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G Vergara

Publications and source records attributed to G Vergara.

At least 55 records · Page 3Linked to original sources
PubMed1991

[Supraventricular reentry tachycardia and athletic fitness].

Paroxysmal supraventricular reciprocating tachycardias (PSRT) which are due to a different type of reentry including the atrioventricular reentry circuit of Wolff-Parkinson-White (WPW) syndrome, may disturb the professional career of an athlete. Moreover even severe episodes of preexcited atrial fibrillation of WPW may occur. PSRT in athletes may present various clinical consequences: unimportant symptoms, or severe hemodynamic effects on the athletic performance particularly during sports activity at intrinsic high risk. The athletes are evaluated by clinical protocol which includes Holter monitoring ergometric test, echocardiography study, thyroid check and transesophageal electrophysiologic study at rest and during exercise. The arrhythmological study should be carefully performed in order to exclude an underlying heart disease, to study electrophysiological mechanisms and possible hemodynamic effect sports activity relate of the inducible and clinical tachyarrhythmias. Sometimes, these PSRT may disappear after interruption of athletic activity because of modifications of electrophysiological conditions related to the sports activity.

Electrocardiography, Ambulatory↗
PubMed1991

[Role of antitachycardia pacemakers in the treatment of supraventricular hyperkinetic arrhythmias].

The use of an antitachycardia pacemaker in the treatment of hyperkinetic supraventricular arrhythmias is founded on a reliable electrophysiological ground and on an high technology. Nevertheless the clinical impact of this approach is not considerable since the 5% to 7% of the potential candidates are in effect treated with an antitachycardia device. The success of new therapeutical procedures (i.e. catheter ablation) together with the shifting of the clinical, technical and commercial interest towards the electrical treatment of the malignant ventricular tachyarrhythmias are the main causes of the minor role that now the antitachycardia pacemakers play in the management of the patients with hyperkinetic supraventricular arrhythmias.

Aged↗
PubMed1991

[Usefulness of a complete echographic evaluation of the atrial dimensions for the diagnosis of idiopathic atrial fibrillation].

Left atrial enlargement may occur sometimes through only the increase of the supero-inferior (S-I) diameter, with normality of the antero-posterior (A-P) and latero-medial dimensions. In this study, both the largest dimensions of the left atrium and S-I and transversal dimensions of the left atrium and S-I and transversal dimensions of the right atrium were investigated, among the 98 pts suffering from recurrent paroxysms of atrial fibrillation (FAP). On the basis of the clinical, ECGraphic and echocardiographic data, a subgroup of 78 pts has been found, with FAP reliable to heart disease, which mostly appeared as accompanying a finding of atrial enlargement--left or right or both--. The remaining 20 pts distinguished, by means of the echocardiographic findings, as following: a) "idiopathic" FAP, neither dependent on heart disease nor on atrial enlargement (no. 11 pts); b) FAP dependent on "unexplained" atrial enlargement, i.e. unreliable to definite cardiac pathology (no. 9 pts). Among the b) pts, 7 showed the only, isolated S-I dimension increased. Therefore, the determination of the all largest dimensions of the atria, in pts with recurrent FAP, appeared able to more carefully distinguish the true cases of "idiopathic" FAP.

Adult↗
PubMed1991

[Electropharmacological test with class-I C drugs in paroxysmal supraventricular re-entrant tachycardia: is a negative result with a drug predictive of the ineffectiveness of other drugs of the same class?].

UNLABELLED: Propafenone and flecainide, both I C class drugs, are first choice in the treatment of paroxysmal supraventricular reciprocating tachycardia. The aim of this study was to check whether a negative or paradoxical electropharmacological test with one of the two drugs was predictive of an equally negative or paradoxical test with the other drug. Thirty patients with disabling paroxysmal supraventricular reciprocating tachycardia, 16 M, 14 F, mean age 30.6 +/- 16 years, were studied with serial electropharmacological tests using esophageal approach. The reentry circuit was sustained by an anomalous pathway in 25 patients (83.5%) whereas it was idionodal in the other 5 (16.5%). Propafenone was tested in 13 patients (43.5%, group A) after flecainide had resulted negative or paradoxical in the first test. In 17 patients (56.5%, group B) flecainide was tested after propafenone had resulted negative or paradoxical. The second drug tested was also ineffective in 14 of the 30 patients (group A + group B) while it had positive results in 16 patients. Specifically, propafenone was positive in 6 of the 13 patients (group A) in whom flecainide had been negative, and flecainide was positive in 10 of the 17 patients (group B) with acute negative or paradoxical propafenone test. These "acute" results were confirmed in steady-state with esophageal study and in the follow-up (21.9 +/- 9.3 months). CONCLUSIONS: 53.5% of the patients who are "non responders" to the electropharmacological test with one of the two drugs (propafenone or flecainide) may be "responders" to the other drug. Thus the ineffectiveness of one of the two drugs is not predictive of ineffectiveness of the other.

