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3,300
Equivalence of the standard monophasic waveform shocks delivered by automated external defibrillators?
To study whether two different types of monophasic waveform shocks (i.e. monophasic damped sinusoidal [MDS] and monophasic truncated exponential [MTE] waveform shocks) are of equivalent efficacy.</AbstractText>Retrospective review of defibrillation efficacy and outcome in ventricular fibrillation/ventricular tachycardi...
3,301
Characteristics and outcome among patients suffering from in hospital cardiac arrest in relation to the interval between collapse and start of CPR.
To describe survival after in-hospital cardiac arrest in relation to the interval between collapse and start of cardiopulmonary resuscitation (CPR).</AbstractText>All patients suffering in-hospital cardiac arrest in Sahlgrenska University Hospital in G&#xf6;teborg, Sweden between 1994 and 1999 in whom resuscitative eff...
3,302
Influence of early defibrillation on the survival rate and quality of life after CPR in prehospital emergency medical service in a German metropolitan area.
Early defibrillation by emergency medical personnel has been shown to improve survival in patients suffering from out-of-hospital cardiac arrest with ventricular fibrillation. Due to organisational differences it is difficult to compare results in various studies. Comparison of studies has been simplified by introducti...
3,303
Perioperative management of long QT syndrome in a child with congenital heart disease.
During cardiac catheterization, a 2(1/2)-year-old boy developed sudden cardiac arrest. The presence of a long QT interval in the electrocardiogram (ECG) along with ventricular arrhythmia and syncope at that moment enabled us to diagnose long QT syndrome (LQTS). Immediate defibrillation and beta-blocker (metoprolol) the...
3,304
Electrical restitution and cardiac fibrillation.
Combined experimental and theoretical work has shown that restitution properties of the cardiac action potential duration and conduction velocity contribute to breakup of reentrant wavefronts during cardiac fibrillation independent of preexisting electrophysiologic heterogeneities in the tissue. Developing therapies th...
3,305
Risk of sudden death after successful accessory atrioventricular pathway ablation in resuscitated patients with Wolff-Parkinson-White syndrome.
Cardiac arrest in patients with Wolff-Parkinson-White (WPW) syndrome can be due to ventricular fibrillation mediated by fast conduction over the accessory pathway during atrial fibrillation. However, if primary ventricular fibrillation is the reason for resuscitation, placement of an implantable cardioverter defibrilla...
3,306
Myocardial protection during ventricular fibrillation by inhibition of the sodium-hydrogen exchanger isoform-1.
Activation of the sarcolemmal sodium-hydrogen exchanger isoform-1 (NHE-1) in response to the intense intracellular acidosis that develops during ischemia has been identified as an important mechanism of myocardial cell injury. NHE-1 inhibition in the quiescent (nonfibrillating) heart ameliorates functional manifestatio...
3,307
Sex-related differences in the presentation and outcome of out-of-hospital cardiopulmonary arrest: a multiyear, prospective, population-based study.
To examine whether previously observed sex-related differences in coronary artery disease syndromes also apply to patients with out-of-hospital sudden cardiac arrest, a probable subset of patients with coronary artery disease who are easy to recognize and are treated in a standardized fashion.</AbstractText>Prospective...
3,308
Off-pump coronary artery bypass grafting in patients with left ventricular dysfunction.
Coronary artery bypass grafting in patients with severe left ventricular (LV) dysfunction still remains a high risk procedure due to its high mortality and morbidity. Off-pump surgery can be an alternative technique in these patients. We analyzed our results of off-pump coronary surgery in patients with left ventricula...
3,309
[Effects of preceding stable or unstable angina on hospital morbidity-mortality of myocardial infarction. Results of a continuous series of 1,910 patients].
The aim of this study was to determine the effect of preceding unstable angina on the short-term prognosis of myocardial infarction based on early complications: cardiac failure, cardiac rupture, ventricular septal defect, sustained ventricular tachycardia ventricular fibrillation and hospital mortality. A continuous s...
3,310
Risk stratification for postoperative cardiovascular events via noninvasive assessment of endothelial function: a prospective study.
Brachial artery endothelial function is impaired in individuals with atherosclerosis and coronary risk factors and improves with risk reduction therapy. However, the predictive value of brachial artery endothelial dysfunction for future cardiovascular events is unknown.</AbstractText>We preoperatively examined brachial...
3,311
[A case of postoperative acute myocardial infarction due to the interruption of anticoagulant therapy].
A 67-year-old male patient was scheduled for stripping of a lower limb varix. He had received long-term anticoagulant therapy using oral warfarin because of implantation of an aortic mechanical heart valve. Warfarin therapy was discontinued 3 days before surgery to prevent excessive bleeding during the perioperative pe...
3,312
Glyburide prevents isoflurane's reducing effects on hydroxyl radical formation in the postischemic reperfused rat heart.
