia. Orv Hetil. 2021; 162(12): 468-470.

[ECG pearl: tonic-clonic seizure detected by implantable loop recorder]. / EKG-gyöngyszem: tónusos-clonusos epilepsziás roham kimutatása implantábilis loop recorderrel.

A 52-year-old woman is presented with repetitive transient loss of consciousness. Implantable loop recorder (ILR) recorded muscle artifacts during the generalized tonic-clonic seizures. Seizure was diagnosed and antiepileptic drug was started. The patient has been asymptomatic for 9 months. Orv Hetil. 2019; 160(29): 1143-1145.

[Role of implantable loop recorder in the clinical diagnosis of syncope: results of the introduction of an effective diagnostic tool]. / Az implantálható loop recorder szerepe a syncope diagnosztikájában: egy hatékony vizsgálati módszer bevezetésének eredményei.

INTRODUCTION: Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. AIM: In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. METHOD: The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. RESULTS: There were 52 loop recorder implantations within the study period. During the 167 (± 136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. CONCLUSIONS: The high diagnostic rate of implantable loop recorder in the everyday clinical practice is in accordance with the findings in prospective clinical studies. This observation supports the early application of loop recorder in the diagnostic algorithm of syncope.

[A new ECG marker of anterior acute myocardial infarction]. / Az akut anterior myocardialis infarctus új EKG-jele.

ST-segment elevation is the hallmark of acute transmural myocardial ischemia caused by acute occlusion of a coronary artery. ST-segment elevation is the major criterion for the patients with chest pain to immediate reperfusion therapy. Despite its clinical importance, the mechanism of ST-elevation remains unclear. Two patients are reported with proximal left anterior descending coronary occlusion but without ST-segment elevation. The distinct ECG patterns were tall, with symmetrical T-waves and upsloping and digoxin-like ST-segment depression. Patients with these ECG patterns need immediate coronary intervention.