Supraventricular tachycardia (SVT) is a common arrhythmia in children. Acute conversion of the SVT begins with documentation of the arrhythmia. In life-threatening situations direct current (DC) cardioversion is mandatory. Before DC cardioversion, vagal maneuvers may be performed. Adenosine is the first-line drug for acute pharmacological conversion. For patients with chronic SVT there are 3 approaches: “no treatment”, antiarrhythmic drug therapy, or radiofrequency catheter ablation. From 1995 to 2000, a total of 343 children and adolescents underwent 329 radiofrequency (RF) catheter ablation procedures in the University of Miami. The success rate for all accessory pathways was 93%; for atrioventricular nodal reentrant tachycardia: 98%; for atrial flutter: 88%; for ectopic atrial tachycardia: 82%; and for junctional ectopic tachycardia: 63%. The overall recurrence rate at a follow up period of 29±23 months was 2.6 %. The procedure time was 235±109 min and the fluoroscopy time was 43±39 min. Our ablation-related complication rate was 2%. We designed several treatment algorithms according to disease categories, severity of symptoms, effects of drug therapy, weight of the patients, and the accessory pathway location and conduction characteristics. By fully utilizing all currently available treatment options it is hoped that these algorithms can be stailored to the needs of each patient.

Atherosclerosis is by far the most frequent cause of coronary heart disease (CHD). Large studies have provided unequivocal evidence that lipid lowering by statins significantly reduce the incidence of CHD endpoints. New insights in the pathophysiology show that statin therapy reduces progression of atherosclerosis, and leads to plaque stabilization as well as a reduced plaque thrombogenicity. In patients with CHD, treatment with statins may prevent plaque rupture of atherosclerotic lesions and therefore reduces the occurrence of acute coronary syndromes. Patients with hemodynamically relevant stenosis and angina interfering with quality of life and patients who have less exercise tolerance may be regarded as candidates for coronary intervention. In these patients, aggressive lipid-lowering may complement angioplasty by stabilizing untreated lesions. According to the guidelines of the National Cholesterol Educational Program, LDL-cholesterol of no more than 100mg/dl is considered optimal in patients with CHD or other atherosclerotic diseases.

This paper reports a clinical observational and multi-parametric study performed in a series of elderly patients with dilated cardiomyopathy and kidney failure. Elderly patients affected by dilated cardiomyopathy and kidney failure are usually treated with digitalis, diuretic and angiotensin converting enzyme inhibitors (ACE-I). Thirty elderly patients with dilated cardiomiopathy and kidney failure were enrolled and treated with digitalis, diuretic, full dosage angiotensin II receptor antagonists (irbesartan 150 mg daily) and low dosage ACE-I (lisinopril 5 mg daily). Patients were followed by physical examination, laboratory tests (serum creatinine, creatinine clearance 24hrs urine sample) to monitor kidney function. To evaluate the evolution of dilated cardiomyopathy, patients were follow-up with electrocardiogram and echocardiography. Data were expressed as mean and statistical analysis was performed with Student’s t-test for paired data. At 90-day follow-up we found relevant clinical and laboratory reduction of mean creatinine levels (1.73 mg/dl versus 2.13 mg/dl; p= 0.65). There was an increase in mean creatinine clearance (24hrs urine sample) 79.43 ml/min versus 59.11 ml/min; p= < 0.05). Electrocardiographic and echocardiographic parameters also improved. Such good results could be related to more effective antagonism of angiotensin II, which is not only produced by ACE but also through other pathways.