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Biomedical subjects

E Piccolo

Publications and source records attributed to E Piccolo.

At least 109 records · Page 6Linked to original sources
PubMed1977

[Evolutive study of the vectorcardiogram from the 14th day to the 6th month of life on the normal infant].

With the purpose of a better evaluation of the changes of cardiac potentials during the early hemodynamic arrangement of the normal heart, the authors analyze the VCG of 10 normal children periodically recorded from the 14th day to the 6th month from birth. Rotation of QRS, T and P loops in the three planes, direction and voltage of principal planar and spatial vectors were analyzed. The QRS loop showed a balanced distribution between right and left ventricular forces in the second week and developed a leftward orientation from the 4th week to the 3rd month, as demonstrated both by the loss of clockwise rotation of horizontal QRS loop and by the progressive leftward and backward direction of intermediate vectors. The initial vectors were sketched or absent in the 14th day and increased successively until the typical Q loop. The voltage of terminal vectors did not change in the course of time, but the S loop in the horizontal plane lost its original clockwise rotation and shifted to middle posterior line. The T loop progressively shifted backward so that it was always posterior after the 30th day. The P loop in the frontal plane was similar to the adult's one while in the horizontal plane it often presented a figure-of-eight. The semeiological aspects and the electrogenic considerations of these changes were discussed.

Age Factors↗
PubMed1977

[The mechanism of the chronic supraventricular tachycardia: an intracavitary electrophysiological study (author's transl)].

Chronic Supraventricular Tachycardia (CST) or Chronic Atrial Tachycardia is a relatively rare arrhythmia. Because of very poor number of cases studied with electrophysiologic techniques its mechanism is still debated. Three cases of CST, one of persistent type and two of repetitive type, are reported. His bundle electrogram, high and low right atrial electrograms and atrial stimulation were performed in every case, ventricular stimulation in only one case. The Amiodarone, Pindolol, Verapamil and vagal manoeuvres effects were evaluated in all cases. The site of origin of tachycardia, atrial in cases 1 and 3 and junctional in case 2, was estabished by atrial map. The electrophysiologic findings suggested the presence of an ectopic focus in cases 1 and 3 and of an AV nodal re-entry circuit in case 2. Our results and those of the literature indicate that the site and the mechanism of CST, as in paroxysmal supraventricular tachycardia, is not univocal. Their electrophysiologic evaluation by means of endocavitary techniques can allow a more satisfactory therapeutic approach.

Adolescent↗
PubMed1976

[The vectorcardiogram of the normal child, 2-12 years of age (author's transl)].

Morphological aspects and the most important vectorial parameters of the VCG (Frank method) of normal children, aged 2 to 12 years, were analyzed. The total group consisted of 110 subjects (10 for each )ear) subdivided into three subgroups of progressive age. Semeiologic evaluation of the QRS in the frontal and sagittal planes was not significant because of the stereotypes of the figures. In the horizontal plane the majority of cases showed typical triphasic development of the vectorial groups, while biphasic morphology was found in the minority. The triphasic loop presented 1) a balance between anterior and posterior forces which was more frequent in the youngest children, 2) a posterior orientation which was more frequent in the oldest children or 3) an anterior orientation which was infrequent. Since the anterior orientation of triphasic QRS was not related to the age -- it may also be seen in normal adults -- it was attributed to a variation of ventricular activation. The biphasic loop was attributed to immaturity of ventricular conduction. The evaluation of quantitative parameters was in agreement with the results of other studies. The changes of initial and intermediate vectors were probably due to the more important development of the left ventricle. The QRS duration increased with age. The T loop was posterior in the majority of the youngest children and progressively advanced with age, although it remained posterior in an important number of cases of children aged twelve.

Age Factors↗
PubMed1976

[Morphological aspects and electrophysiological evaluation of the vectorcardiogram in inferior myocardial infarction (author's transl)].

The purpose of the paper is to evaluate the vectorcardiographic characteristics of the QRS in inferior myocardial infarction, now extended and modified in the light of recent advances in electrophysiology. The VCGs (Frank system) of 70 patients with old inferior myocardial infarction were analyzed. The most important parameters previously considered by others and the behaviour of the different vectorial groups were considered. The results of the analysis of these parameters were concordant with those obtained by others. The morphologic evaluation of the QRS on different planes allowed our cases to be divided into five vectorcardiographic groups. The evaluation of the morphological aspects of the QRS for a more sure diagnosis of myocardial infarction, specially considering false positive cases, was considered from the semeiological point of view. Moreover, it was shown that some alterations of VCG cannot be apparent electrocardiographically. The electrogenetic meaning of vectorcardiographic alterations, probably related with depth and width of necrosis and with conduction disturbances in the subdivisions of left bundle branch, were evaluated.

