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Results 551 - 600 of 1019
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Parker M M - - 1998
Sepsis and septic shock are common problems in the ICU and carry a very high mortality. Myocardial depression is a common finding in patients with sepsis, and is usually reversible as the patient recovers. Both exogenous mediators, such as endotoxin, and endogenous cytokines, including tumor necrosis factor-alpha, interleukin-1beta, and interleukin-6, ...
Chen P S - - 1998
The aim of this article is to review the current concepts of ventricular defibrillation. We studied the interaction between strong electrical stimulus and cardiac responses in both animal models and in humans. We found that a premature stimulus (S2) of appropriate strength results in figure-eight reentry in vitro by inducing ...
Karnad D R - - 1998
OBJECTIVE: To study cardiovascular haemodynamics following scorpion envenomation. SETTING: Intensive care unit of a university hospital. PATIENTS: Eight patients with Indian red scorpion (Mesobuthus tamulus) stings. INTERVENTION: Captopril (6.25 to 12.5 mg orally) every 30 minutes until pulmonary oedema resolved. MAIN OUTCOME MEASURES: Haemodynamic data obtained by pulmonary artery catheterisation. ...
Karch S B - - 1998
This study was conducted to measure emergency medical services (EMS) response times in sudden out-of-hospital cardiac arrests and relate those times to probability of survival in cardiac arrest victims in Las Vegas casino-hotels from January 1993 to June 1996. Times from 911 activation to casino arrival and casino arrival to ...
Gray R A - - 1998
BACKGROUND: The effects of cardioversion of atrial fibrillation on the activation sequence of the ventricles have not been previously studied. In this study we examined the events in the ventricle that follow the application of atrial defibrillatory shocks. METHODS AND RESULTS: We used video imaging technology to study the sequence ...
Fava C - - 1998
A 76 year old man, who had undergone tonsillectomy for non Hodgkin's malignant lymphoma, died suddenly in rapidly evolving cardiogenic shock with electrocardiographic signs of acute lateral myocardial infarction. Post mortem examination showed three cardiac lesions, two in the left ventricle and one in the right atrium, corresponding to the ...
Barry W L - - 1998
Cardiogenic shock is defined as profound circulatory failure resulting in insufficient tissue perfusion to meet resting metabolic demands. It occurs in approximately 7.5% of patients with acute myocardial infarction. Treatment strategies include inotropic agents, use of intra-aortic balloon counterpulsation, and revascularization. Current evidence supports the use of primary angioplasty. Surgery ...
Simons G R - - 1998
The objective of this study was to assess the safety and efficacy of transvenous low energy cardioversion of atrial fibrillation in patients with ventricular tachycardia and atrial fibrillation and to study the mechanisms of proarrhythmia. Previous studies have demonstrated that cardioversion of atrial fibrillation using low energy, R wave synchronized, ...
Ko W J - - 1998
A 37-year-old woman had postpartum myocardial infarction complicated with cardiogenic shock. The infarction was attributed to diffuse coronary artery spasm caused by methylergonovine, which had been used to treat the postpartum haemorrhage due to placenta increta. The haemodynamics could not be maintained with catecholamine infusion and intraaortic balloon counterpulsation. At ...
Bhandari A K - - 1998
The efficacy of low-energy T wave shocks for induction of ventricular fibrillation (VF) was evaluated in 33 patients undergoing implantable cardioverter defibrillator (ICD) implantation (33 sessions) or predischarge ICD testing (20 sessions). To induce VF, the ventricle was paced for eight cycles at a 400-ms cycle length (S1-S1), and the ...
Olinic D - - 1998
The clinical, in-hospital and mid-term (14 +/- 12 months), results of primary percutaneous coronary angioplasty (PTCA) were investigated in 74 consecutive patients (pts) with acute myocardial infarction excluded from thrombolysis, of whom 9 pts with cardiogenic shock. In pts without cardiogenic shock at admission, the success rate of primary PTCA ...
Jones J - - 1998
During the first minute of fibrillation, circulating wavefronts excite new fibrillation action potentials almost immediately following termination of the preceding action potential. The extension of refractoriness hypothesis states that a successful defibrillating shock must produce a uniform postshock refractoriness of a specific optimal duration throughout the ventricle, which blocks these ...
