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Biomedical subjects

G Rognoni

Publications and source records attributed to G Rognoni.

At least 37 records · Page 2Linked to original sources
PubMed1986

[Arrhythmia in patients with a DDD bicameral pacemaker].

Dual chamber pacemakers, with coordinate atrial and ventricular sensing and stimulation (DDD), even if allowing "physiological" pacing, exhibited new and complicated arrhythmic manifestations, whose real frequency is still unascertained. In 65 patients (mean age 68 +/- 12 years), implanted with a DDD multiprogrammable device (15 pts. Medtronic Versatrax 7000 A, 50 pts. Pacesetter AFP 283), we carried out a 24 hours Holter monitoring while pacemaker was programmed with standard parameters. In a subset of 15 patients Holter monitoring was performed before and after pacemaker implantation. We evidenced: a) atrial sensing and/or pacing malfunction in 3 patients (4.5%); b) pacer-unrelated arrhythmias in 49 patients (75%): atrial extra beats 35 patients (54%), ventricular extra beats 23 patients (35%), non-sustained ventricular tachycardias 10 patients (15%), atrial tachyarrhythmias 8 patients (12%); c) supraventricular arrhythmias with PM-mediated high rate ventricular pacing in 12 patients (18%); d) PM induced and sustained endless loop tachycardias in 31 patients (47%); e) arrhythmias depending on over-sensing in 11 patients (17%): myopotential interferences 9 patients (14%), cross-talk ventricular pacing inhibition 2 patients (3%). The prevalence of ventricular arrhythmias was not different before and after the pacemaker implantation. The prevalence of atrial extrasystoles (53% versus 40%) and atrial tachyarrhythmias (26% versus 6%) decreased after the pacemaker implantation. Aimed reprogramming with progressive extension of atrial refractory period (from 250 to 400 msec and DDX) achieved disappearance of PM-endless loop tachycardias in 95%. Use of multi-programmability lowered the incidence and symptoms of most PM-related arrhythmias. Drug therapy was of choice in clinical arrhythmias unrelated to pacer.

Amiodarone↗
PubMed1985

Respiration-dependent ventricular pacing compared with fixed ventricular and atrial-ventricular synchronous pacing: aerobic and hemodynamic variables.

A pacemaker that adapts heart rate in response to the patient's metabolic requirements has been developed. The pacemaker uses breathing frequency and tidal volume as the indicators of physiologic demand. Maximal physical work capacity, anaerobic threshold, oxygen uptake (16 patients) and hemodynamic variables (9 patients) were assessed with fixed rate (VVI), atrial synchronous (VDT/I) and respiration-dependent ventricular (VVI-RD) pacing. All subjects attained their anaerobic threshold in stress tests with VVI pacing. The maximal physical capacity (p less than 0.001), work time to attain the anaerobic threshold (p less than 0.01) and oxygen uptake (p less than 0.001) were significantly greater with VVI-RD than with VVI pacing. The transition from the supine to the standing position was characterized by a significant increase of cardiac index at rest with both VDT/I and VVI-RD pacing as compared with VVI pacing. Progressive increments in the cardiac index and average left ventricular stroke work index were significantly different at submaximal and maximal exercise when VVI and VVI-RD were compared. At maximal exercise, mean cardiac output was also significantly different: 10.21 +/- 2.5 (SD) liters/min with VVI, 11.2 +/- 0.8 liters/min with VDT/I (p less than 0.05) and 12.65 +/- 3.1 liters/min with VVI-RD (p less than 0.05) pacing. Maximal oxygen extraction values were greater with VVI and VVI-RD pacing than with VDT/I pacing. Pulmonary artery end-diastolic pressures at maximal exercise were within the normal range with the three different modes of pacing. In conclusion, there is a significant (25%) improvement in exercise performance with VVI-RD pacing as compared with VVI pacing.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

Increasing cardiac rate by tracking the respiratory rate.

The rate responsive pacemaker using respiratory rate as a sensor was implanted in 22 patients, 19 patients for ventricular pacing and three for atrial pacing. The level of exercise achieved with this system was consistently higher than with a fixed ventricular pacing rate. In addition, no special chemical or mechanical sensors are required; the sensor itself is simple, long-lasting, and energy efficient. Thus, this system adapts easily to the individual patient.

Adolescent↗
PubMed1984

Respiration as a reliable physiological sensor for controlling cardiac pacing rate.

A study was carried out to determine whether variations in the respiration rate during physical exercise could be used as a physiological variable in controlling the rate of an implanted pacemaker. The relation between respiration rate and heart rate was significantly correlated in 73 patients (19 with normal lung function, four with restrictive pulmonary disease, and 50 with obstructive airways disease) during repeated calibrated ergometric tests; no significant differences were found between the subgroups. An external computerised programmable system with algorithm control activated by a radio frequency system was used to vary the cardiac stimulation rate in relation to respiration rate in 11 patients implanted with ventricular inhibited pacemakers. In addition, a prototype programmable pacemaker dependent on respiration rate was implanted in two patients. Maximum values of oxygen uptake, minute ventilation, and work time were increased during the exercise stress tests when the variable cardiac pacing rate was used. Thus respiration rate appears to be a valid and stable physiological variable for controlling the cardiac stimulation rate in order to improve cardiac output in patients dependent on pacemakers.

Aged↗
PubMed1984

Permanent physiological pacing.

Ideal physiological form of pacing responds to body's needs for varying cardiac output indipendent of the requirement to synchronize with atrial activity. The atrial synchronous pacemakers are superior to the ventricular inhibited fixed rate pacing mode. Alternative methods of sensing physiological demands with single chamber ventricular pacing that produce a physiological rate response to exercise are described. System based on QT sensing and pacing system responsive to changes in respiratory rate have undergone successful clinical trials. Hemodynamics of rate responsive pacing are described. The highest cardiac performance during stress test in rate responsive pacing was achieved with the respiratory dependent pacemaker.

