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Biomedical subjects

M Santini

Publications and source records attributed to M Santini.

At least 163 records · Page 9Linked to original sources
PubMed1990

Relation of prognosis in sick sinus syndrome to age, conduction defects and modes of permanent cardiac pacing.

A large population of sick sinus syndrome (SSS) patients was analyzed to determine whether age of patients, presence of conduction disturbances and mode of permanent pacing are related to the occurrence of supraventricular tachyarrhythmias, cerebral embolism and cardiac mortality. Three hundred thirty-nine patients permanently paced (135 AAI, 79 DDD, 125 VVI) because of SSS were followed for a mean period of 5 years (range 2 to 10). Patients were divided into 4 groups according to age (less than 70 or greater than 70 years) and the presence or absence of an associated conduction disturbance. Sixty-eight percent of VVI, 55% of AAI and 40.5% of DDD patients were greater than 70 years of age. In the VVI and DDD groups a conduction disturbance was present in 67 of 204 (33%) patients; conduction disturbances were more common in patients greater than 70 years old (46 of 111, 41%) than in those less than 70 years old (21 of 93,22%). The Wenckebach threshold (greater than 140 beats/min) remained unchanged during the follow-up period in 82% of AAI patients. In 9% of these patients, the Wenckebach threshold showed some degree of deterioration, but only in 2 patients was it less than 100 beats/min (1.5%). Spontaneous second-degree atrioventricular block was observed in 7 patients (5%); it disappeared in 6 of these patients when drug therapy was discontinued.(ABSTRACT TRUNCATED AT 250 WORDS)

Age Factors↗
PubMed1990

[Endocavitary transcatheter electric fulguration as a therapeutic alternative in refractory ventricular tachycardia].

Three patients affected by dilated cardiomyopathy complicated by refractory ventricular tachycardia, with a high risk of sudden cardiac death, underwent transcatheter electric fulguration. The technique was applied transeptally, using the terminals of two catheter electrodes as cathode and anode. These were placed at the right and left ventricular apex, at septal level where the "critical" arrhythmia point had been identified by endocardial mapping. All patients had previously experienced more than one episode of cardiac arrest and had successfully taken several antiarrhythmic drugs. All patients presented variable morphology of ventricular tachycardia (whether spontaneous or induced). In all of them clinical tachycardia was considered as having a left bundle branch block morphology with an earlier activation at low septal level. After treatment, antiarrhythmic therapy (amiodarone 200 mg/day) was continued for all patients, although at a lower dose than before fulguration. One patient has been free from sustained ventricular tachycardia for more than two years after fulguration. In the other patients we observed an early and late arrhythmic recurrence (respectively within 1 and 8 months following fulguration) in spite of antiarrhythmic therapy. The second patient presented no further recurrence after permanent pacemaker implantation. The third patient showed an arrhythmic recurrence, with a different morphology from the previous one, concomitantly with a septic process. This technique does not appear dangerous and may be used, in highly specialized centres, on carefully selected patients as a therapeutic approach after pharmacological therapy and before automatic defibrillator implantation or surgical antiarrhythmic intervention.

Adult↗
PubMed1984

[Combinations of some anti-arrhythmia drugs].

The need to treat severe and repetitive arrhythmias which are often resistant to treatment with single different drugs has led to an increasing interest towards associations of antiarrhythmic drugs. The advantages of this associations could be: enhancing effect of different pharmacological properties, synergism, reduction of doses and side-effects. The risks are: induction or aggravation of excitability and conduction disturbances, impairment of contractility, hypotension, interaction with digoxin. This study describes our experience in using associations of antiarrhythmic drugs of different classes (IA + II, IA + III, IB + III) or of the same class (IA). We also report our preliminary results with the use of Propafenon-Amiodarone association in the acute treatment of electrophysiologically induced ventricular tachycardias and in the chronic treatment of repetitive and symptomatic ventricular tachycardias. Our experience demonstrates that the association of antiarrhythmic drugs is effective in the treatment of severe and repetitive arrhythmias only if the patients are carefully selected and the risks of unwelcome electrophysiological actions and side-effects are taken into account.

