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Biomedical subjects

I Maté

Publications and source records attributed to I Maté.

29 records · Page 2Linked to original sources
PubMed1978

Anterograde and retrograde bradycardiac block in the His-Purkinje system. Finding in a patient with acute myocardial infarction.

A patient with an acute inferior myocardial infarction developed a complete atrioventricular block and intermitent periods of atrioventricular conduction with QRS complexes showing right bundle branch block associated with left anterior hemiblock. Recordings of the His bundle electrogram showed that the atrioventricular block was infrahisian and that in periods of resumed atrioventricular conduction, the His-ventricle (H-V) interval was long. Ventricular escape beats showed concealed conduction to the atrioventricular node. Anterograde atrioventricular conduction was always resumed through the left posterior division when the preceding division when the preceding intervals between ventricular escape beats and the atrium (V-A intervals) were shorter than 580 msec. The same phenomenon occurred with right ventricular pacing. A retrograde His potential could be observed. Retrograde conduction of ventricular escape beats and ventricular paced beats was blocked if the H-V interval and the interval between the His bundle and the ventricular paced beat (H-V interval) were long (more than 600 msec and 550 msec, respectively). The existence of an intermittent anterograde and retrograde bradycardiac infrahisian block was inferred from the previously mentioned data; a fixed retrograde atrial nodal block was also present.

Acute Disease↗
PubMed1978

Fascicular block within the His bundle.

The findings in a patient with complete atrioventricular block and normal morphology and duration of the QRS complex are presented. A His bundle electrogram was obtained, which led to the location of the atrioventricular block within the His bundle. A careful review of the electrocardiograms obtained during the seven years preceding the onset of complete atrioventricular block showed a QRS complex with the features of left anterior hemiblock and a progressive impairment of atrioventricular conduction. From these data, we inferred that the different degrees of atrioventricular block and the left anterior hemiblock were caused by lesions within the His bundle involving the fibers destined for the left anterior division of the left branch. After the onset of complete atrioventricular block, with the subsidiary pacemaker located in the His bundle distal to the lesions, the QRS complex became normal, indicating the integrity of the bundle branches and fasciculi. The atrial and proximal His potential intervals and those between distal His and ventricular potentials were normal.

Bundle of His↗
PubMed1978

Myocardial involvement in systemic lupus erythematosus. A noninvasive study of left ventricular function.

A relatively high incidence of heart failure is noted among patients with systemic lupus erythematosus (SLE) without clearly defined clinical causes. To evaluate left ventricular performance in patients with SLE without evidence of cardiovascular disease, noninvasive measurement of the systolic time intervals was carried out. Simultaneous recording of the electrocardiogram, phonocardiogram and carotid arterial pulsation were obtained in 25 patients with systemic lupus erythematosus and compared with 22 normal subjects. The patients with SLE had a shorter left ventricular ejection time (P less than 0.05), a longer pre-ejection period (P less than 0.02) and an increased ratio of pre-ejection period/left ventricular ejection time (P less than 0.005). These abnormalities on ventricular function were independent of age, duration of the disease, hypertension, renal involvement, anemia, immunologic activity and corticosteroid treatment. Several etiologic possibilities are discussed and the clinical usefulness of this method to detect and follow-up the cardiac dysfunction in systemic lupus erythematosus is emphasized.

Adolescent↗
PubMed1977

Bradycardia-dependent interatrial block with retrograde left atrial activation.

A patient with a peculiar interatrial block is reported. The electrocardiogram showed a short PR interval and negative P waves in II, III, and aVF, which were preceded, 0-07 s earlier, by another positive P wave present in the right praecordial leads which were absent in the limb leads. From the study with His bundle electrograms, high right atrial electrograms, and bipolar oesophageal electrocardiograms, it could be proved that atrioventricular, His-Purkinje, and right intra-atrial conduction were normal, and that P waves recorded in limb leads represented left atrial depolarization; whereas the ones in the right praecordial leads corresponded to right atrial activation. The vectorial analysis from both P waves and atrial potentials showed that the left atrium was activated in a retrograde fashion, because of an interatrial block. This block was bradycardia dependent and it disappeared in the cycles shorter than 800 ms.

