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Biomedical subjects

R M Luceri

Publications and source records attributed to R M Luceri.

46 records · Page 3Linked to original sources
PubMed1984

Follow-up of DDD pacemakers.

With the increasing complexity of DDD pacemakers, follow-up of these pulse generators has also become more complex. A pattern for testing DDD pacemakers should be developed, the patient should be taken through these pacing sequences in a systematic way, and the values should be recorded. To adequately follow-up the patient with a DDD pacemaker, one must know the patient and his underlying rhythm, the pulse generator and its programmable flexibility, and any peculiarities of the particular pulse generator.

Aged↗
PubMed1984

Long-term survival after prehospital cardiac arrest: analysis of outcome during an 8 year study.

We analyzed long-term follow-up data accumulated during an 8 year study of survivors of prehospital cardiac arrest. All patients included in this study were primary entrants via community-based rescue systems; patients who were tertiary referrals (survivors of cardiac arrest from other hospitals) were not included in this analysis. In the group of 61 patients entering our study between 1975 and 1980, with a follow-up to 1983, there have been a total of 24 deaths (39%). Sixteen of the 24 deaths were the result of recurrent cardiac arrest; eight were nonsudden cardiac deaths or noncardiac deaths. The mean duration from entry to death in the nonsurvivors was 27.5 +/- 19.7 months, and the time from the index event to last follow-up in the long-term survivors was 59.9 +/- 19.4 months. Life table analysis demonstrated a 10% rate of recurrence of cardiac arrest in the first year, with a 5% per year rate in each of the subsequent 3 years. Left ventricular ejection fractions at entry were not significantly different between survivors (mean = 45.3 +/- 13.6%) and nonsurvivors (mean = 37.6 +/- 12.6%), and the severity of ejection fraction abnormality at entry did not correlate with time to death in the nonsurvivors. However, ejection fraction was significantly lower in patients who died from causes other than recurrent cardiac arrest than in those who died of cardiac arrest (24.5 +/- 9.1% vs 42.7 +/- 9.2%; p less than .002).(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Arrhythmia Agents↗
PubMed1983

Ectopic left atrial rhythm that produces QRS changes in absence of Wolff-Parkinson-White syndrome.

In an 18-year-old patient without manifest or concealed Wolff-Parkinson-White syndrome, spontaneous and paced left atrial impulses penetrated a left-sided AV nodal input and thereafter activated the ventricles in a normal fashion exclusively through the His-Purkinje system. On the other hand, sinus and paced right atrial impulses entered a right-sided atrioventricular nodal input that was completely dissociated from the left-sided input to subsequently activate the ventricles partly through Mahaim fibers and partly through the His-Purkinje system. The Mahaim fibers, which acted as "bystanders" during episodes of atrioventricular nodal reciprocating tachycardia, seemed to have extended from a "distal," common (right-sided) intranodal pathway (or "proximal" His bundle) to the right ventricle or, although this is less likely, to the right bundle branch. More studies are necessary to determine whether the association on the surface electrocardiogram of an ectopic slow left atrial rhythm with changes in QRS morphology (but not in QRS duration) always reflects the existence of Mahaim fibers.

Adolescent↗
PubMed1983

The arrhythmias of dual-chamber cardiac pacemakers and their management.

The field of cardiac pacing has developed exponentially in the past several years. The widespread use of atrioventricular synchronous pacemakers has resulted in the recognition of several types of pacemaker-associated arrhythmias. Certain of these arrhythmias follow asynchronous stimulation of either cardiac chamber; others are the result of the artificial bypass tract created with dual-chamber sensing and pacing. All the arrhythmias, however, are associated with normal pacemaker function.

Arrhythmias, Cardiac↗
PubMed1982

Myopotential inhibition of unipolar AV sequential (DVI) pacemaker.

Whereas myopotential inhibition of QRS-inhibited (VVI) pacemakers is well known, its occurrence in patients with AV sequential (DVI) pacemakers has not been reported. The present communication deals with spontaneous and induced myopotential inhibition of a multiprogrammable Intermedics unipolar AV sequential (DVI) pacemaker. The bedside maneuvers that were performed in the patient exposed the problem, therefore serving to establish the diagnosis. Although external adjustment of the sensitivity was the simple, non-invasive solution in this case, more studies are required to determine the success rate of this approach as well as the incidence and clinical significance of myopotential inhibition of unipolar DVI pacemakers.

Aged↗
PubMedDate not supplied

Implantable devices for the treatment of cardiac arrhythmias.

The development of implantable devices for the treatment of tachyarrhythmias has resulted in additional therapeutic choices for the affected patients. Technologic advances now permit one to choose from a wide variety of devices capable of intervening automatically in the presence of supraventricular or ventricular arrhythmias. Although all methods remain in the investigational stage at this time, sufficient evidence has been gathered to support the efficacy of certain devices in the presence of various arrhythmias. Pacemaker-energy pulses may be delivered in various sequences to interrupt re-entrant rhythms, and their reproducible success can be effectively demonstrated in the electrophysiology laboratory. Cardioverting and defibrillating devices are capable of recognizing and successfully interrupting malignant ventricular arrhythmias. The automatic defibrillator has already been reported to reduce 1-year arrhythmic mortality in high-risk patients. Although still in the infant stages of development, the continuing advances in device technology suggest that their future applications are indeed promising.

Arrhythmias, Cardiac↗