The role of K(ATP) channels in isoflurane's reducing effects on oxygen free radical formation are not well known.</AbstractText>To investigate whether glyburide, an ATP-regulated potassium (K(ATP)) channel blocker, abolishes isoflurane-induced cardioprotective effects and whether it affects hydroxyl radical formation i...
3,313
Effects of adrenaline pretreatment on the arrhythmias observed following ischemia and reperfusion in conscious and anesthetized rats.
A short episode of ischemia induced by coronary artery occlusion can precondition the myocardium against arrhythmia. The factors that have the potential to protect the myocardium from subsequent ischemia and reperfusion are controversial. In this study, the preconditioning-like effects of adrenaline were investigated i...
3,314
An emergency department observation unit protocol for acute-onset atrial fibrillation is feasible.
We sought to describe the feasibility of an emergency department observation unit (EDOU) treatment protocol for the management of uncomplicated acute-onset atrial fibrillation (AAF).</AbstractText>This descriptive case series took place at a major suburban, university-affiliated teaching hospital. Patients were prospec...
3,315
Effects of active compression-decompression cardiopulmonary resuscitation with the inspiratory threshold valve in a young porcine model of cardiac arrest.
Active compression-decompression (ACD) cardiopulmonary resuscitation (CPR) with the inspiratory threshold valve (ITV) has been recently recommended by the American Heart Association for treatment of adults in cardiac arrest (class IIb: alternative, useful intervention), but this new technique has never been used in a p...
3,316
Headache as a manifestation of fatal myocardial infarction.
Cardiac ischemia typically causes chest pain, variously radiating elsewhere. Convergence of cardiac nerve fibers on central pathways receiving somatic afferents from the head is likely to be responsible for the perception of cardiac ischemic pain as headache. A 47-year-old man was admitted to the emergency room of our ...
3,317
Cytokine responses to myocardial revascularization on cardiopulmonary bypass: intermittent crossclamping versus blood cardioplegic arrest.
The inflammatory responses to the different myocardial protection approaches have not been thoroughly investigated. We sought to study the cytokine responses to cardiopulmonary bypass (CPB) using the intermittent aortic crossclamping with ventricular fibrillation (IAC) versus blood cardioplegic arrest (BC) techniques.<...
3,318
Magnesium deficiency during lactation as a precipitant of ventricular tachyarrhythmias.
A young ICD recipient with a history of syncope and idiopathic polymorphic ventricular tachycardia/ventricular fibrillation presented after an ICD discharge. She had delivered her first child 8 days prior to the event and she had been lactating. Numerous short runs of polymorphic ventricular tachycardia/ventricular fib...
3,319
The challenge of endocardial right ventricular pacing in patients with a tricuspid annuloplasty ring and severe tricuspid regurgitation.
On occasion, patients with a tricuspid annuloplasty ring may require permanent cardiac pacing. Although it is technically possible to pass a ventricular transvenous lead through a tricuspid valve with an annuloplasty ring, the procedure is complicated by considerable chamber enlargement and mechanical distortion of the...
3,320
How to test mode switching in pacemakers implanted in patients: the MOST study.
Optimal management of atrial arrhythmias with dual chamber pacemakers requires proper performance of automatic mode switching (AMS). The aim of this study was to develop a reliable technique to test the AMS function by using an external electronic device capable of mimicking the occurrence of supraventricular arrhythmi...
3,321
Delayed cardioprotective effects of exercise in dogs are aminoguanidine sensitive: possible involvement of nitric oxide.
Dogs were subjected to exercise on a treadmill, using a protocol in which the speed and slope were increased every 3 min, and which elevated both heart rate (to a mean of 198+/-14 beats.min(-1)) and mean arterial blood pressure (to 150+/-4 mmHg). Then, 24 or 48 h later, the dogs were anaesthetized with a mixture of alp...
3,322
Clinical value of left atrial appendage flow velocity for predicting of cardioversion success in patients with non-valvular atrial fibrillation.
Echocardiographic parameters for predicting cardioversion outcome in patients with non-valvular atrial fibrillation are not accurately defined.</AbstractText>To evaluate the role of left atrial appendage flow velocity detected by transoesophageal echocardiography for prediction of cardioversion outcome in patients with...
3,323
Antiarrhythmic effect of nifekalant on atrial tachyarrhythmia in four patients with severe heart failure.
Nifekalant is a class III antiarrhythmic drug, which prolongs the refractory period of the atrial and ventricular myocardium, without negative inotropic action. Intravenous nifekalant was administered in four patients with atrial tachyarrhythmia and severe heart failure to terminate or prevent atrial tachyarrhythmia.</...
3,324
Mechanisms of ventricular fibrillation during coronary angioplasty: increased incidence for the small orifice caliber of the right coronary artery.
