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Yum Myung-Kul - - 2002
INTRODUCTION: During head-up tilt (HUT) test, patients with neurocardiogenic syncope show a sudden severe decrease in heart rate at the beginning of their induced syncopal attacks (termed intermittency). They also exhibit slow and progressive increases in their mean heart rates long before the induced syncopal attacks (termed nonstationarity). The aim ...
Eckardt Lars - - 2002
INTRODUCTION: The value of noninvasive markers reflecting repolarization and/or conduction abnormalities in identifying patients with abnormal ECG showing a pattern of atypical right bundle branch block and ST elevation syndrome (Brugada syndrome) at risk for life-threatening arrhythmias is controversial. Because right precordial ST elevation reflects inhomogeneous repolarization, we hypothesized that ...
Aslan Ozgur - - 2002
OBJECTIVES: To investigate the value of head-up tilt table testing (HUTT) with low-dose isosorbide dinitrate (ISDN) in the evaluation of patients with unexplained syncope and to compare the results of HUTT with ISDN and HUTT with isoproterenol. PATIENTS AND METHODS: Forty-three patients with unexplained syncope (21 women, with a mean ...
Ashby Dale T - - 2002
If not diagnosed by history, examination, or ECG, the diagnosis of syncope can be difficult with a low yield from echocardiography, ambulatory ECG recording, electrophysiological study, and tilt table testing. During 2 years, 48 patients with unexplained syncope or presyncope from three hospitals in one city underwent the implantation of ...
Masaki Riko - - 2002
Right bundle branch block and ST segment elevation (RBBB-STE) in the right precordial leads have been reported as a distinct clinical and electrocardiographic syndrome in patients prone to ventricular fibrillation (VF) in the absence of structural heart disease (Brugada syndrome). The purpose of the study was to investigate the role ...
Smart Steven - - 2002
OBJECTIVES: To investigate the cause of worse survival in older patients after myocardial infarction (MI). DESIGN: Prospective 18-month and longer follow-up study of a cohort of 167 patients (mean age +/- standard deviation 58 +/- 12, including 71 aged >or=65) with acute MI for cardiac events, defined as cardiac death, ...
Stone Marc E - - 2002
The number of patients supported by ventricular assist devices (VADs) that present for noncardiac surgery is increasing in our institution. Our recent experience with eight such patients is reported, along with a review of the most commonly implanted VADs and the anesthetic implications and considerations for VAD-supported patients undergoing noncardiac ...
Manganelli Fiore - - 2002
This study was designed to investigate whether, in patients with hypertrophic cardiomyopathy (HC), tilt-induced volume unloading triggers a peripheral reflex similar to that seen in patients with a history of vasovagal syncope or rather acts through an intrinsic cardiac mechanism secondary to diastolic dysfunction. Thirty-seven patients with HC (10 with ...
Schläpfer Jürg - - 2002
OBJECTIVES: We sought to compare the long-term survival rates of patients with sustained ventricular tachyarrhythmia after myocardial infarction (MI) who were treated according to the results of electrophysiological (EP) study either with amiodarone or an implantable cardioverter-defibrillator (ICD). BACKGROUND: Patients with sustained ventricular tachyarrhythmias after MI are at high risk ...
Garcia-Moran E - - 2002
AIMS: To determine the effectiveness of the implantable cardioverter defibrillator (ICD) in preventing recurrence of syncope in patients with structural heart disease, previously unexplained syncope and inducible ventricular arrhythmias. METHODS: Thirty-eight patients with syncope, structural heart disease and inducible arrhythmias had an ICD implanted. All ICDs delivered antitachycardia pacing and ...
Borger van der Burg Alida E - - 2002
INTRODUCTION: Radiofrequency ablation (RFCA) of ventricular tachycardia (VT) is a potential curative treatment modality. We evaluated the results of RFCA in patients with VT. METHODS AND RESULTS: One hundred fifty-one consecutive patients (122 men and 29 women; age 57 +/- 16 years) with drug-refractory VT were treated. Underlying heart disease ...
Blanc J-J - - 2002
AIMS: Syncope is a frequent and potentially dangerous symptom. The epidemiological data are based on series mainly collected 20 years ago in the U.S.A. and do not adequately assist in the management of patients admitted now for this symptom in Europe. METHODS AND RESULTS: To evaluate prospectively the epidemiological aspects ...
