145 e-Letters

published between 2011 and 2014

  • Re:Comments on: The infective endocarditis team: recommendations from an international working group
    John B Chambers

    We thank Dr San Roman and colleagues for their comment on our editorial. They suggest that all cases with endocarditis should be referred to a reference center because the specialist expertise to monitor their progress may not be available at general hospitals.

    The typical length of intravenous antibiotic therapy for patients with endocarditis is 4-6 weeks and beds in most cardiac centers are limited so that...

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  • Low risk of malignant arrhythmias and sudden cardiac death after alcohol septal ablation
    Josef Veselka

    I read with interest a study by Balt et al. (1) concluding that among patients who underwent alcohol septal ablation (ASA) for hypertrophic obstructive cardiomyopathy (HOCM) only 7% of patients experienced malignant tachyarrhythmia (VT/VF) in the first post-ASA month, while no VT/VF were observed later. I wish to support their study and comment on our own experience dealing with this topic. Based on multi-centre and mult...

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  • Please don't forget the family
    David W Pitcher

    Dear Editor

    The learning points that Luther and colleagues have raised from this case are well made. Brief limb-jerking is not uncommon during syncope and such 'convulsive syncope' may lead to an incorrect diagnosis of epilepsy and/or unnecessary referral to a neurology service. This misdiagnosis is not uncommon in people with inherited cardiac conditions such as long QT syndromes; it may delay appropriate asse...

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  • Survival by stroke volume index in patients with low-gradient normal EF severe aortic stenosis: insights into myocardial function and dysfunction.
    Jonathan C Rodrigues

    We read with interest the recent article on survival by stroke volume index (SVI) in patients with low-gradient (LG) normal ejection fraction (EF) severe aortic stenosis (AS), which demonstrated lower SVI is incrementally associated with mortality [1].

    The authors discuss a putative mechanism of low stroke volume secondary to concentric remodeling which results in reduced LV cavity size. This, is turn, impedes...

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  • Clinical Genomics and the adult with congenital heart disease: new opportunities"
    Isma Rafiq

    We are intrigued by the article by Priest et al. The importance of genomics has been clearly identified and the article beautifully describes the role of genetics in cardiovascular medicine but concentrates on inherited arrthymias, cardiomyopathies and occasional pharmacogenomics profiling. We suggest they have failed to consider the large, unrecognized need for genomics in adults patients with congenital heart conditions....

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  • Re:Pre-procedural fasting for coronary interventions: is it time to change practice?
    Tahir Hamid

    Dear Editor;

    We read with interest the comments from Wijeyeratne et al (1) regarding our paper. They commend our study (2) for questioning the need for fasting prior to percutaneous cardiac procedures and highlight the lack of evidence either for or against the necessity to fast in this scenario. We agree with their comments and fully accept the limitations of our retrospectively analysed data. While we don???t exp...

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  • Role of late gadolinium enhancement cardiovascular magnetic resonance in the risk stratification of hypertrophic cardiomyopathy (HCM) - but what about 'apical' HCM?
    Amardeep Ghosh Dastidar

    We read with great interest the article by Ismail et al, (1) looking at the role of late gadolinium enhancement (LGE) cardiac magnetic resonance in the risk stratification of patients with hypertrophic cardiomyopathy (HCM). We would like to congratulate the authors for delineating the interesting findings that the amount of myocardial fibrosis was a strong univariable predictor of sudden cardiac death (SCD) albeit the e...

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  • Correspondence: sudden death is associated both with epilepsy and with use of antiepileptic medications
    Prisca R. Bauer

    We read with interest the recent paper by Bardai et al1(1), which reports that epilepsy and antiepileptic drugs (AEDs) were independently associated with sudden cardiac death (SCD). We are unconvinced that such a clear distinction between disease and drug effects can be made in this study as all people with epilepsy were by definition taking AEDs. We believe this is why SCD risk in those with epilepsy (Table 2) and in AED...

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  • The role of Left Ventricle in the Autograft Complication after ROSS operation
    Shoujun Li

    We have read the interesting article from Luciani and colleagues [1] documenting the outcomes into the second decade after the Ross procedure in infants and children from the Italian Paediatric Ross Registry. Conclusion concisely stated the Ross procedure was a low risk palliative procedure for aortic valve abnormalities at the expense of valve-related reoperation.

    Contrary to prior evidence, autograft reoperat...

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  • Epistenocardiac pericarditis can be an electrocardiographic challenge!

    We enjoyed the image challenge published by Wu et al which illustrates a case of contained left ventricular rupture [1]. In the explanation, authors have excluded pericarditis based on the absence of fever and characteristic pericarditis ECG findings. We would like to emphasize that early post-infarction pericarditis ("epistenocardiac") is notorious to cause atypical ECG changes which are often territorial to the infarct...

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