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The aim of this study was to examine whether wavelet transform analysis of the electrocardiogram (ECG) can improve the prediction of the maintenance of sinus rhythm in patients with atrial fibrillation (AF) after external DC cardioversion. We examined a variety of wavelet transform-based statistical markers as potential candidates for the prediction of patient status post-cardioversion. Considering a 'success' as a patient who remains in normal sinus rhythm for one month post cardioversion and 'failure' as a patient who does not, it was shown the proposed non-parametric classification system can achieve 89% specificity at 100% sensitivity using a non-parametric classification method.

Background: Psychologic dysfunction is common in patients with heart disease. Patients with end-stage cardiac failure have cognitive dysfunction that can affect their ability to comply with complex treatment regimes. The prevalence of cognitive dysfunction in patients with stable, moderately severe cardiac failure is not known. The purpose of this study was to evaluate the prevalence of memory dysfunction in that population., Methods: Twenty patients with previous myocardial infarction (MI), New York Heart Association class III or IV cardiac failure symptoms, and left ventricular ejection fraction (LVEF) <40% were studied. Twenty patients with previous MI, no heart failure symptoms, and LVEF >50% were studied as a control group. Memory function was assessed with the Rivermead Behavioural Memory Test and digit span test. Results were controlled for affective state and estimated premorbid intellectual function with the National Adult Reading Test., Results: Patients with cardiac failure performed as well as controls in the memory test (mean [95% confidence intervals] score 18.2 [16.5-19.9] versus 19.7 [18.1-21.4] points, P =.20) and digit span test (10.1 [9.2-11.0] versus 11.0 [9.9-12.2] points). Affective symptoms were more prevalent among patients with cardiac failure. Estimated premorbid intellectual function appeared poorer in patients with cardiac failure (reading test score 24 [7-36] versus 32 [11-46] points). Memory test outcomes were not significantly affected after adjustment for these variables., Conclusions: Patients with prior MI and stable, moderately severe cardiac failure do not have significantly memory impairment. Memory dysfunction is not likely to interfere with rehabilitation or compliance with treatment regimes. Anxiety and depression, however, are relatively common in this group.

Unstable angina is a common condition that presents a challenge to physicians because of its complex pathophysiology, and because of the high incidence of associated death and myocardial infarction. This article summarizes key strategies that can be employed in managing unstable angina and describes their interaction with the mechanisms that underpin the condition.

Muscle stimulator programming is fundamental in ensuring optimal latissimus dorsi graft function after cardiomyoplasty. The ventricle-muscle synchronization delay has a significant effect on graft function, but can be difficult to optimize. The established method for ensuring appropriate synchronization involves the use of M-mode echocardiography. We present two educational cases in which M-mode and Doppler echocardiography have been instrumental in illustrating electrophysiologic and haemodynamic factors which need to be considered in evaluating an appropriate synchronization delay.