Hsu W - - 1998
Previous studies suggested that time periods exist during ventricular fibrillation when defibrillation shocks are more effective. However, there is no agreement on the amount of energy that can be saved or whether an implantable defibrillator can time shocks to these time periods. We conducted a study having two parts to ...
Kleen M - - 1997
Myocardial blood flow heterogeneity in shock and small-volume resuscitation in pigs with coronary stenosis. J. Appl. Physiol. 83(6): 1832-1841, 1997.-We analyzed the effects of shock and small-volume resuscitation in the presence of coronary stenosis on fractal dimension (D) and spatial correlation (SC) of regional myocardial perfusion. Hemorrhagic shock was induced ...
Holmes D R - - 1997
Cardiogenic shock remains a highly lethal event. Fortunately, recent data indicate that some of these high risk patients derive particular survival benefit from aggressive treatment strategies. As yet, there are no randomized trial data, although two trials are currently being performed. Selection bias can affect results, as pointed out by ...
Yamanouchi Y - - 1997
The polarity of a monophasic and biphasic shocks have been reported to influence DFTs in some studies. The purpose of this study was to evaluate the effect of the first phase polarity on the DFT of a biphasic shock utilizing a nonthoracotomy "hot can" electrode configuration which had a 90-microF ...
Kapoor R - - 1997
We investigated the effect of hemorrhagic shock and reinfusion on the cardiac function and contractility, plasma CK and CK-MB activity and lactate concentration, oxyradical-producing activity of polymorphonuclear leukocytes (PMNL-CL), cardiac chemiluminescence (LV-CL), antioxidant enzyme activity [superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GSH-PX)] and malondialdehyde (MDA) concentration in anesthetized dogs ...
Nayak H M - - 1997
Analysis of stored electrograms from bipolar far-field electrodes is considered to be useful in differentiating supraventricular from ventricular arrhythmias. A case of inappropriate ICD shocks for sinus tachycardia is presented whereby successive shocks caused marked widening of the ventricular electrograms. Analysis of these stored electrograms, recorded from far-field bipolar electrodes, ...
Rubin M - - 1997
The use of cardiac ultrasonography in the emergency department currently has two primary indications: determining the presence of cardiac tamponade and determining cardiac activity in patients with apparent pulselessness. Physicians are able to recognize both conditions after appropriate, but not overextensive, training sessions. The evaluation of penetrating trauma, acute myocardial ...
Prakash A - - 1997
Internal atrial defibrillation (IAD) has been extensively evaluated for clinical efficacy but the need for concomitant demand pacing and the effect of IAD shocks on pacemaker function is not well studied. We prospectively evaluated: (1) the incidence of bradycardia as a result of IAD shocks; and (2) effect of these ...
Meldrum D R - - 1997
The heart is a tumor necrosis factor (TNFalpha) producing organ. Locally (v systemically)-produced TNFalpha likely contributes to myocardial dysfunction via direct suppression of myocardial contractile function, the induction of myocardial apoptosis, and the genesis of cardiac hypertrophy. Although recent studies have demonstrated increased myocardial TNFalpha following endotoxemia, it remains unknown ...
Efimov I R - - 1997
INTRODUCTION: Epicardial point stimulation produces nonuniform changes in the transmembrane voltage of surrounding cells with simultaneous occurrence of areas of transient positive and negative polarization. This is the phenomenon of virtual electrode. We sought to characterize the responses of epicardial ventricular tissue to the application of monophasic electric shocks from ...
La Vecchia L - - 1997
Percutaneous transluminal coronary angioplasty was performed after failed thrombolysis in a 54-year-old man for total occlusion of the left main coronary artery in the setting of acute myocardial infarction with cardiogenic shock. The procedure was successful in terms of vessel recanalization and restoration of flow. The recovery of muscle function ...
Sokoloski M C - - 1997
BACKGROUND: It is recognized that a ventricular vulnerability period exists during which atrial shock delivery may induce a ventricular tachyarrhythmia. This study was designed to define the zone in which the ventricles are vulnerable to induction of ventricular tachyarrhythmia during delivery of atrial shocks in the sterile pericarditis canine model ...
Bueno H - - 1997
BACKGROUND: There are some specific high-risk subgroups of patients with acute inferior myocardial infarction, such as older patients and those with right ventricular involvement. However, the clinical implications of right ventricular infarction in elderly subjects have not been studied previously. METHODS AND RESULTS: To determine the clinical impact of right ...
