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Biomedical subjects

F Burkart

Publications and source records attributed to F Burkart.

At least 163 records · Page 9Linked to original sources
PubMed1978

[Long-term prognosis of pacemaker therapy in acute myocardial infarct with arrhythmias].

The short- and long-term results of provisional pacemaker therapy in fresh myocardial infarction have been investigated. In this cardiac unit in the period 1975--1977 provisional pacemakers were implanted in 48 patients due to severe conduction disturbance or sinus node syndrome with non-tolerated heart failure. 16 patients had bifascicular block (11 anterior, 3 diaphragmatic, and 2 non-localizable infarctions): in 9 (56%) of them, progression to complete AV block occurred. 27 patients exhibited AV block of 2nd to 3rd degree without evidence of fascicular blockades (21 diaphragmatic, 3 anterior, and 3 non-localizable infarctions). In 5 patients, sinus node dysfunction was the reason for pacemaker implantation. Hospital mortality in the group was 31.2% and thus was twice as high as the hospital mortality in all patients hospitalized in this unit with myocardial infarction during the same period (16.5%). The hospital mortality in patients with anterior infarction was 57.2% compared with a mortality of 16.7% in patients with diaphragmatic infarction. Late mortality (18 months after myocardial infarction) in the group was 46.8%. None of the patients with diaphragmatic infarction died during this observation period. In the patient group with anterior infarction, the mortality rose to 85.8%. Of the 14 patients who died in hospital, death in 12 was due to severe heart failure: neither bradycardic nor tachycardic arrhythmias were immediate factors in death. At autopsy, all patients exhibited severe coronary sclerosis with extensive myocardial infarction. Only 2 patients died from arrhythmia (atrial fibrillation/asystole). In 6 of the 34 survivors, a definitive pacemaker was implanted. 3 of these patients died in the first year after the myocardial infarction. Death was sudden in all three.

Arrhythmias, Cardiac↗
PubMed1978

[Treatment of iatrogenic transvenous foreign body embolism].

Embolization of central venous devices, such as infusion catheters, ventriculo-atrial drains for hydrocephalus or intracardial pacemaker leads, may cause fatal secondary complications. Removal of the embolized foreign bodies is therefore mandatory in the majority of cases. 26 in a series of 27 patients underwent removal procedures which have been successful in 24. The specific approach is described in the different subgroups of embolized foreign bodies. Removal has been achieved transvenously through the internal jugular vein in most instances of embolization of infusion or pressure catheters, using forceps or ureteric stone catheters. Thoracotomy was necessary in 8 patients, twice with with cardio-pulmonary bypass. There were no complications due to interventions for catheter extraction. This experience justifies an active approach to treatment once the diagnosis is established.

Adolescent↗
PubMed1978

Intrinsic sympathomimetic activity of beta-adrenoceptor blocking agents.

The pharmacological methods used to assess the intrinsic sympathomimetic activity (ISA) of beta-blockers are discussed. The clinical relevance of ISA to respiratory function, peripheral resistance and cardiac function is reviewed. It appears doubtful whether ISA is always of predominant clinical significance and an alternative explanation is offered for many clinical effects observed with certain beta-blockers, e.g. pindolol, oxprenolol, tolamolol, metoprolol, etc. Some effects of these beta-blockers resemble those of labetalol, a new drug with both alpha and beta-blocking activity. Some clinical effects of certain beta-blockers are more likely to be due to alpha-blocking activity than to their ISA.

Adrenergic alpha-Antagonists↗
PubMed1977

[Stress hemodynamics in fresh myocardial infarct].

Hemodynamic measurements before and during graded leg-up tilt were performed in 20 patients on the 1st and 3rd day following myocardial infarction. In those with an elevated pulmonary capillary pressure (greater than 11 mm Hg), independent of the cardiac index, the tilt-test (i.e. an additional increase in preload) unmasked heart failure. When applied to test drug responses, furosemide (n = 7) reduced the tilt-stimulated cardiac index with an attendant fall in pulmonary capillary pressure; nitroglycerine (n = 7) did not change cardiac index but reduced the pulmonary capillary pressure.

Cardiac Output↗
PubMed1977

[Hypersensitive carotid sinus reflex in older patients. Incidence and significance for the diagnosis of sick sinus node].

Carotid sinus massage was performed in 100 consecutive patients over the age of 50 years: 63 showed a normal reaction and sinus bradycardia occurred in 12, whereas sinus arrest was registered in 22 and total AV block in 3. With atrial pacing only 2 patients with sick sinus syndrome could be detected. Intravenous administration of atropine did not help to identify them. We conclude that in 1/4 to 1/3 of these elderly people the sinus node reacts in a hypersensitive manner to carotid sinus massage, but this does not imply the diagnosis of sick sinus syndrome.

Aged↗
PubMed1977

[Early mobilisation after myocardial infarction. A prospective and controlled study (author's transl)].