Adolescent↗
PubMed1990

[Transesophageal electric atrial stimulation as an electro- pharmacological method of treatment of supraventricular tachycardia].

From 1985 to 1988 the authors performed 299 procedures of transesophageal atrial pacing in 162 patients with hyperkinetic supraventricular arrhythmias. The pacing abolition of atrial flutter had been mainly applied with an invasive technique. The employment of transesophageal atrial pacing received its large development, but simplified this, the probability of abolishing supraventricular tachycardia becoming lower.

Adult↗
PubMed1990

[Stable ventricular tachycardia in arrhythmogenic dysplasia of the right ventricle in sportsmen].

Right ventricular arrhythmogenic dysplasia (RVAD) is a typical asymptomatic arrhythmogenic cardiopathy in athletes, which is occasionally concurrent with normal ventricular function and life-threatening arrhythmias. A total of 32 athletes (28 males and 4 females, mean age, 23 years, mean follow-up, 6.7 years) were examined for severe cardiac arrhythmias with left bundle branch block. The conclusive diagnosis of RVAD was established from clinical, echocardio-, and angiographic evidence. The protocol of the examination involved Holter monitoring, loading tests, electrophysiological study, two-dimensional echocardiography, cardiac angiography of the right and left ventricles, coronary angiography. The most severe arrhythmias were observed in athletes whose mean age was 23.4 years, 20 patients had sustained ventricular tachycardia (it occurred only in 19 who were indulging in sports), 6 presented with transient ventricular tachycardia, and 1 had ventricular fibrillation. They all had been considered fit for sports. The disease proceeded severely in 16 of 32 athletes (in 13 of 16 while indulging in sports), the conditions close to syncope were seen in 9 patients (8 had sustained ventricular tachycardias and 1 had transient ventricular tachycardias), syncopes were observed in 5 patients (sustained ventricular tachycardias).

Adult↗
PubMed1990

[Microbiological study of urethritis in men].

From 1985 to 1987 we obtained urethral samples from 453 patients with a clinical diagnosis of urethritis. N gonorrhoeae was isolated in 55%, a rate that increased along the study period. The most common other agent was U urealyticum alone or in combination with other organisms. Among 82 patients, the incidence of chlamydia trachomatis was 19%. The proportion of Beta-lactamase producing strains among N gonorrhoeae varied form 7% in 1985 to 13% in 87 and 3% in 1988.

Adolescent↗
PubMed1990

Electropharmacological test with pentisomide (CM 7857) in patients with sustained ventricular tachycardia.

Pentisomide (CM 7857) is a new class I antiarrhythmic drug whose effect on sustained ventricular tachycardia has only been slightly investigated to date. The aim of this paper is to examine the pentisomide action on selected patients with ventricular tachycardia inducible during intracavitary electrophysiological study. Thus, 12 patients (9 M, 3 F, mean age: 45.2 years, range: 24-78), all but two with detectable heart disease, underwent electropharmacological tests with pentisomide after they had resulted "non responders" (8 patients) or had had a proarrhythmic worsening effect (3 patients) to electropharmacological tests with amiodarone or flecainide or propafenone or mexiletine. After the inducibility and the reproducibility of ventricular tachycardia has been assessed in the basal state, all patients underwent several attempts to reinduce ventricular tachycardia, during the i.v. infusion of pentisomide 1.5 mg/kg/5 min followed by continuous infusion of 1 mg/kg/h, at the same time drug plasma level was assessed. Ventricular tachycardia inducibility was still inducible after pentisomide, but with a longer cycle length (446 +/- 88 versus 337 +/- 82 msec) than in the basal state (p less than 0.0025). No patients had proarrhythmic worsening effects. The pentisomide plasma level (available in 5 patients) ranged from 3.4 to 22.3 (mean 8.9 micrograms/ml). Four patients underwent chronic oral treatment (in 1 pt in association with amiodarone) with a good clinical outcome (mean follow-up 6.25 months, range 1-12). We stress the absence of proarrhythmic worsening effects and the powerful effect of the drug on ventricular tachycardia cycle length.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1989

Transesophageal atrial pacing: a first-choice technique in atrial flutter therapy.

