Akitoshi Sasaki

Cardiac hemangioma: a report of two cases and review of the literature

Cardiac hemangioma is extremely rare. We encountered two patients with cardiac hemangioma detected by thoracic echocardiography during a medical checkup. In the first case, transthoracic echocardiography revealed a pedunculated tumor in the left ventricle. Selective left coronary angiography demonstrated that the main feeding artery of the tumor arose from the third diagonal branch of the left anterior descending coronary artery. In the second case, thoracic and transesophageal echocardiography showed an oval tumor arising from the right atrium. Both tumors were successfully resected. Histopathological examination revealed that one of the tumors was a capillary hemangioma and the other was a mixed capillary and cavernous hemangioma. After operation, both patients had an uneventful recovery without any complications.

Brugada-like electrocardiogram detected after reconstructive operation for oesophageal cancer

A 63-year-old male was admitted to our surgical department for an operation for oesophageal cancer. He had no episodes of syncope or a family history …

Dislodgment of an Atrial Screw‐In Pacing Lead 10 Years After Implantation

Dislodgment of an atrial screw‐in pacing lead is quite rare. This report describes a rare case of an atrial screw‐in lead dislodgment 10 years after implantation. Although it is an uncommon complication, very late dislodgment can occur postoperatively, and careful follow‐up is necessary. (PACE 2004; 27:264–265)

Prolonged Asystole during Head-Up Tilt Test in a Patient with Malignant Neurocardiogenic Syncope

A 27 year‐old man was taken to our emergency room after collapsing during a conference. The patient had a history of syncope twice since age 15. A marked sinus bradycardia and asystole were induced causing the patient to collapse when tested to stand up in the emergency room. Cardioinhibitory type neurocardiogenic syncope was considered to be the cause of the syncope. Therefore the patient was treated with oral disopyramide at a daily dose of 150 mg. Three weeks later, a head‐up tilt test was performed for evaluation of drug effectiveness. However, a prolonged asystole for 24 seconds due to sinus arrest without escape beat was induced 7 minutes after starting the tilt at 80 degrees. Although the tilt table was returned to the flat position immediately, it took an additional 30 seconds for complete recovery of the patients consciousness.

Bepridil Revisited: Efficacy for Persistent Atrial Fibrillation

The purpose of this study is to clarify the efficacy and safety of bepridil for persistent atrial fibrillation (AF). Method Bepridil (100-200mg/day) was administered to 159 patients (141 males, 58 years) with persistent AF. The effects of conversion and maintenance of sinus rhythm (SR) were evaluated. If sinus restoration was not obtained until 3 months observation, DC cardioversion was performed. Results In 87 of 159 patients (55%), SR was restored within an average 2.1 months following administration of bepridil. 74 of those 87 patients (85%) have been maintained in SR for the average follow-up of 16 months. The 31 out of remaining 72 patients failed pharmacological conversion were performed DC cardioversion. All of patients restored SR, and 18 of them (58%) could be maintained SR for an average of 20 months. Although ECG revealed significant prolongation of QT interval from 0.38 to 0.42 sec, QTc was unchanged and no serious adverse complications including torsade de pointes were recognized. Conclusion Bepridil is clinically safe and useful with favorable efficacy for conversion and maintenance of SR in patients with persistent AF.

18. Atrial Fibrillation: Electrical Cardioversion and Drug Prophylaxis18.7 Bepridil Revisited: Efficacy for Persistent Atrial Fibrillation

The purpose of this study is to clarify the efficacy and safety of bepridil for persistent atrial fibrillation (AF). Method Bepridil (100-200mg/day) was administered to 159 patients (141 males, 58 years) with persistent AF. The effects of conversion and maintenance of sinus rhythm (SR) were evaluated. If sinus restoration was not obtained until 3 months observation, DC cardioversion was performed. Results In 87 of 159 patients (55%), SR was restored within an average 2.1 months following administration of bepridil. 74 of those 87 patients (85%) have been maintained in SR for the average follow-up of 16 months. The 31 out of remaining 72 patients failed pharmacological conversion were performed DC cardioversion. All of patients restored SR, and 18 of them (58%) could be maintained SR for an average of 20 months. Although ECG revealed significant prolongation of QT interval from 0.38 to 0.42 sec, QTc was unchanged and no serious adverse complications including torsade de pointes were recognized. Conclusion Bepridil is clinically safe and useful with favorable efficacy for conversion and maintenance of SR in patients with persistent AF.

18. Atrial Fibrillation: Electrical Cardioversion and Drug Prophylaxis

The purpose of this study is to clarify the efficacy and safety of bepridil for persistent atrial fibrillation (AF). Method Bepridil (100-200mg/day) was administered to 159 patients (141 males, 58 years) with persistent AF. The effects of conversion and maintenance of sinus rhythm (SR) were evaluated. If sinus restoration was not obtained until 3 months observation, DC cardioversion was performed. Results In 87 of 159 patients (55%), SR was restored within an average 2.1 months following administration of bepridil. 74 of those 87 patients (85%) have been maintained in SR for the average follow-up of 16 months. The 31 out of remaining 72 patients failed pharmacological conversion were performed DC cardioversion. All of patients restored SR, and 18 of them (58%) could be maintained SR for an average of 20 months. Although ECG revealed significant prolongation of QT interval from 0.38 to 0.42 sec, QTc was unchanged and no serious adverse complications including torsade de pointes were recognized. Conclusion Bepridil is clinically safe and useful with favorable efficacy for conversion and maintenance of SR in patients with persistent AF.