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Tachycardia-induced cardiomyopathy is an entity characterized by reversible dysfunction of the left ventricle, which can be induced by different types of arrhythmia such as atrial fibrillation, atrial flutter, incessant supraventricular tachycardia and ventricular arrhythmia (more frequent causes). Correct identification of the causative arrhythmia and normalization of the heart rate (e.g through medical treatment, electrical cardioversion, ablation) can lead to recovery of left ventricular function. Tachycardia-induced cardiomyopathy should be suspected in patients with tachycardia and left ventricular dysfunction (heart failure setting), especially when there is no history of previous heart disease. Its usual phenotype is that of non-ischaemic/non-valvular dilated cardiomyopathy and it can occur in both children (main cause: permanent junctional reciprocating tachycardia) and adults (main cause: atrial fibrillation). With proper treatment, most cases recover within a few months, though there is a risk of relapse, especially when the causal arrhythmia reappears or its control is lost. This is a narrative review that comprehensively addresses the pathophysiology, clinical manifestations, and therapeutic management of tachycardia-induced cardiomyopathy. This article is part of the Emerging concepts in heart failure management and treatment Special Issue: https://www.drugsincontext.com/special_issues/emerging-concepts-in-heart-failure-management-and-treatment., Competing Interests: Disclosure and potential conflicts of interest: The authors declare that they have no conflicts of interest relevant to this manuscript. The International Committee of Medical Journal Editors (ICMJE) Potential Conflicts of Interests form for the authors is available for download at: https://www.drugsincontext.com/wp-content/uploads/2022/11/dic.2022-8-4-COI.pdf, (Copyright © 2023 Báez Cabanillas MA, Colque R, Tibaldi MA, Kaplinsky E, Perrone S, Barbagelata A.)

The increasing number of heart transplant recipients receiving immunosuppression with mammalian target of rapamycin inhibitors prompted the implementation of a South American Transplant Physicians Group to register these patients in a database. Everolimus (EVL) is a signal proliferation inhibition that reduces graft vascular disease when used de novo. Recently, its administration has expanded to subjects with resistant rejection or with side effects due to other immunosuppressive drugs (calcineurin inhibitors and/or steroids), allowing for better regulation of the immunosuppressive regimen. Herein we have shown the data collected from patients receiving EVL in ten South American Heart Transplant Centers. We have concluded that the administration of EVL is a useful adjunctive therapy that allows the reduction or suspension of other immunosuppressive drugs that caused unwanted side effects, without a loss of immunosuppressive efficacy, with manageable side effects, and constituting a valuable therapeutic option.

Despite improvements during the last decades, heart transplantation remains associated with several medical complications, which limit clinical outcomes: acute rejection with hemodynamic compromise, cytomegalovirus (CMV) infections, allograft vasculopathy, chronic renal failure, and neoplasias. Everolimus, a proliferation signal inhibitor, represents a new option for adjunctive immunosuppressive therapy. Everolimus displays better efficacy in de novo heart transplant patients than azathioprine for prophylaxis of biopsy-proven acute rejection episodes of at least ISHLT grade 3A (P < .001), of allograft vasculopathy (P < .01), and of CMV infections (P < .01). These findings suggest that everolimus potentially play an important role as part of immunosuppressive therapy in heart transplant recipients. Heart transplant investigators from Latin America produced recommendations for everolimus use in daily practice based on available data and their own experience.

Liquid-shake cultured shoot-clumps of Narcisus confussus were treated with the commonly used biotic elicitors methyl jasmonate, arachidonic acid, chitosan and salicylic acid. The effects of these compounds on the growth of the explants, as well as on the amount of the alkaloids released to the liquid culture medium and accumulated in the tissues at the end of the experiment were studied. The obtained results showed that, in general, high doses of these compounds had a negative effect on the growth of the explants, particularly the salicylic acid. On the contrary, the addition of methyl jasmonate, mainly at 25 microM, promoted the release of galanthamine and other related alkaloids to the liquid medium in proportions of up to 300% in relation to the control explants, and also their accumulation in tissues. The other elicitors studied did not have any interesting effects on the production of these Amaryllidaceae-type alkaloids.

Despite the progress in the knowledge of the pathophysiology of the atrial fibrillation (AF), the pharmacologic and non pharmacologic approach to prevent and control this arrhythmia has been shown to be discouraging. In the past few years a new type of AF has been described, of which the focal mechanism -especially bound to the pulmonary veins- allows ablation treatment through the radiofrequency (RF) with a catheter. We present our initial experience with this type of method, in two young patients who suffered from multiples episodes of AF and resistance to the conventional treatment. In both patients the RF ablation was done in the left superior pulmonary vein. One of them received an ablation in only one focus, and the other needed a veno-atrial disconnection through the elimination of the pulmonary venous potential from this vein. After three month of follow-up, patients remain asymptomatic with no relapse.

Introduction and Objective: Cardiovascular disease is the leading cause of death in women. Approximately one of every two women will die of some cardiovascular event, such as myocardial infarction. Thereby, the significance of discarding or confirming coronary artery disease in women presenting with chest pain. The objective of this trial was to demonstrate that on the bases of the Douglas and Ginsburg's clinic screening, it is possible to predict the existence of coronary artery disease in the angiography., Material and Methods: For this research only women with angina pectoris were included. These were 189 patients (cineangiographies) whose clinical determinants and angiographic findings were related., Results: Taking in to account the estimated likelihood, there was a low-risk group A with 29 patients, a moderate-risk group B with 55 patients and a high-risk group C with 105 patients. There was no significant coronary artery disease in the first group, there was a significant coronary artery disease in 13 patients in the second group and 72 patients in the third group. Group A had 0%, 72%, 0% and 47%, group B 15.2%, 59.6%, 23.6% and 46.3%, and group C had 84.7%, 68.3%, 68.5% and 84.5%, of sensibility, specificity, positive and negative predictive value, respectively., Conclusion: The usage of the Douglas and Ginsburg's clinic Screening is very effective at the time of deciding whether to perform a coronary angiograpy or not, and it has very good correlation between the probability degree and the presence of coronary artery disease in the coronary angiography.

Tachycardia-induced tachycardia is the phenomenon in which one tachycardia degenerates into another. Few data are available in patients suffering from AV nodal reentrant tachycardia an atrial fibrillation. For related to AV nodal reentrant triggered by tachycardia; there is a possible effective treatment by eliminating the slow nodal pathway, with radiofrequency ablation, as shown by other authors. In this study we present data on three patients with repeated episodes of documented atrial fibrillation and at least one episode of AV nodal reentrant tachycardia or regular palpitations. Radiofrequency ablation of the slow AV nodal pathway was successfully performed in both, and at a follow up of 6, 9 and 10 months, respectively, no new episode of AV nodal reentrant tachycardia or atrial fibrillation was documented.