Orthodromic and Antidromic Pacemaker Circus Movement Tachycardia

Pacemaker circus movement tachycardia (PCMT) during DDD pacing is usually sustained by retrograde natural and antegrade electronic atrioventricular (AV) conduction. As PCMT is often initiated by a ventricular premature beat (VPB) one method of its prevention is the programming of an atrial stimulus synchronously following a ventricular extrasystole. A patient is described with preserved antegrade, but without retrograde, i.e., VA, conduction. The optional pacemaker mode of synchronous atrial stimulation following a VPB caused an unusual PCMT sustained by retrograde electronic and antegrade natural AV conduction. This PCMT is similar to a natural reentry tachycardia, the most common variety of which (based on retrograde conduction) is termed antidromic and that which we describe is orthodromic.     

DETECTION OF HEPATITIS C VIRUS ANTIBODIES AND HEPATITIS C VIRUS RNA IN PATIENTS WITH ALCOHOLIC LIVER DISEASE

The prevalence of hepatitis C virus (HCV) antibody was determinedin 130 patients with alcoholic liver disease using a second-generationanti-HCV enzyme immunoassay (ELISA 2) and confirmed by a sensitivepolymerase chain reaction procedure measuring HCV RNA. Hepaticdisease was evaluated by clinical and biochemical studies and,whenever possible, by liver biopsy. Seventy-one patients werediagnosed as having cirrhosis, and 59 alcoholic hepatitis (n= 33) or fatty liver (n = 26). The prevalence of anti-HCV inthe total group was 9.2% and did not differ significantly inthe cirrhotics (11.3%) as compared with the non-cirrhotics (6.8%).HCV RNA was detected in six out of eight cirrhotics and threeOut of four non-cirrhotics who were ELISA 2 positive. A positivetest for antibodies to hepatitis core antigen (anti-HBc) wasmore frequent in anti-HCV-positive patients (75%) than in theanti-HCV-negative group (14%, P<0.001). Anti-HBc was alsofound more frequently in the cirrhotics (25.4%) than in thealcoholics without cirrhosis (11.9%). However, the prevalenceof hepatitis B surface antigen was equally low in both groups(cirrhotics 1.4%, non-cirrhotics 1.7%). No correlation was observedbetween the prevalence of anti-HCV antibodies and the severityof liver dysfunction. These results indicate that HCV, and especiallyHCV-viraemia, is less frequent in alcoholics in southern Germanythan suspected in previous studies, and that the prevalenceof HCV markers in alcoholics has been overestimated by ELISA1 used alone.     

Lucid dreaming: an age‐dependent brain dissociation

The current study focused on the distribution of lucid dreams in school children and young adults. The survey was conducted on a large sample of students aged 6–19 years. Questions distinguished between past and current experience with lucid dreams. Results suggest that lucid dreaming is quite pronounced in young children, its incidence rate drops at about age 16 years. Increased lucidity was found in those attending higher level compared with lower level schools. Taking methodological issues into account, we feel confident to propose a link between the natural occurrence of lucid dreaming and brain maturation.