Biomedical subjects

J Vedel

Publications and source records attributed to J Vedel.

36 records · Page 2Linked to original sources

PubMed1977

[Current indications of coronary arteriography in coronary artery disease (with the exception of acute myocardial infarction) (author's transl)].

The indications of coronary arteriography have multiplied in recent years. Therapeutic indications have followed knowledge of the good results of revascularisation surgery. Initially limited to severe stable angina improved little or not at all by major anti-angina agents, they have been extended, in the view of many, to include various types of unstable angina where, in addition to the symptomatic improvement obtained, an attempt is made to decrease the incidence of myocardial infarction and of long term mortality. Indications relative to determination of the extent of disease may be preventive: the fear of severe coronary lesions on the basis of effort test results, the fear of a second infarction immediately following a primary lesion, or as a virtually routine examination in young individuals in order to better assess the degree of disease and to guide treatment. Diagnostic indication should be rare.

Angina Pectoris, Variant↗

PubMed1976

[Atrioventricular conduction by a bundle of Kent discovered after a surgical A.V.B].

The case is reported of an 8 year old child who had a 1/1 atrio-ventricular conduction by the bundle of Kent after accidental surgical division of the bundle of His; this "accessory" pathway conducted satisfactorily over a period of 12 years. At the age of 20, the patient had a complete conduction block of the bundle of Kent, causing a complete atrio-ventricular block; this indicated the definitive insertion of a pacemaker.

Bundle of His↗

PubMed1976

[Epicardial scintigraphy in 4 cases of ventricular tachycardia caused by reentry of blood after myocardial infarct. Origin of the tachycardia and surgical approach].

110 point cartography was carried out over the ventricular pericardium during sinus rhythm (SR) and during ventricular tachycardia (VT) in four patients whose infarctions were 15 days, 4 months, 4 years and 7 years previously, and in whom electrocardiographic investigation had suggested a ventricular reentry phenomenon. The macroscopical appearances of the heart at operation suggested that the infarct was situated along the left side in two cases, and in or along the septum in two others. Cartography in sinus rhythm showed that the onset of ventricular activity was compatable with a site of origin in the node/bundle of His. Cartography during VT showed up the epicentre of the abnormal impulses which were always situated outside the exit points and dependent upon the node/bundle of His system as demonstrated by cartography in sinus rhythm. Moreover, in at least two cases this was found to lie outside the infarcted area, in portions of the myocardium which could be considered as healthy. In one case it was found to lie along the anterior interventricular groove, facing the septal infarct. In two cases the arrhythmia will not recur, one having achieved this status bu simple ventriculotomy. The failures are reported in relation to the extent of the lesion anatomically, which may cause disorientation of the surgical approach, and make the results difficult to interpret.

Aged↗

PubMed1976

[Epicardial scintigraphy in 4 cases of ventricular tachycardia caused by reentry of blood after myocardial infarct. Study of intra-ventricular conduction disorders in sinus rhythm and in tachycardia, and their relations to anatomical data].

Ventricular pericardial cartography in sinus rhythm (SR) and during ventricular tachycardia (VT) in four cases of myocardial infarction has yielded additional information in the study of conduction disorders in myocardial ischaemia: 1. The significant slowing of activity in SR as well as in VT is demonstrated by this direct method. It is associated with a diminution in amplitude of the pericardial potentials in the zones affected by the ischaemia; 2. Cartography during VT accentuates or reveals disorders of conduction which are slight or latent in SR; 3. Disorders of intra-ventricular conduction are found to be related either to segmental blocks on the branches of the bundle of His, or as focal blocks (peri-infarct block) on the left side, whose nature can be shown up even during VT; 4. Secondary activation of the myocardial fiber found to be related either to segmental blocks on the bundle of His during VT is demonstrated.

Arrhythmia, Sinus↗

PubMed1976

[Course and prognostic factors of unstable angina. Apropos of 100 cases].

The immediate and medium term (3 years) of unstable angors was specified by the study of 100 hospitalized patients. The cases selection was based on the existence of angina pain which had appeared or reappeared less than a month before, during more than fifteen minutes and/or repeated, which were more and more frequent, less and less sensitive to nitroglycerine, and in the absence of recent myocardial infarction signs. The immediate course seemed relatively favorable; during the initial hospitalisation there were only nine myocardial infarctions and three deaths. The alarming factors of initial prognosis are essentially the persistence or recurrence under medical treatment of angina pain hardly relieved by nitroglycerine. The course over three years was bad; 23.6% of deaths, especially of cardiac origin (14/17) were noted; more than 80% or the surviving patients kept enduring more or less severe pains; persistence of electric signs on the ECG during the initial course was the only significant pronostic factor that was regularly noted. As regards the 16 patients treated by surgery, operative death rate remained high (3/16), but remote functional results were good (8/12 asymptomatic). Only randomized studies on homogenous groups, carried out during an enough long course, will enable us to specify therapeutic indications better.

Adult↗

PubMed1975

[Recording of conduction tissue potentials in intraventricular conduction disorders. (apropos of 147 patients)].

147 patients, 31 controls and 116 patients with intraventricular conduction disturbances, have been submitted to an endocardial investigation: HR lengthening in case of bundle-branch block indicates a low diffusion of the conduction disturbances and has a pejorative signification. The most important legthenings of this interval have been observed in the cases with delay in the common trunk of His bundle: -- In case of trunkular delay, 66% of the patients have a HR interval longer than 80 msec, and the average value of HR is 82 msec. -- In the absence of obvious trunkular delay, 8% of the patients only have a HR interval longer than 80 msec, with an average value of 67 msec. For these latter patients no branch potential was recorded. -- In some cases one is certain of the presence of a conduction disturbance of both branches and the HR value then never exceeded 60 msec. -- Branch potential recording makes it possible to determine the site of the conduction disturbance of the branch and show mild variations of the HR interval and of both components.

Action Potentials↗

PubMed1974