Ventricular fibrillation (VF) is not an infrequent complication of percutaneous transluminal coronary angioplasty (PTCA). However, it is not clear why there is a marked discrepancy in the higher incidence of VF during right coronary artery (RCA) approach.</AbstractText>We analyzed in detail every case of VF occurring i...
3,325
Combination IK1 and IKr channel blockade: no additive lowering of the defibrillation threshold.
Selective blockade of the inward rectifier potassium channel I(K1) by barium, or of the rapidly activating delayed rectifier potassium channel I(Kr) by D,L-sotalol, prolongs repolarization and reduces the defibrillation threshold (DFT). This study hypothesized that combination I(K1) and I(Kr) channel block would produc...
3,326
Idiopathic eosinophilic endomyocarditis in the absence of peripheral eosinophilia.
In this case report we present two patients with unusual manifestations of eosinophilic endomyocarditis: A 69-year-old patient with a history of heart failure and ventricular fibrillation and a 16-year-old woman with ventricular fibrillation and an ECG indicating acute myocardial infarction had both normal blood eosino...
3,327
Single chamber ventricular compared with dual chamber pacing: a review.
Since its introduction in the 1950s, the cardiac pacemaker has become increasingly sophisticated in an attempt to mimic normal cardiac physiology. Rapidly evolving pacing technology has seen pacemakers evolve from crude, fixed-rate, single chamber ventricular devices to dual chamber rate-adaptive units. While there is ...
3,328
Amiodarone as compared with lidocaine for shock-resistant ventricular fibrillation.
Lidocaine has been the initial antiarrhythmic drug treatment recommended for patients with ventricular fibrillation that is resistant to conversion by defibrillator shocks. We performed a randomized trial comparing intravenous lidocaine with intravenous amiodarone as an adjunct to defibrillation in victims of out-of-ho...
3,329
Differential effects of sarcolemmal and mitochondrial K(ATP) channels activated by 17 beta-estradiol on reperfusion arrhythmias and infarct sizes in canine hearts.
We have demonstrated the effects of estrogen on modulation of ATP-sensitive K(+) channels; however, the subcellular location of these channels is unknown. The purpose of the present study was to investigate the role of the sarcolemmal and mitochondrial ATP-sensitive K(+) channels in a canine model of myocardial infarct...
3,330
Altered cardiovascular responses in mice lacking the M(1) muscarinic acetylcholine receptor.
Although the M(2) muscarinic acetylcholine receptor (mAChR) is the predominant functional mAChR subtype in the heart, some responses of the cardiovascular system to acetylcholine (ACh) may be mediated by other mAChR subtypes. The potential effect of M(1) mAChR on heart function was investigated using M(1) knockout (M(1...
3,331
An evaluation of coronary artery bypass grafting without aortic cross-clamping due to severely atherosclerotic ascending aorta.
We evaluated coronary artery bypass grafting (CABG) in which aortic cross-clamping is not done due to severe atherosclerosis of the ascending aorta.</AbstractText>Subjects were 51 patients undergoing CABG without aortic cross-clamping during cardiopulmonary bypass under moderately hypothermic ventricular fibrillation i...
3,332
Effects of different preproendothelin-1 mRNA anti-sense oligodeoxynucleotides on ischemic arrhythmias in rats.
The effects of four anti-sense oligodeoxynucleotides (AS-ODNs) against rat or human preproendothelin-1 mRNA on ischemic arrhythmias in anesthetized rats were studied. AS-ODN (60 nmol/kg) or control (normal saline; sense-ODN, and scrambled-ODN, 60 nmol/kg) was injected 2 h before acute myocardial ischemia elicited by th...
3,333
Novel electrophysiologic parameter of dispersion of atrial repolarization: comparison of different atrial pacing methods.
Heterogeneity of ventricular repolarization plays a major role in reentrant tachyarrhythmias in cardiac tissue. However, the role of atrial repolarization added activation time (AT) to refractoriness in atrial vulnerability has not been investigated in detail.</AbstractText>The study population consisted of 34 patients...
3,334
[The best of 2001. Echocardiography].
The year 2001 will be characterised by the confirmation of the essential place of harmonic imaging in echocardiography, a technique which has improved in a very important fashion the definition of the endocardial contour, thus giving a more reliable analysis of the segment kinetics, as much at rest as during a physical...
3,335
[The best of 2001. Arrhythmia].
Among the classic problems of rhythmology, which can be classified topographically into atrial rhythm disturbances, junctional rhythm disturbances and ventricular rhythm disturbances, it is certainly the atrial rhythm disorders, including atrial fibrillation, which constitute the "final frontier". Population aging come...
3,336
[Contribution of the implantable ECG monitor in the etiologic diagnosis of syncope and unexplained recurrent syncopal attacks. Initial experience with 32 patients].