Aged↗
PubMed1975

Vectocardiography in tetralogy of Fallot before and after operation (palliative and corrective surgery).

Vectorcardiograms from 55 patients with diagnosed tetralogy of Fallot were studied and divided into the following three groups: A, 35 nonoperated cases; B, 23 with systemic-pulmonary shunt (nine studied preoperatively and also in A); and C, ten after total correction. In group A, two different types of QRS loop occurred in the horizontal plane (HP); 23 clinically and hemodynamically severe cases had right anterior position with clockwise (C) rotation, and 12 less severe cases had right posterior position with counterclockwise (CC) rotation or figure-8 morphology. In the frontal plane the QRS loop was located inferiorly and to the right, with C rotation (80 percent); two cases had the left anterior hemiblock (LAHB) pattern, and another two severe cases had CC rotation and right superior position. Group B had an evident increase of left ventricular forces in the HP, compared with group A; group-B rotation was preferentially CC or figure-8 morphology. Group C had a pattern of right bundle-branch block in nine cases (classic in one and uncharacteristic in eight); four cases also had LAHB.

Adolescent↗
PubMedDate not supplied

[Lipomatous hypertrophy of the interauricular septum, fibrosis of the bundle of His and calcification of the mitral annulus associated with multiple rhythm and conduction disorders. The anatomicoclinical correlations].

We present the case of a 72 years old female with multiple episodes of atrial fibrillation, interatrial block and different degrees of atrioventricular block, that died because of stroke. Postmortem pathologic examination showed a lipomatous hypertrophy of the interatrial septum (previously suspected on echocardiogram), his bundle and right branch degeneration as well as mitral annular calcification extended to conduction system. According to these pathologic findings, rhythm and conduction disturbances are correlated with the two levels (atrial and atrioventricular) where anatomic abnormalities were found.

Aged↗
PubMedDate not supplied

[Massive thrombosis of the left atrium. Surgical experience with a series of 117 patients].

From 1975 to 1988 we have operated 117 patients with left arterial thrombosis associated with rheumatic mitral valve disease. Seventy-seven were female and 40 male, with ages ranging from 22 to 69 years. In 75 cases (64.1%) the valvular lesion was mitral stenosis. Embolic antecedents were present in 38 cases (32.4%) and 95 patients (81.1%) were in class III or IV of the NYHA functional classification. In 48 cases we performed a mitral commissurotomy and in 51 cases mitral valve replacement, associated to left artrial thrombectomy. In the remaining 18 patients we made other valve procedures. The hospital mortality was 15 cases (12.8%), eight because low cardiac output, four because severe brain injury and three because posterior atrioventricular sulcus disruption. In 41.1% of the survivors there was serious hospital complications, standing out the incidence of 8 cases of transient neurologic accidents. We have followed 98 of the 102 hospital survivors between 10 and 140 months (mean 57 months). Three patients died in the follow-up, two of them during a reintervention because bioprosthesis disfunction and the third one during a reintervention because prosthetic infective endocarditis. Nine additional patients were reoperated because recidivant valvular lesions or because prosthetic disfunction, and two patients suffered embolic events during the follow-up. The antithrombotic therapy was abandoned in 19.6% of patients. At present 73.6% are in functional class I and 26.3% in class II. The association of left atrial thrombosis with with mitral valve disease induce a surgical morbimortality greater than usual for isolated valvular lesions, being mandatory a watchfull surgical technic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMedDate not supplied

[Percutaneous transluminal angioplasty in aortic coarctation in young adults].

The results of percutaneous balloon angioplasty in 9 cases of adult aortic coarctation are described. One case was associated with bicuspid aortic valve and another with organic aortic stenosis. Two of them were female, and the rest were male. The mean age range between 15-26 years (19 +/- 4.2). Pressure gradients fell from 59 +/- 13 mmHg to 15 +/- 11 mmHg postdilatation (p less than 0.0001), and the internal lumen diameters increase from 5 +/- 3 mm up to 13 +/- 2 mm (p less than 0.0001). In one case an intimal dissection appears as complication. At consequence of these results, the percutaneous balloon angioplasty seems to be a good therapeutic procedure in the adult aortic coarctation.

Adolescent↗