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Long QT syndrome (LQTS) is a rare (1:2500–1:10,000) inherited disorder characterized by the onset of arrhythmogenic syncope, polymorphic ventricular tachycardia, and sudden cardiac death. The aim of this article was to describe an unexpected success with an unusual therapeutic modality of a patient diagnosed with LQTS syndrome (suspected Romano–Ward syndrome) during an 8-year period. A 59-year-old female patient was admitted to the hospital due to chest pain and nausea, and after diagnostic and therapeutical approach, a permanent dual-chamber rate-modulated (DDDR) pacemaker was implanted instead of the implantable cardioverter defibrillator (ICD). During the 8-year period, the patient remained stable, without rhythm disorder. Romano–Ward syndrome as a congenital LQTS carries a high risk of sudden cardiac death and presents an indication for ICD. In this patient, for objective reasons, this could not be performed. Implantation of a DDDR with an appropriate pharmacological therapy, including propranolol, in this case, proved to be a successful therapeutic modality.

Although the International Court of Justice in 2010 concluded that Kosovo’s independence was not contrary to international law, Kosovo’s continued standing as a semi-recognised state hinders its acceptance into international organisations. This article reviews Kosovo’s unsuccessful (the UN, UNESCO and Interpol), successful (the IMF, the World Bank) and potentially successful (the Council of Europe) applications for acceptance into international organisations. It argues that, at least in terms of its membership of international organisations, for as long as Kosovo’s statehood remains contested, it will be a ‘Western’ rather than a fully ‘international’ state, for three reasons. First, because international law is strongly biased against secession, secessionist states such as Kosovo face obstacles when attempting to join international organisations, even if supported by powerful countries such as the US. Second, Kosovo’s chances for acceptance into international organisations are higher if the organisation is heavily influenced by the US and key Western European countries, and decision-making is not based on unanimity. Finally, if competing powers such as Russia can exercise veto rights and/or the scope of states voting for acceptance of Kosovo into international organisations is extended beyond North America and Europe, the probability of acceptance by such international organisations decreases. [ABSTRACT FROM AUTHOR]