Following an exhaustive aetiological investigation, 10 to 26% of syncopal attacks remain unexplained. In these cases the correlation between symptoms and rhythm is a deciding step for the aetiological diagnosis. We report our initial experience using an implantable electrocardiographic monitor, a new diagnostic tool in...
3,337
Natural history of Brugada syndrome: insights for risk stratification and management.
Treatment of patients with Brugada syndrome is complicated by the incomplete information on the natural history of the disease related to the small number of cases reported. Furthermore, the value of programmed electrical stimulation (PES) for risk stratification is highly debated. The objective of this study was to se...
3,338
Class I antiarrhythmic drug and coronary vasospasm-induced T wave alternans and ventricular tachyarrhythmia in a patient with Brugada syndrome and vasospastic angina.
A 50-year-old man presented with a history of transient chest pain and palpitations. The 12-lead ECG at rest showed normal sinus rhythm. A slight ST segment elevation was observed in leads V1 to V3. During hospitalization, atrial fibrillation developed, and oral pilsicainide was administered. Thirty minutes after the d...
3,339
Analysis of troponin I levels after spontaneous implantable cardioverter defibrillator shocks.
Serum cardiac troponin I (cTnI) is a sensitive and specific marker for myocardial injury. Myocardial ischemia and/or injury can be a trigger for ventricular arrhythmias. The aim of this study was to assess the frequency and significance of elevated serum cTnI levels after spontaneous implantable cardioverter defibrilla...
3,340
[Atrial fibrillation: always cardioversion? No].
Two major treatment strategies have emerged in the management of patients with atrial fibrillation (AF): restoration of sinus rhythm and antiarrhythmic drug prophylaxis versus ventricular rate control and chronic anticoagulation. Besides the potential benefits of the restoration of sinus rhythm, several considerations ...
3,341
Proarrhythmic effects of adenosine: one decade of clinical data.
In 1989, adenosine was introduced into the American clinical setting as an antiarrhythmic drug for the acute management of reentrant supraventricular tachycardia involving the atrioventricular node. During this decade of use, evidence for proarrhythmic effects of the drug have been documented. In addition to the mostly...
3,342
Does heart rate identify sudden death survivors? Assessment of heart rate, QT interval, and heart rate variability.
The objective was to test whether the circadian variability of several electrocardiographic variables distinguishes sudden cardiac death survivors from heart disease patients without a history of cardiac arrest and from normal subjects. Heart rate, heart rate variability, and QT interval have been reported to identify ...
3,343
Correlates of left atrial size in hypertensive patients with left ventricular hypertrophy: the Losartan Intervention For Endpoint Reduction in Hypertension (LIFE) Study.
Left ventricular hypertrophy has been suggested to mediate the relation between hypertension and left atrial enlargement, with associated risks of atrial fibrillation and stroke. However, less is known about correlates of left atrial size in hypertensive patients with left ventricular hypertrophy. We assessed left atri...
3,344
Phase I trial of the histone deacetylase inhibitor, depsipeptide (FR901228, NSC 630176), in patients with refractory neoplasms.
The primary objectives of this trial were to define the maximum tolerated dose (MTD) and to characterize the toxicities and pharmacokinetics of depsipeptide (FR901228) given on a day-1 and day-5 schedule every 21 days. A secondary objective of the trial was to seek evidence of antineoplastic activity.</AbstractText>Pat...
3,345
[New guidelines for basic and advanced resuscitation of adults and children].
We present the latest changes in the guidelines for resuscitation from the International Liaison Committee on Resuscitation (ILCOR). Defibrillation performed by non-medical personnel is more strongly endorsed than before. In unintubated patients the ventilation-to-compression ratio should always be 2:15. With a foreign...
3,346
Isolated noncompaction of ventricular myocardium associated with fatal ventricular fibrillation.
A female infant with isolated noncompaction of ventricular myocardium who developed ventricular tachyarrhythmia is described. Wolff-Parkinson-White syndrome was shown by electrocardiography. At 9 months of age, the patient suddenly developed cardiac arrest. Electrocardiography following resuscitation with DC cardiovers...
3,347
Plasma levels of brain natriuretic peptide increase in patients with idiopathic bilateral atrial dilatation.
Idiopathic bilateral atrial dilatation (IBAD) is an extremely rare anomaly and is usually associated with atrial fibrillation. Plasma levels of atrial natriuretic peptide (ANP) have been shown to increase in patients with atrial fibrillation. However, secretion of ANP and brain natriuretic peptide (BNP) in patients wit...
3,348
Purkinje involvement in arrhythmias after coronary artery reperfusion.
Previous studies have indicated that the endocardium may be responsible for a large portion of ventricular tachycardia (VT) seen with reperfusion of ischemic myocardium. To evaluate the role of the Purkinje system in nonreentrant VT arising from the endocardium after reperfusion, the anterior descending coronary artery...