Brown G - - 1997
Azathioprine is administered to treat increasing numbers of disorders over a wide range of organ systems. The potential for the drug to cause widespread organ dysfunction is not fully appreciated. In fact, azathioprine can cause multisystem organ dysfunction involving the kidneys, liver, and cardiovascular system. The discovery of global cardiac ...
Mukae S - - 1997
The impairment of mitochondrial in non-infarcted myocardium under cardiogenic shock complicated by acute myocardial infarction was studied. We induced acute myocardial infarction in dogs by ligating the circumflex branch of the left coronary artery (LCX). On basis of left ventricular systolic pressure (LVPs) after 60 minutes, we divided the dogs ...
Mehdirad A - - 1997
A patient with an ICD accidentally grasped a power line and was electrocuted. He was unable to release the cable during electrocution though he remained conscious. After receiving a shock from his ICD, the powerline was released. ICD interrogation revealed inappropriate detection of alternating current and delivery of a shock.
Berger P B - - 1997
BACKGROUND: Although retrospective analyses have revealed an association between survival and coronary angiography and angioplasty in patients with acute myocardial infarction complicated by cardiogenic shock, the degree to which bias in the selection of patients to undergo these procedures contributes to this observation remains unclear. METHODS AND RESULTS: We studied ...
Brodie B R - - 1997
We reviewed the timing and mechanism of death in 1,184 consecutive patients with acute myocardial infarction (AMI) treated with primary angioplasty from 1984 to 1995. Of 98 deaths, 48 (49%) occurred early on day 0 or 1. The mechanisms of death were pump failure in 60 patients (61%), reinfarction in ...
Kovack P J - - 1997
OBJECTIVES: We sought to explore the potential benefit of combining intraaortic balloon counterpulsation (IABP) with thrombolysis for acute myocardial infarction (MI) complicated by cardiogenic shock. BACKGROUND: In community hospitals, this condition is usually managed with thrombolysis alone. METHODS: We reviewed the charts of 335 patients from two community hospitals who ...
Chauhan A - - 1997
We reviewed our experience with 28 unselected, consecutive patients undergoing left main coronary artery (LMCA) angioplasty who had been considered unsuitable for coronary artery bypass graft surgery (CABG). Fourteen patients (50%) had a protected LMCA circulation. Balloon angioplasty was performed in 11 patients (39.3%), and stents were implanted in 17 ...
Torchiana D F - - 1997
OBJECTIVES: A total of 4756 cases of intraaortic balloon pump support have been recorded at the Massachusetts General Hospital since the first clinical insertion for cardiogenic shock in 1968. This report describes the patterns of intraaortic balloon use and associated outcomes over this time period. METHODS: A retrospective record review ...
Mattke S - - 1997
We report on inadequate shocks delivered by an ICD for VT converting spontaneously to AF with slow ventricular response. This represents a correct behavior of the reconfirmation algorithm, as the detection of intervals longer than the fibrillation detection interval and shorter than the bradycardia escape interval is required to inhibit ...
Buff D D - - 1997
BACKGROUND: Circadian patterns of onset favoring the morning hours have been demonstrated for many cardiovascular disorders. Although much is known about cardiogenic acute pulmonary edema (CAPE), the relationship between time of day and CAPE episode onset has not been previously studied. METHODS: We examined 154 consecutive episodes of CAPE treated ...
Blanck Z - - 1997
INTRODUCTION: To describe the delivery of noncommitted implantable cardioverter defibrillator (ICD) shocks despite self-termination of ventricular arrhythmias. Abortive shock capability should eliminate the delivery of shocks for self-terminating ventricular arrhythmias. The delivery of noncommitted shocks despite abortive shock capability is, therefore, unexpected and previously unreported. METHODS AND RESULTS: Among 118 ...
Sweeney R J - - 1997
INTRODUCTION: Multiple-pathway electrode configurations generally allow improved current distribution over the heart and lower defibrillation thresholds than single-pathway systems. However, current distributions using multiple pathways are largely determined by electrode type and location. We hypothesized that switching the current among multiple pathways at high frequency (HF) could allow the switching ...