Zimmerman Michael A - - 2002
Vasopressin is a vital homeostatic protein which regulates fluid balance via its antidiuretic effects and vascular tone via its vasoconstrictive effects. Endogenous vasopressin deficiency has been implicated in several disease states resulting in vasodilatory shock. In particular, vasopressin levels are low in patients following cardiac surgery and in those with ...
Kozák Milan - - 2002
BACKGROUND: The endothelins are peptides with vasoconstricting and growth-promoting properties. Endothelin-1 (ET-1) is known for its direct positive inotropic and chronotropic effects on isolated heart, and for growth effects. The aim of this pilot study was to investigate the frequency distribution of a common polymorphism of the endothelin (ET-1) gene ...
Mitchell L Brent - - 2002
OBJECTIVES: The purpose of this study was to determine the mechanisms of sudden death (SD) in patients with ventricular tachyarrhythmias (ventricular tachycardia/ventricular fibrillation [VT/VF]) treated with an implantable cardioverter defibrillator (ICD). BACKGROUND: Despite ICD therapy, some patients with VT/VF still die suddenly. Optimal ICD use requires determination of the mechanisms ...
Mitchell L E - - 2002
AIMS: To ascertain the proportion of adults with a pacemaker in situ attending the Accident and Emergency Department because of syncope or unexplained falls and the cause of index symptoms in these patients, including the prevalence of hypotensive syndromes. METHODS AND RESULTS: Patients presenting to the Accident and Emergency Department ...
Mittal Suneet - - 2002
INTRODUCTION: Two randomized trials (Multicenter Automatic Defibrillator Implantation Trial [MADIT] and Multicenter Unsustained Tachycardia Trial [MUSTT]) suggest that implantable cardioverter defibrillator (ICD) placement is associated with improved survival in patients with coronary artery disease, depressed left ventricular function, and nonsustained ventricular tachycardia (VT) who also have inducible sustained VT. However, ...
Junge Mirko - - 2002
A 66-year-old patient with terminal heart insufficiency (NYHA IV) received maximum medical therapy, but was also in need of an implantable-cardioverter-defibrillator (ICD). The ICD functioned flawlessly for the whole duration of implantation. It reverted several ventricular tachycardias with anti-tachycardial pacing alone, whereas some needed cardioversion as well. The patient died ...
Niehaus Michael - - 2002
Patients with ICDs might experience oversensing associated with inappropriate shock therapy when paced at low bradycardia rates or if they have a low intrinsic rhythm. The amplifier gain of automatic gain control is maximal at long RR intervals and might lead to oversensing of myopotentials. The hypothesis was that an ...
Senges Julia C - - 2002
In the MADIT study, a selected group of postinfarction patients with asymptomatic nonsustained ventricular tachycardia (NSVT) has been shown to benefit from prophylactic ICD treatment. The present study analyzed the variability of NSVT in a patient population fulfilling the non-invasive MADIT criteria. Three consecutive Holter ECGs were performed in weekly ...
Petrac Dubravko - - 2002
AIM: To prospectively evaluate long-term clinical outcome in patients who underwent radiofrequency catheter ablation for the treatment of idiopathic ventricular tachycardia (VT). METHODS: Twenty consecutive patients with idiopathic VT resistant to drugs were treated by temperature-controlled radiofrequency ablation. The site of VT origin was localized by pace mapping and endocardial ...
Sanatani Shubhayan - - 2002
BACKGROUND: A recently developed implantable loop recorder (ILR) has been used in adult patients whose syncope remains unexplained in spite of extensive investigations. Syncope in the patient with congenital heart disease presents a diagnostic challenge. We applied this technology to a cohort of pediatric patients. METHODS: We reviewed our experience ...
Wang Jenn Chyuan - - 2002
OBJECTIVE: To study the response of regular broad-complex tachycardia (BCT) demonstrating right bundle branch block (RBBB) to treatment in the Emergency department (ED). METHODS: Retrospective chart review of management of patients with BCT, RBBB without a history of ischaemic heart disease. A diagnosis of ventricular tachycardia (VT) was made if ...
Wehling Martin - - 2002
Flecainide (CAS 54143-55-4) has been associated with increased mortality in patients with ventricular dysfunction and arrhythmias. It is a potent suppressant of supraventricular arrhythmias, but safety data for use in this condition are rare. A meta-analysis was performed including 122 prospective studies on the use of flecainide in patients with ...