3,349
Metabolic causes and prevention of ventricular fibrillation during acute coronary syndromes.
The mechanisms leading to ventricular fibrillation that occur during acute myocardial ischemia are ill understood. Whether primary ventricular fibrillation is due to a transient imbalance of electrolytes, an alteration of membrane permeability, electrical re-entry phenomena, or other factors, one overriding influence i...
3,350
Slow inactivation in voltage-gated sodium channels: molecular substrates and contributions to channelopathies.
Slow inactivation in voltage-gated sodium channels is a biophysical process that governs the availability of sodium channels over extended periods of time. Slow inactivation, therefore, plays an important role in controlling membrane excitability, firing properties, and spike frequency adaptation. Defective slow inacti...
3,351
[Immediate postoperative arrhythmias follwing pneumonectomy for lung cancer].
Immediate postoperative arrhythmias after pneumonectomy for non small cell lung cancer is a serious complication. Frequency is estimated 10 to 28% of all patients. The goal of this study is to evaluate the incidence of this complication in our experience, preoperative risk factors, therapeutic implications and short ou...
3,352
Relation of left ventricular hypertrophy to cardiovascular complications in diabetic hypertensives.
The presence of diabetes mellitus and other risk factors of atherosclerosis, such as obesity, smoking and hyperlipidemia, in hypertensive patients makes the prognosis worse. Authors compared the clinical findings in diabetic hypertensive patients with and without left ventricular hypertrophy, the presence of which was ...
3,353
[A case of ventricular fibrillation during emergency clipping operation for cerebral aneurysm].
A 59 year-old woman with subarachnoid hemorrhage underwent emergency neck clipping of cerebral aneurysm. Her preoperative examination showed atrial fibrillation, pulmonary edema and hypokalemia. Ventricular fibrillation developed immediately after clipping of the aneurysm and recurred 7 times thereafter during the surg...
3,354
Activity-rest stimulation protocol improves cardiac assistance in dynamic cardiomyoplasty.
No data have ever been published regarding cardiac assistance in demand dynamic cardiomyoplasty (DDCMP). We tested the efficacy of the Doppler flow wire in measuring beat-to-beat aortic flow velocity and evaluating cardiac assistance in demand cardiomyoplasty patients.</AbstractText>The technique was tested in seven pa...
3,355
Asymptomatic versus symptomatic persistent atrial fibrillation: clinical and noninvasive characteristics.
This prospective study was designed to investigate the differences between asymptomatic versus symptomatic arrhythmia as well as left ventricular dysfunction in a consecutive population of patients with persistent atrial fibrillation.</AbstractText>A total of 282 consecutive outpatients referred with persistent atrial ...
3,356
Clinical meaning of ascites in patients with endomyocardial fibrosis.
To evaluate the clinical meaning of ascites and the main features of patients with ascites and endomyocardial fibrosis.</AbstractText>We studied 166 patients with endomyocardial fibrosis (mean age 37 years, 114 women) treated over the last 20 years. Ventriculography findings, surgery or necropsy confirmed the diagnosis...
3,357
Cold water submersion and cardiac arrest in treatment of severe hypothermia with cardiopulmonary bypass.
In the paediatric population, submersion injury with drowning or near-drowning represents a significant cause of morbidity and mortality. This study reviews retrospectively our own experiences and the literature on the use of cardiopulmonary bypass (CPB) to rewarm paediatric victims of cold water submersion who suffer ...
3,358
The epidemiology of out-of-hospital 'sudden' cardiac arrest.
It is difficult to assemble data from an out-of-hospital cardiac arrest since there is often lack of objective information. The true incidence of sudden cardiac death out-of-hospital is not known since far from all of these patients are attended by emergency medical services. The incidence of out-of-hospital cardiac ar...
3,359
Hypertrophic cardiomyopathy: a systematic review.
Throughout the past 40 years, a vast and sometimes contradictory literature has accumulated regarding hypertrophic cardiomyopathy (HCM), a genetic cardiac disease caused by a variety of mutations in genes encoding sarcomeric proteins and characterized by a broad and expanding clinical spectrum.</AbstractText>To clarify...
3,360
Protective effects of poly (ADP-ribose) synthase inhibitors on digoxin-induced cardiotoxicity in guinea-pig isolated hearts.
Reactive oxygen species, generated and released during digoxin-induced cardiotoxicity, can produce an activation of poly (ADP-ribose) synthase (PARS). Our objective was to examine the effects of PARS inhibitors, 3-aminobenzamide (3-AB ) and nicotinamide, on digoxin-induced arrhythmias in guinea-pig isolated hearts. 3-A...
3,361
Role of Purkinje conducting system in triggering of idiopathic ventricular fibrillation.
Ventricular fibrillation is the main mechanism of sudden cardiac death, but the source of its spontaneous initiation has not been mapped. 16 patients were investigated by electrography and radiofrequency ablation after resuscitation from recurrent idiopathic ventricular fibrillation. Triggers of ventricular fibrillatio...
