Biomedical subjects

L Giec

Publications and source records attributed to L Giec.

At least 37 records · Page 2Linked to original sources

PubMed1990

[Complex ventricular arrhythmias in ischemic heart disease].

The purpose of the study was to describe the clinical picture in patients with ischemic heart disease (IHD) and verifying severity of ventricular arrhythmias. The study included 856 patients with IHD aged 23-88 years (mean = 55.3), including 659 men and 197 women. Holter monitoring was performed in all patients. Ventricular arrhythmias were graded according to Lown. The patients were divided into five groups: group 1-349 patients with Lown's grade 1 and 2; group 2-95 patients with grade 3; group 3-152 patients with grade 4a and 4b; group 4-11 patients with grade 5; group 5-507 patients (selected from groups 2, 3 and 4) with Lown's grade 3 and 4 or 5. Arterial hypertension was found in 17.1%, myocardial infraction in 66%, and syncope in 12.3% of the patients. The patients with complex ventricular arrhythmias versus Lown's grade 1 and 2 show significant differences especially in respect to: the frequency of previous anterior myocardial infraction, the incidence of pain at rest, loss consciousness, the frequency of ventricular tachycardia and fibrillation, anginal pain and exercise-related arrhythmias. The patients with Lown's ventricular arrhythmia grade 3-5 do not differ significantly in their clinical manifestations of IHD from the patients with ventricular arrhythmias grade from 3 to 5. The development of silent myocardial ischemia during exercise stress testing is typical also for the patients with complex ventricular arrhythmias. A decreased contractility index, ejection fraction and dyskinesis are significantly more frequent in the patients with complex ventricular arrhythmias.

Adult↗

PubMed1990

[Late ventricular potentials and ventricular arrhythmia in patients with stable ischemic heart disease].

Ischaemic heart disease especially after previous myocardial infarction can predispose to the life-threatening ventricular arrhythmias. Late potentials (LP) are confirmed parameters predicting patients prone to sudden cardiac death in ventricular arrhythmias mechanism. Late potentials registered noninvasively from the body surface were analysed in 86 patients with stable ischaemic heart disease (67 males and 19 females aged 35-67, mean 53 years). Registration of signal average electrocardiograms (SA-ECG) were performed by Simson technic (X, Y, Z orthogonal leads) using identical analysing systems and quantitative SA-ECG criteria in all three participating centers. In all patients ventricular arrhythmias detected on 24-hour ecg Holter monitoring were assessed. The localisation of previous myocardial infarction and echocardiographic assessment of left ventricular function were also analysed in each case. The results of SA-ECG were correlated with these clinical findings. Late potentials were detected (according to two or three accepted criteria) in 16 pts (19%), in 53 pts (61%) SA-ECG were normal but in other 17 pts (20%) abnormal SA-ECG (according to only one criterium) were registered. Out of these 17 pts with abnormal SA-ECG, 14 pts had prolonged filtered QRS duration as the only incorrect SA-ECG parameter. Comparative analysis between studied groups shows higher incidence of previous Q-wave myocardial infarctions in patients with LP and with abnormal SA-ECG than in patients with normal SA-ECG (63% and 71% vs 43% respectively; p less than 0.01). Ventricular arrhythmias observed in studied patients occurred with similar frequency in all groups however in patients with LP and with abnormal SA-ECG complex ventricular arrhythmias were more common than in group with normal SA-ECG (56% and 53% vs 49% respectively: NS).(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗

PubMed1990

[Comparative evaluation of the results of Holter monitoring and programmed ventricular stimulation in patients with ischemic heart disease].

