Search PubMed⌕ Search

Biomedical subjects

P Dini

Publications and source records attributed to P Dini.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1984

[Characterization and therapy of ventricular arrhythmias due to transient myocardial ischemic attacks in variant angina].

Forty-two patients with variant angina were studied by ambulatory ECG monitoring to determine the incidence and the characteristics of ventricular arrhythmias during ischemic attacks. Twenty-six patients had no ventricular arrhythmias in 633 ischemic attacks; 16 patients had ventricular arrhythmias in 116/586 ischemic attacks. The number of ischemic attacks per day and the magnitude of ST elevation were significantly (p less than 0.05) greater in patients with ventricular arrhythmias. Ventricular arrhythmias appeared at the onset or at the peak of ST elevation (first phase) in 17 ischemic attacks, during the resolution of ST elevation (second phase) in 43 attacks, during both the phases in 9 attacks. ST alternans appeared during 6 ischemic attacks with arrhythmias. Two episodes of ventricular fibrillation and 22 runs of ventricular tachycardia occurred during the first phase, 17 episodes of ventricular tachycardia were recorded during the second phase. Ventricular tachycardia of the second phase compared with ventricular tachycardias of the first phase were significantly (p less than 0.01) slower, uniform and initiated by a late premature beat. Incidence of arrhythmias of the second phase was strictly correlated with the duration of ischemic attacks. Nine patients who showed ventricular arrhythmias during the second phase of ischemic attacks were enrolled in a cross-over study to assess the antiarrhythmic effects of nifedipine (120 mg/day) and verapamil (480 mg/day). During treatment with nifedipine, the frequency of ischemic attacks declined by 85%, while the frequency of attacks with arrhythmias declined by 97% (p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
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

[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↗
PubMed1978

[Analysis of the Luciani-Wenckebach phenomenon in the A-V node. II. Relationship between conduction and recovery times].

We have studied 20 cases Wenckebach A-V block by atrial pacing. The relationships between conduction time and recovery time of N. AV Wenckebach point, basal A-H time and A-H time of first cycle beat were analysed. No correlation was found between W point, basal A-H and A-H of the first beat by analysing the A-H = f (H-A) we found different curves which occur when the first A-H is longer or shorter than 110. These data were discussed on the basis of modern hypotheses of electrophysiological mechanism of Wenckebach periodism.

Electrocardiography↗
PubMed1978

[Use of ajmaline in the diagnosis of sick sinus syndrome with a-v associated conduction defects].

The electrophysiological effects of ajmaline (1 mg/Kg i.v.) on sinus node were evaluated in 63 control subjects and in 12 pts with sick sinus syndrome (S.S.S.). In the control group the mean spontaneous cycle length (S.C.L.) was found significatively (less less than 0.001) reduced (8,?%), and corrected sinus node recovery time (C.S.N.R.T.) significatively (p less than 0.01) prolonged (30,2%) by the drug. In the patients with S.S.S. the S.C.L. was prolonged by 16% but not significatively and the C.S.N.R.T. by 60,7% (p less than 0.05). In 8/12 pts, with S.S.S. spontaneous sinoatrial blocks appeared or were more frequently observed following ajmaline injection. The use of ajmaline as a unic pharmacologic test for the differential diagnosis of symptomatic bradycardia in patients with atrioventricular associated conduction defects is discussed.

Adult↗
PubMed1978

[Old and new methods for control of pacemakers (author's transl)].

First there is a description of present methods available for controlling the functioning of pacemakers, most of which are already being used in traditional clinic-electronic control. There follows a presentation of telephone monitoring (ECG + Pacing Rate) and its limits so far as photoanalysis is concerned. Mention is made of the new italian system of telephone monitoring which also includes measurement of amplitude and width of the pulse. Personal experience of the diagnostic value of photoanalysis is given. This concords with others as to its necessity to detect any failure from circuitry defects or from breakage or insulation of electrode. In conclusion the hope is expressed of actuating a completely trustworthy control system which includes a high degree of foreseeing failure (telephone monitoring) and diagnostic value (Rx + photoanalysis). At last the advantages of an automatic follow-up system in a pacemaker patient clinic are discussed.

Computers↗
PubMed1978

[The experience in cardiac pacing at the Cardiology Department of St. Camillo Hospital (Rome) (author's transl)].

The experience of the Cardiac Electrostimulation Center of S. Camillo Hospital in Rome on 1503 patients treated with permanent pacemakers for an 11 year period is referred. The Authors analyze the increase of the activity of the Center during these years and some events that caused it. 94.5% of the patients were more than 50 years old; the dominant pathology has been ischemic and idiopathic cardiopathy, which together include 94.7% of the totality. The indication to the implant has been A-V block in 70% of the patients; intraventricular block in 20%; sick sinus syndrome in 10%. In the last years the prophylactic indication has increased (from 0.4% to 4.4%). 2459 pacemakers have been used, of which 79.5% was QRS-inhibit. The mercury prosthesis have been progressively substituted with the lithium ones. 1642 catheters (implant and reimplant) have been used; principally endocardic (95%) and monopolar (85%). The substitution of the catheter has been necessary in 9% of the totality; in 2.6% of the endocardic and in 15.9% of the epimyocardic. Among 50 electrodes, after a period of observation of about 7.7 years, 36 are still in function. The percentage of the complications has been 17.1%; the most important complications have been: dislocation (6%), microdislocation (1.5%), late high threshold (2.1%), failure of catheter (1.2%), generator malfunction (2.3%). The total mortality has been 15.4%; 0.2% caused by deficit of the implant; 2% sudden deaths and 13.2% not depending from the implant; 243 patients (16%) are not to be found. The frequency of out-patients controls has decreased in the last 2 years (from 3.8 controls per years to 1.8).

Aged↗