3,362
Clinical profile and spectrum of commotio cordis.
Although blunt, nonpenetrating chest blows causing sudden cardiac death (commotio cordis) are often associated with competitive sports, dangers implicit in such blows can extend into many other life activities.</AbstractText>To describe the comprehensive spectrum of commotio cordis events.</AbstractText>Analysis of con...
3,363
Successful defibrillation in the prone position.
Early defibrillation provides the greatest chance of survival after ventricular fibrillation. Conventional cardiopulmonary resuscitation and defibrillation requires the patient to be in the supine position. Electrical treatment of arrhythmias such as atrial fibrillation by means of a defibrillator back paddle in patien...
3,364
[Effect of long-term treatment with enalapril, losartan and their combination on the quality of life of patients with congestive heart failure].
To study the effect a combination of enalapril and losartan on life quality in patients with congestive heart failure (HF).</AbstractText>One hundred and eighty six patients with NYHA functional classes II to IV HF were examined. The study inclusion criteria were as follows: a left ventricular (LV) end-diastolic volume...
3,365
Effect of electrode location in great cardiac vein on the ventricular defibrillation threshold.
This study tested the hypothesis that the DFT could be lowered by delivering a weak auxiliary shock in conjunction with a stronger primary shock with the auxiliary shock electrode near the cardiac region where the primary shock electric field is weakest. This hypothesis was tested by determining the DFTs with the auxil...
3,366
QT dispersion in 120 electrocardiographic leads in patients with structural heart disease.
The clinical significance of QT dispersion (QTd) measured in 12-lead ECGs is controversial. The aim of this study was to clarify factors that determine the QTd and its measurement errors in different lead arrays in patients with structural heart disease. Two blinded observers measured QT intervals on a computer screen ...
3,367
Effect of ventricular fibrillation duration on the defibrillation threshold in humans.
Early during ventricular fibrillation, the defibrillation threshold may be low, as ventricular fibrillation most probably arises from a localized area with only a few wavefronts and the effects of global ischemia, ventricular dilatation, and sympathetic discharge have not yet fully developed. The purpose of this study ...
3,368
Non-surgical myocardial reduction in hypertrophic obstructive cardiomyopathy.
Percutaneous transluminal septal ablation was recently introduced as an alternative to surgical treatment of hypertrophic obstructive cardiomyopathy. In this procedure, alcohol is injected into a proximal septal artery to create a localized myocardial infarction.</AbstractText>To characterize the immediate and medium-t...
3,369
Rate control versus electrical cardioversion for atrial fibrillation: A randomised comparison of two treatment strategies concerning morbidity, mortality, quality of life and cost-benefit - the RACE study design.
Persistent atrial fibrillation (AF) does not terminate spontaneously and may cause left ventricular dysfunction and thromboembolic complications. For restoration of sinus rhythm electrical cardioversion (ECV) is most effective. However, AF frequently relapses, necessitating re-ECV and institution of potentially harmful...
3,370
[Alternative pacing sites for the prevention of atrial fibrillation].
Background The induction of atrial fibrillation depends upon the interaction between basic rhythm, ectopic activity, and inter-/intraatrial conduction. In pacing therapy, the atrial pacing site may influence the incidence of atrial tachyarrhythmias. This review discusses the antiarrhythmic potential of different atrial...
3,371
Implantable defibrillator event rates in patients with idiopathic dilated cardiomyopathy, nonsustained ventricular tachycardia on Holter and a left ventricular ejection fraction below 30%.
This study investigated the incidence of appropriate implantable cardioverter defibrillator (ICD) interventions for ventricular tachycardia (VT) or ventricular fibrillation (VF) in patients with idiopathic dilated cardiomyopathy (IDC) and nonsustained VT in the presence of a left ventricular ejection fraction below 30%...
3,372
Effect of shock polarity on the efficacy of transthoracic atrial defibrillation.
The energy requirement for internal ventricular defibrillation is reduced by reversal of shock polarity. The influence of shock polarity on the efficacy of transthoracic atrial defibrillation is unknown.</AbstractText>This prospective, randomized study enrolled 110 consecutive patients who were referred for elective ca...
3,373
Syncopal episodes in a young amateur body builder.
A 36 year old male weight training enthusiast suffered several syncopal episodes. An electrocardiogram confirmed atrial fibrillation with normal ventricular response. The patient admitted to taking anabolic steroids and bromocriptine. The atrial fibrillation was considered to be due to bromocriptine misuse.
3,374
Atrial fibrillation: strategies to control, combat, and cure.
Atrial fibrillation is the commonest clinical arrhythmia, is increasing in incidence and prevalence, and is associated with substantial morbidity and mortality. The arrhythmia may be paroxysmal (self-limiting), persistent (amenable to cardioversion), or permanent. Especially in its paroxysmal form, atrial fibrillation ...
