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Biomedical subjects

D Kałka

Publications and source records attributed to D Kałka.

10 recordsLinked to original sources

[Transient myocardial ischemia in patients after myocardial infarction and late cell potentials].

The role of myocardial ischaemia in the development of late potentials (LP) on the signal-averaged ECG (SAECG) in patients with coronary artery disease (CAD) remains controversial. The aim of the study was to assess the influence of transient, scintigraphically-proven (Tc-99mMI-BI), exercise-induced ischaemia on the presence of LP in 51 pts with angiographically documented CAD. Patients were divided into 2 groups: 26 pts (mean age 53 +/- 7.7) without the history of myocardial infarction (MI) (Group I) and 25 pts (mean age 56.8 +/- 6.4) after MI (Group II). SAECG recording were performed at baseline (A) and during exercise-induced ischaemia (B). The following time-domain parameters of SAECG were analyzed: the root mean square voltage of the last 40 and 50 ms of filtered QRS (RMS40, 50), total time duration of filtered QRS (t0QRS) and time duration potentials < 40 microV (LPD). The ventricular late potentials (LP) were defined as the presence of at least two of the following criteria: tQRS > 114 ms, RMS 40 < 20 mV and LPD > 38 ms. We conclude that transient exercise-induced ischaemia increased the presence of LP in pts with CAD after MI but did not alter the arrhythmogenic substrate for LP in those without the history of MI.

Electrocardiography

[Significance of atrial signal-averaged electrocardiogram analysis in diagnosis of paroxysmal atrial fibrillation in patients with mitral valve prolapse syndrome].

The aim of this study was to assess the clinical usage of recording time-domain parameters of atrial signal-averaged electrocardiogram (ASAECG) in diagnosis of paroxysmal atrial fibrillation (PAF) of patients with mitral valve prolapse (MVP). 85 patients with MVP recognized by echocardiography were divided into two groups: group I (MVP-PAG/+/) 41 pts (15 male and 26 female) mean age 37.1 +/- 8.9 with previously electrocardiographically documented episode of PAF, group II (MVP-PAF/-/) 44 pts (20 male, 24 female) mean age 39.1 +/- 14.3 without PAF. The control group III consisted of 35 persons: 24 male and 11 female in mean age 37.7 +/- 6.2 without any cardiovascular diseases. All patients underwent additional investigations included: T3, T4, electrocardiography, exercise-test with moving "running track", 24-hours monitoring ECG with Holter's method and ASAECG recording. The following time-domain parameters of ASAECG were calculated: the root mean square voltage of the terminal 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and total time duration of filtered P-wave (PWD). The adaptation of time-domain parameters of atrial signal-average in differential diagnostics of PAF during MVP has appeared as useless from clinical point of view.

Adult

[The effect of long term use of amiodarone hydrochloride on time and frequency domain parameters of signal averaged electrocardiogram in patients with ischemia heart disease].

The aim of this study was to assess the influence of amiodarone hydrochloride on time- and frequency-domain parameters of signal-averaged electrocardiogram (SAECG) in patients with ischaemic heart disease (IHD). The study population consisted of 33 patients (18 female and 15 male), mean age 59.2 +/- 7.7. Amiodarone hydrochloride was orally used in the initial dose 600 mg/day for 10 days, and subsequently 200 mg/days for 6 weeks. Recording of SAECG and ambulatory Holter monitoring were made at baseline and in 10 day and after 6 weeks of therapy. The following time-domain parameters were analyzed: the root mean square voltage of the last 40 and 50 ms of the filtered QRS (RMS40 i RMS50), total time duration of filtered QRS (t-QRS) and duration of low amplitude signals < 40 microV in the terminal part of QRS (LPD). Late potentials (LP) were recognized when at least two from three criteria were fulfilled: 1) RMS40 < 20 microV, 2) t-QRS > 114 ms, 3) LPD > 38 ms. Frequency analysis of SAECG allowed to calculate the following parameters in logarithmic scale: energy spectrum > -60 dB (A) and decibel drop at 40Hz (Dd) and also in linear scale: area ratio 20-50/0-20Hz (Ar) and magnitude ratio (MR1-7). The values of RMS40 and RMS50 did not significantly change during amiodarone therapy. The obtained values of t-QRS were significantly longer after antiarrhythmic therapy, respectively 97.8 +/- 9.1 ms at the baseline, 102.1 +/- 10 ms after 10 days (p < 0.05), and 104.1 +/- 10.4 ms after 6 weeks (p < 0.005). Moreover the values of LPD did not significantly change after amiodarone treatment. At the baseline the presence of LP were observed in 3 (9%), after 10 days were recorded in 8 (24%), and after 6 weeks in 7 (22%) cases. Only in one case the LP were observed during the whole antiarrhythmic therapy. Moreover, amiodarone hydrochloride did not statistically significant change frequency-domain parameters in logarithmic scale and in linear scale.

