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Biomedical subjects

R Paliege

Publications and source records attributed to R Paliege.

29 records · Page 2Linked to original sources

[Diagnostic transesophageal atrial stimulation for sinus node function testing. II. Results in patients with and without sinus node syndrome].

By means of transoesophageal atrial stimulation of higher frequency in patients with sinus node syndromes (n = 78) in about 60% of the cases a prolonged sinus node recovery time could be proved. After the end of the stimulation secondary stops appeared in about half of the patients, so that in 81% of the cases at least one pathological result was established. By means of premature individual transoesophageal stimulation (n = 99) in 2/3 of the patients with sinus node syndrome we contrived to perform a calculation of the sinuatrial conduction time. Half of all calculable values were above the normal. In 1/3 of the examined persons pathological stimulation patterns were found. Altogether 90% of the patients showed at least one pathological result, when apart from prolonged sinus node recovery times and sinuatrial conduction times at the same time secondary stops after serial stimulation with higher frequency and abnormal behaviour patterns of the post-extrasystolic stops after individual stimulation were taken into consideration. In patients with different cardiovascular diseases without clinical or electrocardiographic reference to a sinus node dysfunction in 25% of the cases at least one pathological result was found, in which case cannot be clarified, whether latent functional sinus node disturbances or falsely positive results are in question or not. Altogether the non-invasive transoesophageal stimulation technique leads to on principle diagnostic evidences of the same value as the up to now usual stimulation of the right atrium. Methodical problems which arise from the stimulation of the righ atrium in transoesophageal approach are to be taken into consideration in the interpretation of the results.

Adult↗

[Sinostrial node initial block after digoxin--unmasking by double and multiple stimulation].

After intravenous application of 1 mg digoxin in a 28-year-old patient with condition after myocarditis by means of premature atrial individual stimulation a SA-block I. type II was observed. Also in extremely premature stimuli the post-extrasystolic pauses remained compensating. After atrial double and multiple stimulation--a new method for the calculation of the sinuatrial conduction time--totally irregular poststimulation pauses appeared, which were regarded as an expression of a sinoauricular node initial block. Other possibilities of explanation are discussed.

Adult↗

[The effect of diphenylhydantoin on the automatism of the sinus node and on the sino-atrial conduction time in patients with and without sick sinus syndrome].

In 30 test persons (15 patients with disturbed function of the sino-auricular node, 9 of them with classical sick-sinus-syndrome as well as 15 test persons without disturbance of the sino-auricular node, of them 7 healthy ones) the influence of diphenylhydantoin on the function of the sino-auricular node was tested. By means of atrial stimulation the so-called sino-atrial conduction time, the recreation time of the sino-auricular node as well as the duration of the sinus period before and after intravenous application of 250 mg of diphenylhydantoin was estimated. The auricular stimulation was carried out either through an oesophageal electrode probe or usually through an electrode catheter directly placed in the right atrium. In the entire collective the sino-atrial conduction time did prolong itself statistically not significantly by 2 +/- 5ms (x +/- 2 s), in which cases there was not to be observed a different behaviour between test persons with a healthy rhythm and patients with disturbed function of the sino-auricular node. In 2 patients with sick-sinus-syndrome, however, after diphenylhydantoin and individual atrial stimulation in each case sino-atrial blockings of higher degree developed. The maximum absolute and corrected recovery time of the sino-auricular node prolonged itself in patients with syndrome of the sino-auricular node by on an average 1406 +/- 2120 ms or 1378 +/- 2338 ms, in which cases in 1 test person a threatening prolongation of the poststimulation pause to 10 s developed. In another patient after application of diphenylhydantoin an atrial arrest was observed. The automatism of the sino-auricular node of test persons with healthy rhythm was not influenced.

Arrhythmia, Sinus↗

[Double and multiple atrial stimulation--a new method for calculation of sinoatrial conduction time (author's transl)].

By means of a new stimulation procedure--double and multiple atrial stimulation--the so-called sinoatrial conduction time (SACT) was calculated in 62 patients. The results were compared to the SACT calculation after premature single atrial stimulation (correlation coefficient 0.94). By means of the multiple atrial stimulation we were able to measure the "sinoatrial conduction time" in patients with SA-block of type II (missing reset phase) if the cases with SA entry block were excluded. The modified stimulation procedure helps to improve the assessment of functional disturbances of the sinoatrial node. This method for calculation of SACT is an advantage especially in patients with abnormally delayed SA conduction and in those with very short duration of spontaneous cycle length.

Electric Stimulation↗

[Esophageal sound for electrocardioversion and simultaneous electric stimulation of the heart].

In extrathoracic as well as oesophageal electrode technique sometimes in most cases short insignificant asystolias following the electric cardioversion are observed. In individual cases, however, an immediate electrostimulation of the heart may be necessary. An oesophageal sound was developed which may be used for cardioversion as well as for stimulation if necessary. With the help of this sound the effectiveness of the electric atrial and ventricular stimulation and the electrocardioversion was proved.

Arrhythmias, Cardiac↗

[Effect of long term treatment with trenimon in chronic progressive polyarthritis].

It is reported on the therapeutic effects with trenimon in patients with rheumatoid arthritis half a year and one year after the end of the treatment. When critically judged the quota of success was 32.5% for the total judgement after half a year. Significant relations dosis-effect could be ascertained only for the parameters of clinical activity up to 1 year and humoral inflammatory signs after half a year. When the therapeutic success is assessed in any case the additional therapeutic expenditure must be taken into consideration. Before the beginning of the therapy there was no ascertained relation between success of therapy and duration of the disease, sex, age, activity and function.

Adult↗