3,375
Long-term follow-up of patients after coarctation of the aorta repair.
Late cardiovascular complications after operative repair of coarctation of the aorta include systemic hypertension, premature coronary artery disease, aortic valve abnormalities, aortic aneurysm, and recoarctation. We report the outcome in 274 subjects greater-than-or-equal50 years after coarctation repair. Operative r...
3,376
Biventricular pacing--early experience.
Biventricular pacing has been studied for the treatment of chronic heart failure (CHF). This technique seems to be able to improve symptoms and exercise tolerance, in patients with advanced CHF and prolonged QRS duration.</AbstractText>To present our experience with biventricular pacing in the management of severe CHF....
3,377
Prognosis in patients with heart failure and preserved left ventricular systolic function.
It is recognized that heart failure patients with preserved left ventricular systolic function have better prognosis; nevertheless, there are some studies with conflicting results. Also, there is a paucity of data concerning the prognostic factors in this group of patients.</AbstractText>To determine possible variables...
3,378
Factors associated with early atrial fibrillation after ablation of common atrial flutter. A single centre prospective study.
The occurrence of early atrial fibrillation (&lt; or = 6 months) after ablation of common atrial flutter is of clinical significance. Variables predicting this evolution in ablated patients without a previous atrial fibrillation history have not been fully investigated.</AbstractText>The aim of the present study was: (...
3,379
Improved cardiac function and quality of life following upgrade to dual chamber pacing after long-term ventricular stimulation.
Many patients with sinus node disease or atrioventricular block have previously received pacemakers with only ventricular stimulation (VVI or VVIR). This study aimed to investigate whether quality of life and cardiac function were affected by an upgrade to dual chamber pacing (DDDR or DDIR) following long-term ventricu...
3,380
Long-lasting sport practice and lone atrial fibrillation.
To analyse whether the proportion of patients with lone atrial fibrillation engaged in chronic sport practice was higher than that observed in the general population.</AbstractText>The records of 1160 patients, seen at the arrhythmia outpatient clinic, were reviewed. A total of 70 patients (6%) suffered lone atrial fib...
3,381
[Pharmacological and clinical profile of nifekalant (shinbit injection), a class III antiarrhythmic drug].
Nifekalant (shinbit, MS-551) is a pure class III antiarrhythmic drug (Vaughan Williams' classification), which was approved in Japan in June 1999. This drug prolongs the action potential duration (APD) and the effective refractory period (ERP) in cardiac myocytes mainly by blocking the IKr (the rapid component of delay...
3,382
Limited antifibrillatory effectiveness of clinically relevant concentrations of class I antiarrhythmics in isolated perfused rat hearts.
The Langendorff-perfused rat heart with regional ischemia is increasingly used for evaluating drugs for prevention of phase-1, ischemia-induced ventricular fibrillation (VF). Surprisingly, the effectiveness of Class I antiarrhythmics has not been characterized in this model. One lower and one higher concentration of qu...
3,383
Spatiotemporal transition to conduction block in canine ventricle.
Interruption of periodic wave propagation by the nucleation and subsequent disintegration of spiral waves is thought to mediate the transition from normal sinus rhythm to ventricular fibrillation. This sequence of events may be precipitated by a period doubling bifurcation, manifest as a beat-to-beat alternation, or al...
3,384
New trends in the development of oral antidiabetic drugs.
A large number of oral antidiabetic agents are available today. This article provides a short review of the pharmacology and some clinical aspects of various oral antidiabetic drugs. It focuses mainly on the newest developing drugs (therapy of the near future) and on the most commonly used older groups for the common a...
3,385
Cardiovascular Complications of Neuromuscular Disorders.
In the past decade, advances in molecular genetics have shown that many familial neuromuscular and cardiovascular diseases share a common pathophysiology. They are caused by inherited mutations in the cellular cytoskeleton of cardiac and skeletal muscle cells. The clinical manifestation of cardiac disease in neuromuscu...
3,386
Deterioration of left ventricular function following atrio-ventricular node ablation and right ventricular apical pacing in patients with permanent atrial fibrillation.
Transcatheter radiofrequency ablation of the atrio-ventricular (AV) node followed by ventricular pacing has been shown to improve symptoms and quality of life of patients with atrial fibrillation (AF). It is assumed that function improves, but this has been less well demonstrated. The aim of this study was to assess th...
3,387
What is the optimal electrode configuration for atrial defibrillators in man?
To compare the atrial defibrillation threshold (DFT) for two electrode configurations in patients with drug refractory persistent atrial fibrillation (AF).</AbstractText>11 patients, 73% male, mean age 60.9 (range 38 to 83), underwent implantation of a Medtronic Jewel AF dual chamber defibrillator (model 7250). A step-...
