Isosorbide dinitrate sublingual therapy for inferior myocardial infarction: randomized trial to assess infarct size limitation.

To assess the potential of isosorbide dinitrate sublingual therapy for limiting myocardial infarct size, 41 patients with inferior acute myocardial infarction (AMI) were studied. Twenty patients were randomly assigned to the control group and 21 to the treatment group. Patients in the treatment group received 10 mg of isosorbide dinitrate every 2 hours for 72 hours. To estimate infarct size, QRS scoring, peak creatine kinase (CK) serum levels and CK curves were used. There were no significant differences between the 2 groups in maximal or cumulative activity of CK or QRS score (percent of left ventricle infarcted: 16% in the control group, 17% in the treatment group). In both groups the QRS score increased significantly by 13 hours after AMI, and the increase was highly significant by 19 to 23 hours. Thus, sublingual isosorbide dinitrate at the dosage given did not reduce infarct size in patients with inferior AMI.

[Permanent endocardial pacemaker. Review of 116 implantations (author's transl)]. / Marcapaso endocavitario permanente. A propósito de 116 implantaciones.

A retrospective study on the results of 116 permanent ventricular pacemaker implantations performed in the Service of Cardiology of the Hospital Clinico Universitario in Salamanca is reported. In the majority of cases the indication for a pacemaker was a complete atrioventricular block (53 cases). Sixteen cases had a "sick-sinus syndrome". An apparent cardiopathy was not found in 84 percent of the cases. In the group of patients with cardiopathy that of ischemic type was the most common. The technique of endocardiac catheter pacing was employed in all cases. An 18 percent of global complications occurred, but in no case an early electrode displacement was registered. Complications appeared at a later time included erosion of the pacemaker in ten cases, and displacement and/or deinsertion in seven. The mean life for 18 displaced generators was 41.3 months. A sudden equipment malfunction occurred in two cases, and an inhibition by potentials of the pectoralis major muscle in another. Morbidity rate was lower to that of other published series, may be due to the use of modern generators with a progressive reduction of its diameter and weight and more flexible electrodes which allow a better implantation. The mortality rate was zero.