Search PubMed⌕ Search

Biomedical subjects

J J Welti

Publications and source records attributed to J J Welti.

17 recordsLinked to original sources
PubMed1978

Pacemaker surveillance "à la francaise": an attempt to detect faulty series of permanent pacemakers at an early stage.

Until the present, implantable pacemakers have not been subject to government regulation in France, as it had been feared that unreasonable controls would interfere with the development of this new form of therapy. Physicians were left to choose what seemed the most reliable device, and patients benefitted immediately from every manufacturing and technological advance. Despite advantages, the absence of restriction and regulation had a serious drawback--there was no governmental agency to ensure that manufacturers would inform physicians of an unreliable pacemaker, and once a manufacturer recognized a problem, it could inform the physician at the most commercially opportune time rather than the earliest, safest time for the patient. For this reason, several physicians decided to share their experiences with pacemaker function. The number gradually increased until they were able to set up a system of pacemaker suveillance and reporting which has had the capability of detecting defective pacemaker models at an early date. The center of this pacemaker group is at Hopital Fernand-Widal in Paris and is sponsored by the A.R.E.C. (Association de Recherche et d'Entraide Cardiologiques) and by the pacemaker group of the French Society of Cardiology.

France↗
PubMed1977

[Paroxysmal block in phase 4 of the bundle of His].

Five cases of chronic paroxysmal atrio-ventricular block are reported, being unusual in the siting of the conduction defect within the trunk of the bundle of His, and in the "paradoxical" mode of onset of the block. The ventriculograms which were carried out, and the escapes, were of normal duration in four cases and the intracavitary recordings showed a double His potential in all patients. In one case, the block during phase 4 seemed to occur at the height of the trunkal Wenkebach periods, and in another it could be brought on by manipulation of the vagus. In all five cases, a favorable conduction zone could be calculated, the block to the P waves in phase 4 occuring in an arithmetical fashion after a critical lengthening of the PR interval. The return to sinus rhythm was always related to an escape (or to an electrically induced ventricular complex), but the explanation of the initial capture on electrophysiological grounds is obscure.

Aged↗
PubMed1976

[Malfunctions of pacemakers].

No pacemaker is absolutely reliable : more or less threatening failures can be observed after implantation. Pacemaker runaway has completely disappeared. Sudden battery failure, intermittent or permanent, remains too frequent. Other incidents, less frequent or severe, are also reviewed. Failures are often isolated and sporadic, but can sometimes involve a complete manufacture series. It is a medical duty to follow-up carefully the patients and to announce the failures with a view to permit early recognition of imperfect series. Pacing failures do not play a major role in the mortality in the group of patients with permanently implanted pacemakers. Nevertheless, anticipated replacement of pacemakers increases the cost of the technique.

Arrhythmias, Cardiac↗
PubMed1976

[Action of injected disopyramide on ventricular arrhythmias and atrioventricular conduction].

The authors have studied the bathmotropic and dromotropic effects of intravenous injection of 100 mg of disopyramide, the therapeutic dose being 1 to 2 mg/kg. Out of the 28 severe arrhythmias studied, it was the ventricular extrasystoles which benefited most from treatment (79% completely successful, while there was a lesser degree of success in treating the ventricular tachycardias (35% completely successful, 30% partially successful). The negative dromotropic effect of injected disopyramide on sub-nodal conduction was studied by an endocavitary technique in 10 patients presenting with a spontaneous onset of disordered intracardiac conduction; the effects were moderate. With the exception of 4 cases who sustained complications involving rhythm and haemodynamics, the clinical and cardiovascular tolerance of patients to the drug appeared to be satisfactory.

Aged↗