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Biomedical subjects

H B Burchell

Publications and source records attributed to H B Burchell.

At least 37 records · Page 2Linked to original sources
PubMed1984

Recordings of basal ventricular preexcitation from electrode catheters in patients with accessory atrioventricular connections.

To determine the effects of ventricular preexcitation via accessory atrioventricular connections (ACs) on the sequence of basal ventricular activation, electrophysiologic study records of 22 patients with AC were reviewed. In each, AC site was confirmed by mapping done at operation. Local ventricular preexcitation (VP), defined as earlier timing of a local ventricular electrogram relative to the surface electrocardiographic QRS onset in preexcited compared with in normal QRS complexes, was assessed at the coronary sinus and at the ventricular septal summit recorded from the His bundle site. Five patients with concealed AC did not have VP. VP patterns with manifest AC were similar during average fusion QRS complexes and maximum ventricular preexcitation. Left free wall and left crux AC produced VP apparent on the ventricular electrogram recorded at the coronary sinus alone. With anteroseptal AC, VP was noted only at the ventricular septal summit. Posteroseptal AC produced VP that was apparent on the ventricular electrogram recorded at the coronary sinus and on the electrogram of the ventricular septal summit. Right free wall AC preexcited neither of these basal ventricular regions. The observation of VP patterns may help in localizing AC and may be particularly useful in patients without retrograde AC function at electrophysiologic study.

Adolescent↗
PubMed1983

Digitalis poisoning: historical and forensic aspects.

Since the introduction of digitalis into therapy approximately 200 years ago, there have been continuing admonitions concerning its toxicity. Over 400 years ago, herbalists listed the plant as being poisonous. In fiction, the homicidal use of digitalis has appeared in the writings of Mary Webb, Dorothy Sayers and Agatha Christie. Ten instances in real life of alleged homicide by digitalis and trials of the accused are listed. The drug has been used with suicidal intent rather infrequently, compared with other medications. Possibly, it is more commonly used for such a purpose in France than in England or the United States. The fraudulent use of digitalis in the support of claims for disability because of heart disease has occurred, and one large conspiracy of physicians and lawyers in the swindle of insurance companies during the 1930s is a shameful episode in the record of these professions. Although innocent, one professor of medicine who was involved committed suicide. Two pharmaceutical (manufacturing) blunders that occurred in Belgium and Holland with mislabeling are mentioned. These resulted in numerous deaths and the profession seemed rather slow to recognize the nature of these small epidemics of poisoning. Instances of psychiatric illness with digitalis seem well documented. The story of digitalis toxicity continues into the present and physicians should be vigilant regarding the drug's potential for poisoning that can result from prescribing digitalis with ignorance of proper dosage, pharmacodynamics or drug interactions, as well as from accidental overdose as in children and use with self-destructive or homicidal intent.

Cardiology↗
PubMed1980

In support of Kent.

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Atrioventricular Node↗
PubMed1979

Ebstein's disease.

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Ebstein Anomaly↗
PubMed1979

The interpretation of gross left axis deviation in the electrocardiogram.

In 94 patients with prominent left axis deviation, there was a marked disparity in the mean angles determined by the maximum magnitude of the deflections and that determined by areas. There was also considerable variation in the angle of the maximum vector in the frontal plane (frontal plane angle) and the angle of 50 msec vector in the frontal plane. Similar results were observed in 17 cases of ostium primum atrial septal defect. These differences contrasted with the findings in a normal group of 50 subjects where a close correlation was found. The initial vector was directed to the right in approximately 80% of normals and 60% of the patients with LAD indicative of conduction defects in the left anterior fascicular or its distal ramifications. We conclude that a rightward orientation of the 5--10 msec vector (i.e. causing a Q wave in lead 1) should not be required for diagnosis of left anterior fascicular block. The spatial orientation of the initial vector was always anterior in the control subjects. In these 'normals', as well as in the patients with left axis deviation, the initial vector varied markedly in its azimuth direction (right or left) when superiorly directed; but when inferiorly directed in the normal subjects it was virtually always directed rightward. From these data we were unable to construct rigid criteria which would reliably distinguish aberrant excitation patterns manifested by gross left axis deviation in the electrocardiograms of patients with established heart disease from subjects without defined heart disease. Old infarction patterns, anterior, inferior, and lateral were not obscured by the associated anterior fascicular block.

Adolescent↗
PubMed1978

Harvey's legacy.

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Blood Circulation↗
PubMed1977

Electrocution: an ever-present hazard.

Hospitals have become safer from electric shock accidents, but physicians who delegate to the electronics experts full responsibility in this regard will be shirking an obligation. Every physician should be involved both in programs to prevent these accidents in medical settings and in efforts to educate the public concerning the risk of electrocution in and around the home.

Accidents, Home↗
PubMed1976

A test experience with a machine-processed electrocardiography diagnosis: the recognition of "normal" and some specific patterns.

Five hundred ECG's, machine processed by the commercially available IBM Bonner-Mt. Sinai System, have been reviewed. The diagnostic printouts were of value as an adjunct to the physician's interpretations, but were not sufficiently reliable--in regard to either sensitivity (identification of the abnormal or borderline) or specificity (accuracy in predicting typical abnormalities)--to allow us to condone any claim for it being an independent reliable diagnostic service to noncardiologist clinicians. Despite this desclaimer for current diagnostic reliability of ECG computer analyses, specifically the IBM-Bonner system, we continue to be of the firm conviction that progress through this method of ECG analysis will have much to contribute in future years.

Atrial Fibrillation↗
PubMed1976

Effect of nitroglycerin with and without systemic hypotension on canine regional myocardial tritiated water deposition.

A marked alteration in the transmural distribution of left ventricular blood flow, with a relative increase in subendocardial and mid-wall flows, but with no change in the distribution of the relative blood flow to the two ventricles occurred when nitroglycerin was administered and the systemic arterial blood pressure in the upper body maintained near control levels in anaesthetized, open-chested dogs. The relative increase in subendocardial and mid-wall flows may have resulted from a direct action of nitroglycerin on the coronary vasculature. On the other hand, the intravenous administration of nitroglycerin, when followed by the hypotension which it produces, did not alter the transmural distribution of blood flow in the left ventricle of the dog. Blood flow to the right ventricle relative to flow to the left ventricle increased in this situation.

Animals↗