Adrenergic beta-Antagonists↗
PubMed1983

[Recent developments in the medical treatment of emergency cirrhotic hemorrhage. Vasopressin and glipressin, prostaglandins, somatostatin, propranolol, cimetidine and ranitidine].

Haemorrhages in the course of cirrhosis and portal hypertension are surgical emergencies. Nevertheless medical treatment may be necessary both to revive the patient and temporarily to check the haemorrhaging itself. Some views are presented on the use of drugs, both those already in clinical use and others at the experimental stage, which appear to be effective in the treatment of haemorrhaging in portal hypertension (Vasopressin, glypressin, prostaglandin, somatostatin, propranolol, cimetidine and ranitidine).

Cimetidine↗
PubMed1983

[Prognostic evaluation with invasive technics in patients with hyperkinetic ventricular arrhythmias].

The prognostic value of induction of ventricular tachycardia (VT) by programmed electrical stimulation (PES) was analyzed in 123 patients: 64 (Group I) with spontaneous recurrent VT and 59 (Group II) without a history of serious arrhythmias. Thirty-three patients with spontaneous VT underwent coronary and left ventricular angiography to compare electrical instability with the presence of ventricular disfunction and/or the extent of coronary artery disease (CAD). PES reproducibly induced VT in 49/64 patients with spontaneous VT (sensitivity = 77%) and in 6/59 patients without VT (specificity = 90%). Twenty-two patients (66%) had ventricular disfunction defined by an ejection fraction of less than or equal to 40% or regional wall motion abnormalities. Only 4 patients (33%) had proximal 3-vessel CAD. The mean follow-up period was 16 +/- 12 months. Eight of Group I patients died suddenly and 24 had recurrent symptomatic VT. Three of Group I patients died (1 cardiac failure, 2 non-cardiac deaths), all the survivors were free of serious arrhythmias. In Group I patients mortality was correlated with: recent anterior myocardial infarction, inducible sustained VT with PES, ejection fraction less than or equal to 0.40, ventricular ipoasynergy and or at least one coronary stenosis greater than or equal to 70%. This study suggests that inducible VT is a marker of the risk of sudden death. Electrical instability may occur independent from the etiology of cardiopathy, ventricular disfunction and extent of CAD, but these parameters are correlated to global and sudden mortality in the group of patients with spontaneous VT.

Adult↗
PubMed1982

[Endoscopic sclerosing therapy in esophageal varices. Indications and personal technics].

Variceal bleeding in cirrhotic patients with poor liver function is associated with a high mortality. A non-operative treatment, endoscopic sclerotherapy, was employed in 16 patients. The preliminary results have been encouraging. It has been possible to eradicate esophageal varices in the cronic injection group. A longer follow-up period will be required to assess both the quantitative and the qualitative aspects of survival and to determine how long esophageal varices will remain eradicated as well as how frequently repeated injections will be required.

Contrast Media↗
PubMed1982

[Disorders of formation and conduction of the cardiac impulse in hypertrophic and congestive primary myocardiopathy].

Little information is available regarding cardiac automatism and conduction disturbances in patients affected by congestive (CCM) or hypertrophic (HCM) cardiomyopathies. For this reason 29 patients with HCM (10 cases) and CCM (19 cases) and disturbances of sinus node automaticity or AV conduction underwent an electrophysiologic study. Eight patients affected by HCM were also submitted to cardiac catheterization. Sinus node function was normal in each of the HCM patients, and impaired in 6 of the 19 CCM patients. The intra-atrial conduction was prolonged in only one CCM case. One HCM and 2 CCM patients showed an impaired intranodal AV conduction. Thirteen patients (44%) showed a prolonged HV interval (3 HCM and 10 CCM patients). No calcific deposits on the aortic valve were discovered by X ray stratigraphic examination in any of the patients. In 6 cases a progression of the conduction disturbances was observed. Ventricular pre-excitation was present in 4 patients (13%).

Adolescent↗