Adult↗
PubMed1976

[The VCG in ventricular septal defect in the first two years of life. Qualitative and quantitative analyses (author's transl)].

A group of 37 patients, less than 2 years old, with a ventricular septal defect of variable degree, and a left to right shunt, were studied by vectorcardiography. The duration, the direction and the aspect of the QRS loop on the three orthogonal planes, the voltage of the 0.01; 0.02; 0.04 vectors, the right and the left maximum spatial vectors and their projection on the H and F planes were analyzed and correlated to the right ventricular systolic pressure and Qp/Qs. A clockwise or an eight-type loop on the frontal plane, regardless of RVSP, was observed; on the H plane the loop is, usually, counterclockwise when the pressure is low or medium, and can be of the eight-type but never clockwise when the pressure is systemic. Very interestingly, the quantitative analysis showed a consistent increase of the LMSV. A progressive relationship between the spatial vectors and the right ventricular pressure was noted. The diagnosis of combined ventricular hypertrophy depend upon the following findings: the majority of cases showed a large, counterclockwise and anterior QRS loop on the H with the maximum vector to the left and anteriorly; in all cases the 0.01; 0.02; 0.04 vectors were enlarged, thus warranting the diagnosis of combined ventricular hypertrophy in the first few months of life. 4 cases with low RVSP presented increased initial forces to the right and anteriorly directed, while the major portion of the loop was in the left posterior quadrant on the H plane, with a counterclockwise direction. In our view, the differential diagnosis between this type of aspect and that of diastolic overload of the left ventricle can rest only on the increased voltage of the 0,02 vector which means both systolic and diastolic overload of the right ventricle when accompanied by an increased 0.01 vector which indicates volume overload of left ventricle. Likewise only a quantitative analysis can help in differentiating a combined ventricular hypertrophy from a normal tracing in children under 6 months who show an eight-type loop on the H plane with initial and medium vectors directed anteriorly to the left and counterclockwise, and terminal vectors to the right, posteriorly and clockwise, or in those cases with an anterior clockwise loop on the H plane. Moreover, in the first month of life, the VCG of large VSD with increased pulmonary flux and pressure, can be differentiated from the normal by the QRS loop on the H plane which is clockwise, with initial vectors directed to the left and anteriorly with increased LMSV.

Age Factors↗
PubMed1975

[Venous infusion of nerapamil in the treatment of refractory angina pectoris and arrhythmia due to associated electric instability].

The therapeutic effect of Verapamil in 45 patients with angina that had failed to respond to other drugs is described. Angina was distinguished in terms of its clinical and ECG features. Verapamil was administered i.v., usually in infusions of 10-250 mg/day over periods of hours or days; alternatively, direct injections of 2,5-5 mg were employed. The effect on arterial pressure is particularly stressed. In the great majority of cases, there was a marked improvement in the symptomatology and in arrhythmic changes arising during angina. The importance of the therapeutic effects of the drug is examined and its possible mechanisms of action are discussed.

Adult↗
PubMed1975

[Anti-arrhythmic therapy with verapamil by intravenous infusion].

Rapid and slow venous infusion of various doses of Verapamil in a mixed series of 185 cases of arrhythmia since 1968 is reported. Results and electrophysiological and ECG changes observed for each type of arrhythmia examined are considered separately: atrial fibrillation-flutter, supraventricular paroxystic tachycardia (atrial and/or junctional), and hyperkinetic ventricular arrhythmia. An association of i.v. Verapamil and a quinidine salt per os is suggested as an alternative to cardioversion in cases of recent atrial fibrillation-flutter. Results obtained in the treatment of arrhythmia due to electrical instability following angina and of angina following arrhythmia are also described. A study of His potentials as the premiss for using Verapamil in subjects with stimulus conductivity changes, including W.P.W. syndrome, is also reported. I.v. Verapamil was used in association with atrial and/or ventricular electrostimulation, and/or with electrical counter-shock in cases of arrhythmia (mostly supraventricular) that were especially refractory. Attention is drawn to the use of Verapamil in the control of arrhythmia after electrical cardioversion.

Adolescent↗
PubMed1975

[Evolutive study of the VCG in the first week of the normal newborn infant (author's transl)].

The vectorial and morphological variations of the VCG (Frank method) during the first seven days of life of sixteen normal newborn infants were analyzed. A byphasic distribution of the QRS vectors in the horizontal plane was found at birth. Successive observations showed a rising of initial forces of left septal activation and a slight increase of left parietal forces. The T loop variations were more remarkable, being probably correlated with rapid postnatal hemodynamic modifications. After a few days the T loop was oriented posteriorly and to the left, not changing this direction for many year. The P loop did not differ from the adult's in the majority of cases. Sometimes it showed a figure-or-eight rotation in the horizontal plane, probably due, according to the authors, to a different pathway of atrial activation.

Age Factors↗