24-hour ECG Holter monitoring and programmed ventricular stimulation were performed in 81 patients (64 males and 17 females aged 35-65). No ++anti-arrhythythmic agents nor beta-blockers were administrated. 58 patients suffered from myocardial infarction in the past, and 38 had a history of ventricular tachycardia. Right atrial and ventricular stimulation (in 7 patients also left ventricular stimulation) was performed using stimuli of a 2 ms pulse width. 24-hour ECG Holter monitoring was recorded on a magnetic tape from two bipolar precordial leads. Both examinations results were compared to assess correlation between ECG Holter monitoring parameters and inducibility of VT or VF by programmed stimulation. Significant correlation was stated among occurrence of: 1) spontaneous sustained ventricular tachycardia and induced by stimulation monomorphic sustained VT (p less than 0.005) as well as estimated both sustained and nonsustained VT (p less than 0.010) 2) spontaneous nonsustained VT and induced by stimulation sustained or nonsustained monomorphic VT (p less than 0.025). There was no correlation between spontaneous ventricular arrhythmias estimated by Lown and Wolf's classification and possibility to induce monomorphic VT as well as between any of ECG Holter monitoring parameters and polymorphic VT or ventricular fibrillation induced by stimulation. Aggressiveness extent of stimulation protocol necessary to induce monomorphic VT was similar in patients with or without VT recorded by Holter method.

Adult↗

PubMed1990

[Atrio-ventricular conduction in patients with permanent right-ventricular stimulation. I. Possibilities of evaluation by the method of trans-esophageal electrocardiogram].

UNLABELLED: We analyzed 214 patients with permanent, VVI mode stimulation divided in 5 groups. Group I 89 patients (pts) with sick sinus syndrome (sss) (mean age 60 +/- 14 yrs), group II 21 pts with sss and atrioventricular (a-v) conduction disturbances (mean age 54 +/- 19 yrs), group III 72 pts with a-v block, but without intraventricular conduction disturbances (mean age 68 +/- 11 yrs), group IV 20 pts with a-v block and registered bundle branch block (mean age 67 +/- 7) and group V 12 pts after His bundle ablation (mean age 51 +/- 20 yrs). In all pts we recorded leads I, II, III, V1, V6 and oesophageal (oe) on Mingophon 7 (Siemens-Elema) with paper speed 50 mm/s. All recordings were performed during basic and magnetic rate of the pulse generator. We could analyzed ventriculo-atrial (v-a) conduction in group I-IV respectively in 89.9%, 95.3%, 84.7%, 100%, 83.3% and in all population in 89.2% cases. In 23 pts (10.8%) we could not analyzed v-a conduction due to atrial flutter or fibrillation. V-a conduction was present in groups I-IV in 61.2%, 35%, 21.4%, 45% and 10% cases respectively. CONCLUSIONS: 1. In group patients with sick sinus syndrome and VVI stimulation ventriculo-atrial conduction was recorded in most cases. 2. Ventriculo-atrial conduction was recorded in part of the population with atrio-ventricular block. 3. Frequency of ventriculo-atrial conduction phenomenon is dependent on degree of a-v block. 4. Transesophageal recording of ventriculo-atrial conduction phenomenon in patients with implantable VVI pacemaker is simple, noninvasive and useful method for clinical practice.

Adolescent↗

PubMed1990

[Atrio-ventricular conduction in patients with permanent right- ventricular stimulation. II. Atrio-ventricular conduction time in patients with normal and impaired atrio-ventricular conduction].

UNLABELLED: We analyzed transesophageal ECG recordings of 79 patients (42 men and women aged 17-85 mean 61 +/- 16 yrs) with present ventriculo-atrial conduction phenomenon during permanent VVI stimulation. All measurements we performed on basic and magnetic rate of the pulse generator. V-a conduction time was defined as mean (from 5 measurements) time from spike of the pulse generator to the first deflection of P wave recorded from esophagus and expressed in miliseconds. We compared v-a conduction time (v-act) on basic and magnetic rates of a stimulator and between groups with normal (group A, 49 pts) and prolonged a-v conduction time (group B, 30 pts). Group B was divided on group B-1 (19 pts without bundle branch blocks) and B-2 (11 pts with bundle branch blocks during observations). V-act during magnetic rate (cycle 596 +/- 70 ms) was significantly longer than during basic rate (cycle 834 +/- 66 ms) (191 +/- 48 ms vs 185 +/- 44 ms, p 0.05). V-act in patients with a-v block (group B) was significantly longer than in patients with normal a-v conduction (group B) (219 +/- 45 ms vs 190 +/- 47 ms, p 0.02). The longest v-act was observed in group B-2 (236 +/- 32 ms). CONCLUSIONS: 1. Ventriculo-atrial conduction time could be measured in patients with permanent VVI stimulation using esophageal ECG recording. 2. Shortening of the stimulation cycle prolonges ventriculo-atrial conduction time. 3. Ventriculo-atrial conduction time is longest in group with atrio-ventricular conduction disturbances, especially in group with registered bundle branch block.