Aged

[The effects of long-term treatment of sotalol hydrochloride on time and frequency domain parameters of signal averaged electrocardiogram in patients with ischemic heart disease].

The aim of this study was to assess the influence of sotalol hydrochloride on time- and frequency-domain parameters of signal-averaged electrocardiogram (SAECG) in patients with ischemic heart disease (IHD). The study population consisted of 25 patients (16 women and 9 men), mean age 56.6 +/- 8.3. Sotalol was orally used in dose 160 mg/day during 6 weeks. Recording of SAECG and ambulatory Holter monitoring were made at baseline and in 10 day and after 6 weeks of therapy. The following time-domain parameters were analyzed: the root mean square voltage of the last 40 and 50ms of the filtered QRS (RMS 40 i RMS 50), total time duration of filtered QRS (t-QRS) and duration of low amplitude signals < 40 microV in the terminal part of QRS (LPD). Late potentials (LP) were recognized when at least two from three criteria were fulfilled: 1) RMS40 < 20 microV, 2) t-QRS > 114 ms, 3) LPD > 38ms. Frequency analysis of SAECG allowed to calculate the following parameters in logarithmic scale: energy spectrum > -60dB (A) and decibel drop at 40 Hz (Dd) and also in linear scale: area ratio 20-50/0-20 Hz (Ar) and magnitude ratio (MR1-7). The values of RMS40 and RMS50 and also t-QRS and LPD did not significantly change after sotalol treatment. At baseline the presence of LP was recorded in 7 (28%) cases, after 10 days of antiarrhythmic therapy only in 3 (12%), and after 6 weeks occurred in 6 (24%) cases. Moreover, sotalol hydrochloride did not statistically significant change frequency-domain parameters in logarithmic scale: A and Dd. On the other hand, the parameters in linear scale: MR1, MR4 and MR6 significantly change but these changes were not uniform. These findings suggest that oral treatment of sotalol hydrochloride did not significantly change time- and frequency-domain parameters of signal-averaged electrocardiogram in patients with ischemic heart disease.

Anti-Arrhythmia Agents

[Use of body surface heart potential mapping for registration of electrical phenomenal in the atrium].

Research on body surface potential mapping concerned predominantly the ventricular excitation process. There is only very limited data available documenting surface potential distribution during atrial electric events. The goal of this study was to establish the pattern and criteria of the atrial potential maps in the healthy population, which is substantial for a prospective usefulness of the noninvasive registrations of surface maps in atrial arrhythmias. A group of 54 subjects in whom there was no clinical evidence of cardiac dysfunction underwent a procedure of body surface potential mapping. The recordings were performed using the HPM-7100 system simultaneously from 87 leads covering the entire thorax. Isopotential maps registered during the P wave were subjected to the statistical analysis by means of the own system "Heart Map" enabling the qualitative and quantitative estimation of the atrial maps. To avoid a problem of variable heart rate, a time standardization, by the division of the P wave into 10 time intervals, was applied. In order to eliminate an interindividual variability of heart location in the thorax, a distribution of the constituent values without subordinating them to the individual electrodes was proposed. In consequence, the group-mean isopotential maps of the wave P for the normal subjects were created. According to the migration of the maximum throughout the thoracic surface during the P wave, three phases of the isopotential atrial maps were determined: phase 1 (P1-P4) comprising initial 40% of the P wave, phase 2 (P5,P6)-next 20% of the P wave and phase 3 (P7-P10)-the terminal 40% of the P wave duration. These phases reflect the successive sequences of atrial excitation. During the whole atrial depolarization the minimum of potential, changing its value, was located around lead D7. Furthermore, in the results of the analysis of the constituent values sequences, for the P wave time intervals the additional quantitive parameters were calculated, i.e. areas designated by positive and negative potential and the ratio of these areas. The presented findings revealed that surface maps give the precious insight into spread of atrial excitation. Establishing of the distribution pattern and the criteria of the atrial potential maps for normals enables to undertake the further research on the use of this technique in a various atrial pathology.

Adult

[The effect of sotalol hydrochloride therapy on atrial signal-averaged ECG in patients with paroxysmal atrial fibrillation].

