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the primary cause of thromboembolism. 5,6 Together with LA thrombus, moderate or severe SEC forms the thromboembolic milieu. 7,8 Routine identification of LA thrombus and / or SEC is generally difficult, as it requires semi -invasive procedures, such as transesophageal echocardiography (TEE). The current guidelines on the management of AF recommend the CHA 2 DS-2 VASc score (congestive heart failure, hypertension, age ≥75 years, diabetes, history of stroke IntroductIon Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice, and its thromboembolic complications can cause significant morbidity and mortality. [1][2][3] Therefore, the evaluation of thromboembolic risk and the administration of anticoagulant therapy based on this risk are crucial. 4 In AF patients, left atrial (LA) thrombus and spontaneous echo contrast (SEC), a swirling echo density in the LA and its appendage, constitute

Background: We aimed to assess the association of triiodothyronine (T3) hormone with invasive hemodynamic parameters and all-cause mortality in heart failure with reduced ejection fraction (HFrEF). Results: About 483 HFrEF patients were enrolled. Patients with the lowest T3 tertile had advanced New York Heart Association (NYHA) classes, had higher uric acid, brain natriuretic peptide. T3 level had a positive correlation with cardiac index (CI) and a negative correlation with pulmonary vascular resistance and pulmonary capillary wedge pressure. Adjusted with NYHA III–IV classes, uric acid, aspartate aminotransferase and CI, T3 level was found to be an independent predictor of all-cause mortality. In Kaplan–Meier analysis, the lowest T3 tertile had the lowest survival function. Conclusion: Free T3 is positively correlated with CI and negatively correlated with pulmonary vascular resistance and pulmonary capillary wedge pressure in patients with HFrEF. Lower levels of T3 seems to be a poor prognostic factor in this particular patient population.

In equivocal or suspected cases of Brugada syndrome (BrS), ajmaline testing is frequently used in the diagnostic approach. However, the administration of sodium channel blockers can not only elicit the coved ST-segment elevation characteristic of type 1 Brugada pattern but also induce right bundle branch block (RBBB), which can preclude the electrocardiographic manifestations of BrS. We describe a case report wherein RBBB posed a diagnostic challenge during the ajmaline test for suspected BrS.