Cardiac Output↗
PubMed1983

Respiratory rate as a determinant of optimal pacing rate.

Efforts have been made to utilize biologic parameters for determining optimal cardiac pacing rates. In this study of 67 patients, a significant relationship between heart rate and respiratory rate was observed during dynamic exercise. A system using a radiofrequency activator to modify pacing rate is described. Eleven patients have received VVI pacemakers with a similar implanted radio receiver coil. In two patients the fully automatic system has been successfully implanted. The experience with respiratory rate as a determinant of pacing rate is encouraging.

Aged↗
PubMed1983

[Non-invasive recording of the His bundle electrogram: choice of leads and reliability of the "averaging" technic].

An improvement in detecting His bundle activity using a Marquette high resolution Mac unit, without pharmacologic depression of AV node conduction, was obtained with two surface lead systems, which were selected on the basis of the His bundle anatomical position and its electrostimulation axis. In 8 patients the direction of the His bundle bipolar stimulation vector was evaluated in the frontal plane, on the orthogonal leads and with map of the chest potential. In 39 patients the surface recording, using high-gain amplification, filtering between 50-300 Hz and an averaging of 256-512 cycles, was obtained by positioning the electrodes in the following sites: manubrium sterni-xiphisternum-V4. When this lead system failed, it was replaced by another one, which included V4-right sternal and right vertebral border at the level of the 3rd intercostal space. In 24 patients (PR less than 0.16" in 4 cases) intracavitary and surface H-V recording were compared. The surface interval was measured between the apex of the surface "blip" and onset of the QRS. Sensitivity was 86% with a good correlation (r = 0.94) between invasive and non-invasive measurements. The surface leads, in which the His bundle activity was best detected, were the manubrium-xiphisternum (on the midsternal line) and V4-right vertebral border at the 3rd intercostal space level. Our external measurement technique avoids subjective misinterpretations; the surface H-V interval was on an average 6 msec. shorter than the invasive one. The upper normal value of non-invasive H-V interval is therefore 50 msec in our measurement method.

Aged↗
PubMed1980

Immunogenetic and population genetic analyses of Iberian cattle.

Blood samples were collected from more than 100 animals in each of 2 Spanish cattle breeds (Retinto and De Lidia), 2 Portuguese breeds (Alentejana and Mertolenga), and American Longhorn cattle. All samples for the 4 Iberian breeds were tested for 20 polymorphic systems; American Longhorn were tested for 19 of the 20. For each breed an average inbreeding coefficient was estimated by a comparison of the observed and expected heterozygosity at 7 or 8 codominant systems tested. All breeds had positive values but only 3 breeds had estimates of inbreeding that were statistically significantly different from 0: De Lidia with f = 0.17, Retinto with f = 0.08 and Mertolenga with f = 0.05. The De Lidia breed especially may be suffering from inbreeding depression since this high value is greater than expected if all of the animals were progeny of half-sib matings. Genetic distances were calculated from the gene frequency data on these 5 breeds plus 9 other European breeds. Analyses of these distances show a closely related group of the 4 Iberian breeds and American Longhorn, confirming the close relationships among the Iberian breeds and the Iberian, probably Portuguese, origin of American Longhorn cattle.

Alleles↗
PubMed1979

[Automatic method for the evaluation of the extent of myocardial infarct from the serum of CPK curve].

An off-line system for calculating the extent of infarct from serial serum CPK determinations based on Sobel et al.'s compartmental model is presented. Results in 40 patients with acute infarct in a coronary unit showed that the index of infarct extent had an appreciable prognostic significance. Employment of the MB isoenzyme in the calculation could, it is felt improve the sensitivity of the method.

Adult↗
PubMed1978

[The control of the atrio-ventricular reciprocating tachyarrhythmias. A preliminary electrophysiological study and comparison between amiodarone and verapamil (author's transl)].

The effects of amiodarone (2.5 mg/Kg i.v.) and of verapamil (0.1 mg/Kg i.v.) on refractory periods and on conduction of structures interested in the reciprocating circuit, as well as on the possible echo zones, were comparatively evaluated through electrophysiological test in 8 patients, four of which with W.P.W. from Kent bundle, and four with double A-V pass with reciprocating supraventricular tachicardia (RST) documented crises. None of the two drugs seems to have the theorical requirements of balanced effect to be chosen for the antiarrhythmic prophylaxis in patients with ventricular pre-excitement. In patients with double A-V pass, while both drugs have a sufficiently balanced and regular action on refractory periods and on conduction the irregularity of their effects on echo zones appears to restrict their validity in chronical therapy. According to the Authors, the only useful criteria for the choice of an antiarrhythmic drug for the prophilaxis of R.S.T. to be derived through extrapolation from these electrophysiological tests are: 1) the functional suppression of a circuit structure; 2) the evaluation of effects on echo zones; 3) the possibility or not the evoking R.S.T.

Adult↗
PubMed1978

[Ventricular pre-excitation in old age associated with severe troubles of a-v conduction (author's transl)].

The Authors describe two cases of old people with syncopal crises in which the appearance of ventricular pre-excitement (WPW) is a new phenomenon associated with the progressing of severe troubles in A-V conduction, sometimes only shown by endocavitary electrophysiologic test. The appearance of accessory pathways latent or functionally dumb up to that time might be a substitutive mechanism in the attempt of counterbalacing serious deficiences of A-V conduction. In these patients special care is necessary in the use of antiarrhythmic drugs and in the interpretation of syncopal troubles in order to prescribe a correct therapy.

Age Factors↗