The aim of this study was to evaluate of oral sotalol hydrochloride effects on atrial signal-averaged ECG (ASAECG) during time- and frequency-domain analysis in patients with paroxysmal atrial fibrillation (PAF) during ischemic heart disease (IHD). The study population of 27 was composed of 16 female and 11 male, mean age 56.1 +/- 8.4. The dose of oral sotalol was 160 mg/day for all days. Recording of ASAECG and 24-hours Holter monitoring were made at baseline, after 10 days and after 6 weeks of sotalol therapy. For ASAECG were calculated time-domain parameters: the root mean square voltage of the signals in the last 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and total time duration of filtered P-wave (PWD) and time duration of P-wave for Frank leads X, Y, Z (XP, YP, ZP). During frequency-domain analysis of the terminal part of P-wave we calculated the following parameters in range from 40 Hz to 400 Hz: energy spectrum > -60 dB (A) and decibel drop at 40 Hz (Dd) in logarithmic scale and area ratio 20-50/0-20 Hz (Ar), magnitude ratio (MR1-7) in linear scale for a vector magnitude. Supraventriculat arrhythmias were estimated quantitatively and qualitatively during Holter monitoring. The following parameters were estimated in a case of PAF recording: time of manifestation, duration, number of PAF episodes per day, mean heart rate during PAF and subjective symptoms. Moreover, comparable analysis of the following parameters: dimension of left atrial, age, gender, time duration of IHD and PAF and wall motion disturbances-hypokinesis and also left ventricular ejection fraction, mitral regurgitation was done between patients with effective and no effective of antiarrhythmic therapy. Our observation have indicated that oral sotalol therapy are responsible for statistically significant decrease of total time duration of filtered P-wave (PWD) and time duration of P-wave for Frank leads X, Y, Z (XP, YP, ZP) and increase area ratio 20-50/0-20 Hz in patients with PAF during IHD. Moreover, comparable analysis of above-mentioned parameters have not showed statistically significant differences between examined patients with effective and lack of effective sotalol therapy.

Administration, Oral

[Effect of propafenone hydrochloride on atrial signal-averaged ECG in patients with paroxysmal atrial fibrillation].

Oral propafenone hydrochloride effect was studied on atrial signal-averaged ECG (ASAECG) during time- and frequency-domain analysis in patients with paroxysmal atrial fibrillation (PAF) during ischemic heart disease (IHD). The study comprised 26 patients (15 female and 11 male) mean age 60.8 +/- 6.2. The dose of oral propafenone was 450 mg/day for all days. Recording of ASAECG and 24-hours Holter monitoring were made at baseline, after 10 days and after 6 weeks of propafenone therapy. Time-domain parameters were calculated for ASAECG: the root mean square voltage of the signals in the last 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and total time duration of filtered P-wave (PWD) and time duration of P-wave for Frank leads X, Y, Z (XP, YP, ZP). During frequency-domain analysis of the terminal part of P-wave the following parameters were calculated in range from 40 Hz to 400 Hz: energy spectrum > -60 dB (A) and decibel drop at 4 Hz (Dd) in logarithmic scale and area ratio 20-50/0-20 Hz (Ar), magnitude ratio (MR1-7) in linear scale for a vector magnitude. Supraventricular arrhythmias were estimated quantitatively and qualitatively by Holter monitoring. The following parameters were estimated in a case of PAF recording: time of manifestation, duration, number of PAF episodes per day, mean heart rate during PAF and subjective symptoms. Moreover, comparable analysis of the following parameters: dimension of left atrial, age, sex, time duration of IHD and PAF and wall motion disturbances--hypokinesis and also left ventricular ejection fraction, mitral regurgitation was done between patients with effective and no effective of antiarrhythmic therapy. Our observation have indicated that oral propafenone therapy does not influence any statistically significant differences all time- and frequency-domain parameters of ASAECG in patients with PAF during IHD. Moreover, comparable analysis of above mentioned parameters has not showed statistically significant differences between examined patients with effective and lack of effective propafenone therapy.

Aged

[Heart potential mapping from the thoracic surface in healthy persons].

We have examined 56 normal subjects, 24 females and 32 males. We have calculated the average maps on the basis of 30 patients of the average age of 24.3 years (SD = 4.91). The aim of our studies was to settle the normal heart potentials mapping. The studies were realized in the Laboratory of Electrophysiology in the Department of Pathophysiology of Wrocław Medical Academy. In order to record the heart potential mapping we have used the HPM 7100 system (Fukuda Denshi). We have analyzed isopotential maps, isointegral maps and ventricular activation time maps. We have calculated the average maps using the information system "Heart-Map" Normal heart potential mapping are necessary for statistic analyzing of heart potentials mapping in patients suffering from the heart diseases.

Action Potentials