Trusz-Gluza Maria - - 2002
BACKGROUND: Changes in U-wave amplitude after premature ventricular contractions (PVC) are known as prognostic markers in the long QT syndrome dependent on bradycardia. The purpose of the study was to find correlation between postextrasystolic ST-U segment changes and a history of sustained ventricular tachycardia or ventricular fibrillation (VT/VF). METHODS: The ...
Celiker A - - 2001
BACKGROUND: There is limited experience on sotalol use in the management of childhood arrhythmias. This study reviews the results of our experience with oral sotalol for treatment and prevention of tachyarrhythmias in children. METHODS: The records of 62 patients (27 female, 35 male, mean age: 8.5+/-5.3 years) treated with sotalol ...
Boriani G - - 2001
BACKGROUND: Antiarrhythmic drugs are still used for the treatment of ventricular tachyarrhythmias, in combination with implantable cardioverter-defibrillators or without them. AIM OF THE STUDY: In a double-blind randomized crossover design, the short- and long-term efficacy and safety of oral dofetilide or oral sotalol were compared in 135 patients with ischaemic ...
Miranda C C - - 2001
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 patients receiving prone ventilation in intensive care has been ...
Tong K L - - 2001
INTRODUCTION: Torsade de Pointes (Tdp) is a form of polymorphic ventricular tachycardia in the setting of prolonged QT interval. Any drug that prolongs repolarisation, and hence QT interval, may cause Tdp. Predisposing factors of drug-induced Tdp include female sex, bradyarrhythmia and hypokalaemia. METHODS: We retrospectively analysed the case notes of ...
Sra J - - 2001
With conventional techniques, RF catheter ablation is difficult in patients with unstable VT or with multiple VTs. The feasibility of RF catheter ablation guided by three-dimensional electroanatomic mapping technique in patients whose implanted ICD continued to deliver multiple shocks due to VT despite use of antiarrhythmic medications was assessed in ...
Miller J M - - 2001
Radiofrequency catheter ablation has revolutionized therapy of most forms of supraventricular tachycardia and ventricular tachycardia in the absence of structural heart disease by providing arrhythmia cure in almost 90% of patients. However, this treatment has not been nearly as successful in patients with ventricular tachycardia in the setting of structural ...
Taneda K - - 2001
A growing number of Japanese patients are being treated with ICDs. Efforts are warranted to minimize the rates of ICD shocks that cause discomfort and anxiety. The circadian distribution of ICD discharges was investigated in 80 patients (57+/-10 years of age, 69 men) from ten Japanese medical centers. The underlying ...
Washizuka T - - 2001
The study prospectively investigated the incidence, cause and efficient management of inappropriate discharge by the fourth generation implantable cardioverter-defibrillator (ICD) system in 45 patients (mean age, 57+/-16 years). During the follow-up period of 27+/-17 months, 18 patients (40%) experienced one or more inappropriate therapies: sinus and supraventricular tachycardia (15 patients) ...
Sakabe K - - 2001
Noninvasive markers reflecting repolarization inhomogeneity have been proposed to be useful indices for identifying patients at risk of ventricular arrhythmias based on organic heart disease. In this study, we clarify whether or not repolarization inhomogeneity markers are useful in patients with idiopathic ventricular tachycardia (VT). We investigated T-wave alternans (TWA) ...
Love B A - - 2001
INTRODUCTION: Rapidly conducted supraventricular tachycardias (SVTs) can lead to inappropriate device therapy in implantable cardioverter defibrillator (ICD) patients. We sought to determine the incidence of SVTs and the occurrence of inappropriate ICD therapy due to SVT in a pediatric and young adult population. METHODS AND RESULTS: We undertook a retrospective ...
Gödde P - - 2001
BACKGROUND: The identification of patients at increased risk for ventricular tachycardia or ventricular fibrillation (VT/VF) and sudden cardiac death has consequences for therapeutic options and thus may reduce mortality in patients with coronary artery disease (CAD). HYPOTHESIS: We hypothesized that the intra-QRS fragmentation in magnetocardiographic recordings is increased in patients ...
Moya A - - 2001
BACKGROUND: Because of its episodic behavior, the correlation of spontaneous syncope with an abnormal finding can be considered a reference standard. METHODS AND RESULTS: We inserted an implantable loop recorder in 111 patients with syncope, absence of significant structural heart disease, and a normal ECG; tilt-testing was negative in 82 ...