Here we report on a study of 181 episodes of spontaneous atrial flutter (AF) (mean atrial cycle length 250 +/- 32 msec) treated by transesophageal atrial pacing (TAP) in 138 patients (92 men and 46 women; mean age 59.5 +/- 12.6 years). TAP was effective in 163 episodes (90%); sinus rhythm resumption was immediate in 36 (19.9%) and followed a short period of atrial fibrillation in 64 (35.3%); in 63 episodes (34.8%) a stable atrial fibrillation was obtained. TAP was unsuccessful in 18 cases (10%). All the patients tolerated the procedure well. A statistical elaboration with the Fisher exact test did not evidence a correlation between efficacy and age, sex, atrial cycle length, or underlying heart disease but showed a significant correlation between efficacy and AF duration of less than 1 day (p less than 0.05) and absence of antiarrhythmic pharmacologic pretreatment (p less than 0.01). These data strongly support the immediate first-choice use of TAP in AF therapy.

Adult↗
PubMed1989

Arrhythmia patterns in athletes with arrhythmogenic right ventricular dysplasia.

Arrhythmogenic right ventricular dysplasia (ARVD) is a typical 'silent' arrhythmogenic cardiomyopathy in athletes, with the possibility of normal ventricular performance and life-threatening arrhythmias. We studied 32 athletes (28 M, 4 F), mean age 23 years, follow-up 6.7 years, all previously declared fit for sports activity. They were studied for significant ventricular arrhythmias with LBBB with a final diagnosis of ARVD based on accepted clinical, echocardiographic and angiographic criteria. The study protocol included Holter monitoring (HM), stress test (ST), electrophysiological endocavitary study (EES), 2D echocardiography, RV and LV cardioangiography and coronarography. The most serious arrhythmia appeared at a mean age of 23.4 years, 20 had clinical sustained ventricular tachycardia (VT) (19/20, 95% during sports activity), six non-sustained VT and one ventricular fibrillation (VF). Severe symptoms occurred in 16/32 athletes (50%) during sports activity in 13/16 (81%): presyncope in nine (non-sustained VT in one, sustained VT in eight); syncope in five (sustained VT); aborted sudden death (SD) in one, SD (follow-up) in one. The reproducibility (HM, ST, EES) of clinically severe arrhythmic manifestations which occurred during sports activity was not high. In fact, during sport many factors are at work which may activate several arrhythmogenic mechanisms not easily reproducible in the laboratory. We conclude that a cardioarrhythmological study is mandatory in suspected right ventricular arrhythmias, including morphological study of the RV, to avoid arrhythmic risk during athletic activity.

Adult↗
PubMed1989

[Arrhythmogenic implications of non-iatrogenic thyroid dysfunction].

We studied all patients with hyperkinetic and hypokinetic arrhythmias, who were recovered in the Cardiology Department and Arrhythmologic Centre of S. Chiara Hospital in Trento between 1983 and 1987. From these we selected all the patients who, on admission, had clinical and biochemical symptoms of dysthyroidism. Of the 2465 patients with cardiac arrhythmias, 93 (3.8%) had an evident thyroid pathology which was due to chronic amiodarone treatment in 42 (44.6%) and was primary and non-iatrogenic in 51 (55.4%). In the latter the thyroid pathology consisted of hyperthyroidism in 43 cases (toxic nodular goitre or Graves' disease), and of hypothyroidism in 8. As regard the types of arrhythmias, hyperthyroidism is predominant in patients with atrial fibrillation (70%) and in those with paroxysmal supra-ventricular reciprocating tachycardia (11.5%), but it is also present in patients with hyperkinetic ventricular arrhythmias (14%). Hypothyroidism is found in patients with hyperkinetic ventricular arrhythmias (25%), atrial fibrillation (37.5%) and atrio-ventricular block (37.5%). The average age of the hyperthyroid population with atrial fibrillation is higher than that of patients with paroxysmal supraventricular reciprocating tachycardia. The control of the thyroid pattern, especially as regards atrial fibrillation and paroxysmal supraventricular reciprocating tachycardia results in absence of arrhythmic episodes even without treatment in 40% of cases, and in an easier drug control in the other cases. Our study indicates that it is necessary to carry out systematic research of a thyroid dysfunction in all patients with cardiac arrhythmias, especially as regards women, atrial fibrillation and paroxysmal supraventricular reciprocating tachycardia. It is also evident that in order to achieve long-term control over hyperkinetic arrhythmia it is very important to overcome hyperthyroidism.

Adolescent↗