Das G - - 1997
A patient with a dual chamber pacemaker received two transthoracic (anterior-anterior paddle position) shocks for VF. Subsequent analysis of stimulation thresholds revealed a marked rise in the ventricular threshold only. Later, she received three additional shocks (anterior-posterior paddle position) during electrophysiological study to terminate episodes of induced VT. Following these, ...
Koren W - - 1997
OBJECTIVE: To describe a patient with neutropenic fever complicated by hyperglycemia, lactic acidosis, and fatal myocardial failure associated with clozapine therapy. CASE SUMMARY: A 37-year-old Ashkenazic Jewish man was admitted for agranulocytosis and fever, which developed after 11 weeks of clozapine monotherapy for drug-resistant schizophrenia. Complete blood counts and a ...
Itoh T - - 1997
The authors describe a fifty-five-year-old Japanese man with an acute extensive anterior myocardial infarction associated with a total occlusion of the left main coronary artery. The patient suffered cardiogenic shock and was treated successfully with rescue percutaneous transluminal coronary angioplasty and an intraaortic balloon pump (IABP) after unsuccessful intracoronary thrombolysis. ...
Donatelli F - - 1997
OBJECTIVE: In this paper we describe the preliminary results of a prospective operative protocol designed in order to define the role of emergent myocardial revascularization in extensive acute myocardial infarction and in post-infarction cardiogenic shock. METHODS: Entry criteria are: age < 75 years; anterior acute myocardial infarction with ST segment ...
Swerdlow C D - - 1997
INTRODUCTION: Shocks during the vulnerable period of the cardiac cycle induce ventricular fibrillation (VF) if their strength is above the VF threshold (VFT) and less than the upper limit of vulnerability (ULV). However, the range of shock strengths that constitutes the vulnerable zone and the corresponding range of coupling intervals ...
Holmes D R DR - - 1997
BACKGROUND: Use of aggressive and invasive interventions is more common in the USA than in other countries. We have compared use of resources for patients with cardiogenic shock after myocardial infarction in the USA and in other countries, and assessed the association between use of resources and clinical outcomes. METHODS: ...
Daehlin L - - 1997
We report clinical results with the Lithocut C-3000 shock wave lithotriptor used in treatment of kidney and ureteral stones. The Lithocut C-3000 is a low-cost device. There is no need for anaesthesia. The overall success rate after 3 months was 64% in 143 treatment sessions of 120 stones. For small ...
Watanabe I - - 1997
Arching and barotrauma, seen with high energy DC catheter ablation, are responsible for diffuse cardiac damage and coronary sinus rupture. In six anesthetized dogs, we investigated the effects of an increasing number of short time-constant capacitive shocks on the volume of myocardial damage. Each dog received capacitive shocks of 2 ...
Gjorgov N - - 1997
The effect on ventricular rate of intracardiac shocks for atrial fibrillation was studied in 13 patients receiving 95 shocks. Shocks were synchronized to the R wave and were delivered after R-R intervals > 500 msec, with increasing strength (20 to 400 V). In 10 patients, conversion to sinus rhythm was ...
Hsu W - - 1997
The goal of this study was to determine whether delivering transvenous defibrillation shocks, coordinated with the up/down-slope VF waveform patterns in the shocking lead, would improve the probability of successful defibrillation. Anesthetized swine (32-38 kg, n = 8) were implanted with an RV-->SVC + SQArray transvenous system to measure VF ...
Caterine M R - - 1996
OBJECTIVES: We sought to demonstrate that direct current (DC) shocks to the heart generate free radicals. BACKGROUND: Although it is a lifesaving maneuver, defibrillation is known to have myocardial toxicity. The mechanism of this toxicity is unknown. If DC shocks generate free radicals, free radicals could be a mechanism of ...
Shoemaker W C - - 1996
The aim of the present study was to explore methods, concepts, and techniques that provide recognition of circulatory deficiencies at the earliest possible time in the patient's illness. We used both the standard invasive pulmonary artery thermodilution catheter and noninvasive hemodynamic monitoring systems consisting of a new bioimpedance cardiac output ...
Kerber R E - - 1996
Direct current electric shocks have been used to terminate atrial arrhythmias (cardioversion) in humans since the 1960s. The likelihood of successful cardioversion and maintenance of sinus rhythm is increased if the left atrium is not markedly enlarged and fibrotic, if there is no marked left atrial hypertension (e.g., mitral stenosis), ...
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