Khongphatthanayothin A - - 2001
Ten patients (aged 0-9 years) with the diagnosis of automatic atrial tachycardia (AAT) from August 1997 to August 2000 were reviewed. Three patients had paroxysmal (repetitive) AAT and the tachycardia was incessant in six (defined as presence of AAT for more than 90% of the time). The type of AAT ...
Steinberg J S - - 2001
INTRODUCTION: A prospective registry and substudy were conducted in the Antiarrhythmics Versus Implantable Defibrillators (AVID) Study to clarify the prognosis and recurrent event rate, risk factors, and impact of implantable cardioverter defibrillator (ICD) therapy in patients with unexplained syncope, structural heart disease, and inducible ventricular tachyarrhythmias. METHODS AND RESULTS: Included ...
Brugada P - - 2001
INTRODUCTION: The prognostic value of electrophysiologic investigations in individuals with Brugada syndrome is unclear. Previous studies failed to determine its value because of a limited number of patients or lack of events during follow-up. We present data on the prognostic value of electrophysiologic studies in the largest cohort ever collected ...
Reinelt P - - 2001
OBJECTIVE: To determine the frequency and types of significant, sustained arrhythmias in a mixed ICU. DESIGN AND SETTING: Prospective, observational study in a medical-cardiological-postoperative ICU at a university hospital. PATIENTS: 133 consecutive patients with arrhythmias. MEASUREMENTS AND RESULTS: All patients had continuous ECG monitoring and automatic arrhythmia detection. We assessed: ...
Sarasin F P - - 2001
PURPOSE: To determine the diagnostic yield of a standardized sequential evaluation of patients with syncope in a primary care teaching hospital. PATIENTS AND METHODS: All consecutive patients who presented to the emergency department with syncope as a chief complaint were enrolled. Their evaluation included initial and routine clinical examination, including ...
Sabaté X - - 2001
This case report describes a patient with an automatic ICD who suffered a defibrillation shock without warning symptoms. An electrical interference can be observed in the stored EGM of the episode. The patient explained that the moment he felt the shock he was touching a washing machine. After correct grounding ...
Kojo M - - 2001
We investigated the effect of postural changes on cerebral circulation by measuring carotid artery blood flow (CABF) in the supine position and during head-up tilt (HUT) test using a Doppler flow meter. Subjects included 10 patients with neurally mediated syncope, 10 patients with orthostatic intolerance, 8 with epilepsy, aged between ...
Brembilla-Perrot B - - 2001
The objectives of this study were to: (1) define the incidence of presyncope and/or syncope in patients with paroxysmal junctional tachycardias, (2) determine their causes, and (3) determine the outcome of symptoms. Syncope is a frequent problem and is often caused by paroxysmal tachycardia. The mechanism of hemodynamic instability is ...
Washizuka T - - 2001
This report describes the clinical management of 2 patients with ventricular fibrillation (VF) who received inappropriate shocks from an implantable cardioverter defibrillator (ICD) due to T-wave oversensing. Cardiac sarcoidosis was confirmed as the underlying heart disease in 1 patient and idiopathic dilated cardiomyopathy in the other. Within 2 months after ...
Brembilla-Perrot B - - 2001
The prognosis of patients with bundle branch block (BBB) and myocardial infarction (MI) is poor, particularly for patients suffering from syncope. The purpose of this study was to investigate the diagnostic value of some techniques for the evaluation of the mechanism of syncope in patients with MI and BBB and ...
Englund A - - 2001
Increased dispersion of repolarization, measured invasively or by QT interval measurements, is associated with an increased risk for ventricular arrhythmias and sudden death. Most studies on this issue have included patients with normal intraventricular conduction, and it is not known if this finding has a predictive value also in patients ...
Sakabe K - - 2001
Microvolt T-wave alternans (TWA) and QT interval dispersion (QTD), which reflect temporal and spatial repolarization abnormalities, respectively, have been proposed as useful indices to identify patients at risk for ventricular tachyarrhythmias (VTs). The purpose of this study was to clarify which repolarization abnormality marker is more useful in predicting arrhythmic ...
Sakabe K - - 2001
BACKGROUND: Microvolt T-wave alternans (TWA) has been proposed as a useful index to identify patients at risk of ventricular tachyarrhythmias. Recent studies have demonstrated that antiarrhythmic drugs, such as amiodarone and procainamide, decrease the prevalence of TWA. In this study, we tested whether TWA in patients on antiarrhythmic pharmacotherapy significantly ...
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