Wórum F

Temporary Pacing in Complete Heart Block due to Lyme Disease: A Case Report

The authors present the case of a 44‐year‐old man who was admitted with complete heart block and signs of severe bradycardio, After steroid administration and temporary pacemaker treatment the complete heart block resolved. During this therapy transient ST segment and T wave abnormalities occurred. The positive Borrelia burgdorferi antibody titer arrived only after therapy had been completed. This is regarded as the first case of Lyme carditis with complete heart block diagnosed in eastern Europe. Carditis resolved without antibiotic treatment and has not recurred.

Motor vehicle accident with complete loss of consciousness due to vasovagal syncope

Vasovagal syncope (VVS) is one of the most common causes of complete or partial loss of consciousness, thus it might cause harm to the patients themselves or innocent bystanders while driving a car. In our case report we introduce the case of a 60-year-old man who was admitted to hospital after a serious motor vehicle accident due to loss of consciousness. We demonstrate the process and results of complete cardiologic and neurological assessment. Our case report illustrates the importance of recognition of patients with a high risk for incapacitating symptoms due to VVS, and the use of head-up tilt-table tests to determine the diagnosis and to guide therapy with beta-blocking agents. As transient loss of consciousness during driving may cause potentially fatal accident, it has to be taken into consideration during decision making for issue of driving licenses to patients with VVS.

Closed-Chest Ablation of His Bundle: A New Technique Using Suction Electrode Catheter and DC Shock

The purpose of this paper is to describe a new technique for closed-chest ablation of His bundle. Ten mongrel dogs were generally anesthetized. A bipolare suction electrode catheter was introduced through the femoral vein into the right heart and positioned to the His bundle. When a large His potential appeared, - 100 mmHg suction was applied. In this way the electrode was well fixed on the His bundle. The central terminal of the suction electrode was connected by a switching device to the cathodal output of standard cardioversion unit. A back paddle was positioned adjacent to the left scapula and connected to anodal output of the cardioversion unit. The defibrillator was discharged synchronously with the QRS complex. Using this technique we were able to induce heart block in 9 of 10 dogs by passing an average of 150 J one time through the suction electrode. At the end of the procedure we implanted a used demand pacemaker into the dogs. In 9 of 10 dogs the total AV-Block persisted at the end of the third week. After 3 weeks the dogs were killed and their hearts were investigated histologically.