Adolescent↗

PubMed1989

[Effect of selective and non-selective adrenergic beta receptor blockaders on selected electrophysiologic properties of the human heart].

Beta-2 adrenergic receptors were found in a human heart and their role in regulation of inotropic properties during last year was proved. The aim of our study was comparison of effects of selective (metoprolol) and nonselective (propranolol) beta-receptors blockade on cardiac electrophysiological properties. The study was carried out in 20 patients in the majority without organic heart injury and clinical symptoms of the sinus node dysfunction as well as atroioventricular conduction disorders. Method of the transoesophageal left atrial stimulation was utilized. Examinations were performed after drugs administrations in the same persons, during following days. Propranolol and metoprolol were intravenously administrated in a dose of 0.2 mg/kg b.w. Both drugs statistically significant lengthened sinus rhythm cycle time, sinus node recovery time, sinus node and a-v node effective refraction and lowered Wenckebach's point. They did not significantly effect on sinoatrial conduction and the atrial effective refraction. There were no significant differences between examined beta-blockers. Obtained results allowed us to conclude that: 1) eletrophysiologic properties of propranolol and metoprolol are similar, 2) it seems that in physiological conditions the effects of the adrenergic nervous system on electrophysiologic properties of sinus node, atrio-ventricular node and atrium is mainly realized by beta-1 adrenergic receptors.

Action Potentials↗

PubMed1989

[Our experience with transvenous ablation of the atrioventricular node].

In 7 patients conventional a-v nodal ablation was performed using electrical energy delivered from the cardioverter via a catheter-electrode positioned near His bundle area. In all patients indication for the ablation were rapid symptomatic supraventricular arrhythmias refractory to previous pharmacological treatment. During the ablation 1-2 discharges of 200-300 J energy were used, repeating the procedure in 2 patients after 24 hours. In all patients the complete a-v block was obtained and the injury of the postero-septal accessory pathway in 3 subjects. Patients were pacemaker dependent without recurrences of supraventricular arrhythmias with rapid ventricular response. Except mild and local myocardial lesion expressed by transient increase of indicatory enzymes we did not observed any other complications directly related to the ablation procedure. Our modest experience in application of conventional a-v nodal ablation proves that this procedure could and should be used in selected patients at the medical centers having the appropriate equipment and experience in clinical electrophysiology.

Adult↗

PubMed1988

Predictive value of various types of ventricular response to programmed ventricular stimulation: relation to Holter monitoring.

UNLABELLED: The study was performed to determine the predictive value of programmed stimulation for identification of pts with ventricular arrhythmias: 75 patients were studied by means of 24-hour ambulatory ECG (24 ECG) and programmed right (in some patients also left) ventricle stimulation at sinus and two or three pacing rates using two (standard) and three extrastimuli or burst stimulation (extensive protocol). Lown classes 0, 1-3 and 4a-4b were observed in 24 ECG in 35, 14, and 26 patients, respectively. In programmed stimulation 1-6 repetitive ventricular responses (RVR) were found in 56 pts, nonsustained ventricular tachycardia in 11 and sustained ventricular tachycardia in 21 pts. High incidence of induced VT was found in pts with complex ventricular arrhythmia in 24 ECG, 81% of this group, in all but six pts only standard protocol was used. The 1-6 RVR were observed in almost 40% of pts without any arrhythmia. CONCLUSION: Only VT induction is a useful index for high risk patients.

Arrhythmias, Cardiac↗

PubMed1988