Early mobilisation after acute myocardial infarction is said to increase the risk of ventricular aneurysm and -rupture, reinfarction, sudden death, and heart failure. In order to evaluate these possible negative effects, we run a prospective and controlled study: 2 X 100 consecutive patients with acute myocardial infarction were mobilized conventionally (A) and according to an early mobilisation programme (B) respectively-the two groups were comparable according to age, sex, CHD-history, infarction transmural/non transmural and coronary prognostic index (Norris). There was a significant reduction in the average hospital stay from 31.4 days in group A to 25.8 in group B. The patients were followed up for 32 (A) and 46 days (B) respectively. In the early mobilized group we found no increased risk for heart failure, reinfarction, or sudden death. On the other side, early mobilisation has many psychological, oeconomic and social advantages for patients and hospital.

Early Ambulation↗
PubMed1976

[Exercise hemodynamics and renin before and after acute beta block in patients with essential hypertension].

Hemodynamic and renin studies at rest and during graded upright ergometry were performed in 21 patients with essential hypertension before and after propranolol. Beta-adrenergic receptor blockade reduced exercise-stimulated cardiac and renin responses significantly more when compared with the corresponding effects at rest. Propranolol increased peripheral resistance at rest but not during exercise. The degree of the individual hemodynamic changes after propranolol correlated better with the corresponding control values than with age or renin. A direct relationship between the percent reduction of heart rate and renin responses after acute beta-blockade indicates a parallel suppression of cardiac and renal receptor functions.

Adrenergic beta-Antagonists↗
PubMed1976

[Hemodynamic changes under metoprolol compared to propranolol in hypertensive patients].

The effect of the new beta-receptor-blocking drug metoprolol on hemodynamics and plasma renin activity was studied at rest and during exercise. 5 patients with essential hypertension were investigated before, 4 weeks after and 8 weeks after oral treatment (3 X 50 mg day). The results were compared to data of 5 patients under propranolol matched according to age, arterial blood pressure, and renin concentration. Metoprolol leads to a significant fall in renin and heart rate, whereas cardiac index is depressed only during exercise. Peripheral resistance remains unchanged and left ventricular filling pressure rises slightly. This results in a slight fall in arterial blood pressure. In comparison with propranolol the hemodynamic and renin patterns under metoprolol are similar, the only difference being the slighter fall in blood pressure due to a less depressed cardiac index.

Adult↗
PubMed1976

[Diagnosis and therapy of bradycardial arrhythmias (round table conference)].

In recent years a growing number of pacemakers have been implanted in Switzerland. An indication for this treatment, in addition to AV block with or without syncope, is now sick sinus syndrome. Intracardiac ECG recording is demonstrated, in view of the fact that this technic has made it possible to differentiate blocks in the bundle of His and in the fascicles. The pacemaker systems most used in Switzerland are described, with comparison of the new lithium cells and mercury batteries. The importance of follow-up in these patients is stressed. Finally, reference is made to the ECG alterations in pacemaker carriers which may cause difficulties of interpretation.

Arrhythmia, Sinus↗
PubMed1976

[Prinzmetal angina: clinical aspects and coronarographic findings].

The clinical course and coronary arteriographic findings in 5 patients with Prinzmetal's variant angina pectoris are reviewed. In 4 patients who had ST-elevations inferiorly, 1 had minimal, 1 only slight, and 1 medium coronary artery disease; 1 had coronary spasm. 1 patient with ST-elevation anteriorly had severe stenosis of the anterior descending coronary artery. All 5 patients had normal left ventriculograms, 3 also had normal left enddiastolic pressure, and 2 slight elevation. Medical treatment was carried out in 2 patients and surgical revascularization in 2. Both treatments were accompanied by marked symptomatic improvement. Spontaneous loss of angina occurred in 1 patient. Prinzmetal's variant angina pectoris may be accompanied by a variety of coronary arteriographic findings and the prognosis appears to be more favorable than previously reported.

Adrenergic beta-Antagonists↗
PubMed1976

Haemodynamic responses to exercise and acute beta-receptor blockade in renin sub-types of essential hypertension.

1. Haemodynamic and renin responses to dynamic exercise before and after intravenous beta-adrenoreceptor blockade with propranolol were compared in twenty-one patients with essential hypertension and either high (n = 7), normal (n = 7) or low plasma renin activity (n = 7). 2. Renin and heart-rate responses to exercise and beta-receptor blockade diminished from high-renin to normal and to low-renin patients, effects which were blunted with increasing age. 3. Among the renin groups cardiac output, stroke volume, diastolic pulmonary artery pressure, systemic pressure and peripheral vascular resistance as well as their changes produced by exercise and acute beta-receptor blockade were not significantly different. 4. Long-term anti-hypertensive propranolol effects correlated with pre-treatment renin status, renin stimulation and its suppression by acute beta-receptor blockade as well as with the exercise tachycardia and the patient's age. 5. The results suggest different adrenergic control mechanisms in renin sub-types of essential hypertension, age being a modulating factor.

Adult↗
PubMed1975

[Proceedings: Early mobilization after myocardial infarct--late results].

The longterm effects of early mobilization after myocardial infarction (MI) have been investigated. 122 patients aged under 65 years were reexamined 84.6 +/- 24 weeks after MI. The physical work capacity (PWC) of these men was 22% below the normal value. Patients with angina pectoris after MI had a PWC only 45% of normal. The overwhelming majority (88%) of MI survivors had returned to their jobs by the end of the follow-up period. Of the conventionally treated patients only 70% had returned to work. Age, PWC after MI and psychological status critically influence the rapidity and rate of return to work after MI.

Angina Pectoris↗