3,388
[Sinus node functions, sinoatrial conduction, atrial conductivity after incipient paroxysms of atrial fibrillation and flutter in patients with ischemic heart disease].
Prediction of the rate of recurrent paroxysms of atrial fibrillation (AF) and flutter (AFl) after the first arrhythmia episode; determination of relevant antiarrhythmic treatment.</AbstractText>157 patients with ischemic heart disease (IHD) complicated by new episodes of AF and AFl entered the study. After the initial ...
3,389
Hypertension-related intermyocyte junction remodelling is associated with a higher incidence of low-K(+)-induced lethal arrhythmias in isolated rat heart.
The aim of this study was to characterise the arrhythmogenic mechanisms involved in hypokalaemia-induced sustained ventricular fibrillation (SVF), in hypertensive rats. The hearts from rats with hypertension induced by the nitric oxide synthase inhibitor L-NAME, and age-matched normotensive controls, were perfused in L...
3,390
Treatment of comatose survivors of out-of-hospital cardiac arrest with induced hypothermia.
Cardiac arrest outside the hospital is common and has a poor outcome. Studies in laboratory animals suggest that hypothermia induced shortly after the restoration of spontaneous circulation may improve neurologic outcome, but there have been no conclusive studies in humans. In a randomized, controlled trial, we compare...
3,391
Mild therapeutic hypothermia to improve the neurologic outcome after cardiac arrest.
Cardiac arrest with widespread cerebral ischemia frequently leads to severe neurologic impairment. We studied whether mild systemic hypothermia increases the rate of neurologic recovery after resuscitation from cardiac arrest due to ventricular fibrillation.</AbstractText>In this multicenter trial with blinded assessme...
3,392
Inhibitory effects of pre-ischemic and post-ischemic treatment with FR 168888, a Na+/H+ exchange inhibitor, on reperfusion-induced ventricular arrhythmias in anesthetized rat.
Effects of pre-ischemic and post-ischemic treatment with FR 168888 (5-hydroxymethyl-3-(pyrrol-1-yl) benzoylguanidine methanesulfonate), a Na+/H+ exchange inhibitor, on reperfusion-induced ventricular arrhythmias were examined in an ischemia/reperfusion model of anesthetized rat. FR 168888 (0.3 mg/kg) significantly redu...
3,393
Mitochondrial gene expression and ventricular fibrillation in ischemic/reperfused nondiabetic and diabetic myocardium.
We investigated the mitochondrial gene expression related to cardiac function and ventricular fibrillation (VF) in ischemic/reperfused nondiabetic and diabetic myocardium. To identify potentially more specific gene responses we performed subtractive screening, Northern blotting, and reverse transcription-polymerase cha...
3,394
Outcome studies with device therapy in patients with heart failure.
Heart failure is a common debilitating condition for which pharmacologic therapy thus far has provided only partial relief. Despite, and sometimes because of, medical therapy, the overall prognosis remains poor, with high rates of sudden death and death from progressive heart failure. Device-based therapies offer consi...
3,395
Future of device therapy for arrhythmias.
During the last three decades, implantable devices have been developed that are able to treat complex arrhythmias on an individualized basis, with emphasis on rapid restoration of normal cardiac rhythm or creation of the best physiologic alternative. Currently, new areas for device therapy include atrial fibrillation, ...
3,396
[Cardiac arrest in dental offices. Report of six cases].
The extreme medical emergency situation in the dental setting is cardiac arrest. The need to provide dental treatment to the medically compromised patients, suffering from very high risk heart diseases at special oral medicine hospital dentistry units, expose the dental and medical teams to the possibility of patients'...
3,397
[Utility of cardiac event recorders in diagnosing arrhythmic etiology of palpitations in patients without structural heart disease].
To determine the diagnostic yield of transtelephonic event monitors for identifying the reason for palpitations in patients with no structural heart disease.</AbstractText>For 20 months we enrolled all patients reporting palpitations in whom heart disease had been ruled out by medical history, physical examination, ECG...
3,398
Dilated cardiomyopathy in Presa canario dogs: ECG findings.
Forty-seven Presa canario dogs were diagnosed with congestive heart failure due to dilated cardiomyopathy (DCM). Supraventricular or ventricular tachydysrhythmias were found in 29 dogs. Atrial fibrillation was the most common dysrhythmia. Ventricular dysrhythmias were observed infrequently and had a very important prog...
3,399
Continuous antegrade blood cardioplegia: cold vs. tepid.
Continuous antegrade blood cardioplegia (CABCP) is used at different temperatures. We investigated the consequences of CABCP at 6 degrees C (COLD) vs. 28 degrees C (TEPID).</AbstractText>Anesthetized open-chest pigs (25 +/- 2 kg) were placed on cardiopulmonary bypass (CPB). The hearts were arrested for 30 min by 6 degr...