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Biomedical subjects

L Molina

Publications and source records attributed to L Molina.

101 records · Page 6Linked to original sources
PubMedDate not supplied

[Amiodarone in the control of supraventricular tachyarrhythmias].

The clinical efficacy of amiodarone was observed in a group of 20 patients (9 women and 11 men) with a total 21 supraventricular tachyarrhythmias (16 paroxysms or premature supraventricular beats (PSB) and 5 with established arrhythmias), to whom amiodarone was given during one month: 800 mg/day the first week and 400 mg/day for 3 weeks. An electrocardiogram and a 24 hour Holter were taken before and after treatment. The results observed for paroxysmal arrhytmias and PSB were excellent in 94% and satisfactory in one patient. As for established arrhythmias the results were excellent or satisfactory in 80%. We conclude that ammiodarone is an effective drug with a wide security range in the treatment of supraventricular arrhythmias.

Adolescent↗
PubMedDate not supplied

[Topographic diagnosis of atrio-ventricular conduction defects].

Atrioventricular (A-V) conduction was evaluated in 51 patients who underwent electro-physiological study. Eighteen patients had nodal conduction delay (A-H greater than 150 ms), six of them were congenital, in two others it was associated to a His-Purkinje (H-V) delay. None of them had bundle branch block in the surface ECG. The conduction delay was located within the his bundle in 15 patients (29.4%). In three of them, a split His bundle electrogram was recorded; in the other 12 (80%), His bundle stimulation normalized QRS morphology; in all of these patients H-V interval was longer than 70 ms. His bundle delay was associated to infra H lesion in five patients. In one without ECG changes, atrial and His bundle stimulation demonstrated a left troncular delay with a distal block in the right bundle branch. Thirteen patients had infra His block represented by a long H-V interval (greater than 60 ms). We conclude that His bundle electrograms and stimulation is a low risk procedure very useful in the topographic diagnosis of A-V conduction disturbances.

Adolescent↗
PubMedDate not supplied

[Usefulness of electrophysiologic studies. Report of 224 cases].

Two hundred and twenty four electrophysiologic studies were performed in 194 patients during a two-year period. One hundred and six (54.6%) had tachyarrhythmias: 21 had atrial tachycardia, 28 had the Wolff-Parkinson-White syndrome. Of 51 patients with a normal electrocardiogram a concealed left Kent bundle was observed in 21 cases and only one concealed right Kent bundle; functional James fibers were seen in 7 patients and Mahaim fibers in two. In 15 patients A-V nodal reentry was diagnosed and functional ectopy was observed in 5 patients. The sick-sinus-syndrome was seen in 24 patients and atrial arrest in three. Thirty patients underwent a second electrophysiologic study to evaluate proper antiarrhythmic therapy. Atrioventricular conduction was evaluated in 52 patients. A "suprahisian" delay was found in 34%, troncular lesions were diagnosed in 31%, a distal delay in 25% and mixed conduction disturbances in 10%. We conclude that electrophysiologic studies are a useful procedure to: 1) establish the etiologic diagnosis of tachyarrhythmias; 2) evaluate their potential danger; 3) objectively evaluate antiarrythmic therapy; 4) establish the need for surgical treatment; 5) give the topographic diagnosis and severity of A-V conduction disturbances and 6) indicate the need for definitive pacemaker implant.

Arrhythmias, Cardiac↗
PubMedDate not supplied

[Supraventricular paroxysmal tachycardias with normal electrocardiogram in sinus rhythm].

Paroxysmal supraventricular tachycardia (SVT) was studied in 46 patients with normal electrocardiogram (ECG) during sinus rhythm (SR), All of them had had at least one SVT crisis. They all complained of palpitations starting and ending abruptly, and of more than one hour duration. There were never seen ECG alterations suggesting ventricular preexcitation during SR. An electrophysiologic study using atrial and ventricular programmed stimulation and intracardiac electrograms, was used to establish the diagnosis. There was no significant difference in sex or age distribution according to the ethiologic diagnosis. It was found that 67.4% had a concealed accessory bundle, responsible of the SVT, 32.6% had A-V nodal reentry (p less than 0.01). Of all concealed accessory bundles, 67.7% were left lateral Kent (45.6% of all patients). It is discussed the possibility of antegrade conduction through concealed bundles during SR and that this may be seen by means of a M-mode echocardiography. We conclude that neither sex nor age help to suspect ethiologic diagnosis; the most common accessory bundle is the left lateral Kent and that in some cases it can be detected by M-mode echocardiography. This accessory bundle is the most usual cause of SVT in patients with normal ECG during SR.

Atrioventricular Node↗
PubMedDate not supplied

[Changes in colloido-osmotic pressure in patients on extracorporeal circulation].

Changes in colloidosmotic pressure (COP) were observed in 15 patients submitted to hemodilution for extracorporeal circulation. Preoperative laboratory tests were within normal limits. COP before hemodilution was above 15 mmHg in 14 cases and 12.6 mmHg in one 9-month-old patient, the mean CP was 18.17 mmHg. During extracorporeal circulation the mean COP decreased to 55% of its initial value (9.92 mmHg). Within the first 4 hrs of the postoperative recovery 13 had COP over 11 mmHg; the remaining two died of cardiorespiratory failure with a COP of less than 7 mmHg. One patient that recovered 100% of its initial COP value between 20 and 24 hrs of the postoperative period had his COP decreased to 6 mmHg and developed fatal pulmonary edema. One patient -who died acute bleeding did not diminish his COP under 12.5 mm Hg. We can conclude that COP lower than 10 mmHg can produce fatal cardiorespiratory failure. Extracorporeal circulation time does not influence the COP recovery. Acute bleeding does not diminish COP values. Hemodilution significantly reduces COP; its recovery and stabilization over 11 mmHg are of prognostic value. COP monitoring is a simple and useful method.

Adult↗
PubMedDate not supplied

[The radiofrequency ablation of accessory pathways. The initial experience in Mexico].

Thirteen patients with paroxysmal supraventricular tachycardia (SVT) due to an accessory pathway were submitted to an electrophysiological study and radiofrequency ablation of the Kent bundle. There were 9 males and 4 females. The mean age was 22 years. Other than their SVT, none had any structural heart disease. Ten of them had Wolff-Parkinson-White syndrome, and three had concealed accessory pathways. Two different types of radiofrequency devices were used: one generating damped sinusoid waves, and two other generators producing pure continuous sinusoid waves. With the first type, two attempts were made: one patient with a concealed pathway and one with overt preexcitation. The successful ablation was not achieved because this wave type is 100 times more powerful, it desiccates the tissue, and thus does not produce the right kind of lesion. The other eleven patients were divided in three groups: I) With left overt preexcitation (7 pts) II) Concealed left Kent bundles (2 pts) III) Right Kent bundles. Ablation was 100% successful in group I, while in the other two groups, only one patient of each was successfully ablated. The overall successful rate of these 3 groups was 81.8%. Of the two patients that could not be treated, one had an anterior septal Kent bundle and the other had a concealed left Kent bundle. We believe that catheter ablation is a very promising therapeutic procedure for patients with SVT, besides being a extraordinary instrument that will enable us to be able to understand further clinical electrophysiology.

Adolescent↗