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Biomedical subjects

T L Wu

Publications and source records attributed to T L Wu.

At least 127 records · Page 7Linked to original sources

Electrophysiologic diagnosis of patients with sinus node dysfunction: with special reference to a modified method for calculating sinoatrial conduction time.

The diagnostic value of maximum corrected sinus node recovery time (CSNRT) and sinoatrial conduction time (SACT) was assessed in 15 patients with clinical evidence of sinus node (SN) dysfunction and 16 control subjects. The SACT was calculated by a modified method using only those sinus cycles with A1-A1 intervals falling within one standard deviation of the mean. We also obtained a maximum SACT and a ratio of maximum/mean SACT. We found that the maximum/mean SACT ratio being useful for identifying patients with sinus arrest or sinoatrial block. Abnormal value of the ratio (greater than or equal to 1.85) was also more frequently observed in patients with syncope or dizzy spells than those without (55.6% vs. 33.3%). By applying mean SACT and maximum/mean SACT ratio, calculated by the modified method, together with maximum CSNRT, all patients with SN dysfunction could be completely isolated from the normal subjects.

Adult↗

Ruptured congenital aneurysm of the right sinus of Valsalva into the right ventricle: with special reference to pathoanatomic and hemodynamic characteristics in symptomless cases.

Clinical features of 19 cases with congenital aneurysm of the right sinus of Valsalva rupturing into the right ventricular outflow region (Type 1) were analysed in relation to their pathoanatomic lesions and hemodynamic alterations. Sixteen cases were operated with one surgical death. All were catheterized together with ascending aortographic study. Rupture of the aneurysm in many cases was silent or symptomless and progressive heart failure was not quite common. Symptomatology of the patients did not seem to be related entirely to status of the pathoanatomical lesions or hemodynamic alterations. Time of the rupture, and inherent right ventricular characteristics, tolerating volume overload rather well, might be, in part, responsible for its better prognosis in some cases. However, all patients with ruptured aneurysm of the sinus of Valsalva should be treated surgically. Bacterial endocarditis is a serious complication leading to death.

Adolescent↗

Automaticity of subsidiary pacemakers of patients with dysfunction of the sinus node.

Automaticity (postpacing impulse recovery time) of the sinus node or subsidiary pacemakers (or both) was determined by intracardiac recordings and atrial overdrive pacing in three patients with disease of the sinus node. Their electrocardiographic manifestations included sinus bradycardia, sinoatrial block, sinus arrest, atrioventricular junctional rhythm, and atrioventricular dissociation. One patient, who initially had syncope, demonstrated prolonged time for recovery of the sinus node (maximum corrected value, 3,485 msec) and impaired atrioventricular junctional automaticity (maximum corrected junctional recovery time, 1,460 msec). Of the remaining two patients without syncopal attacks, one had an adequate low atrial or junctional escape mechanism following cessation of pacing. The maximum low atrial escape interval was 1,660 msec, and the maximum junctional recovery time was 1,770 msec (corrected value, 140 msec). The third patient disclosed a prolonged maximum corrected recovery time for the sinus node (870 msec), while the maximum junctional recovery time was only 1,810 msec (corrected value, 160 msec). We conclude that automaticity of the subsidiary pacemakers in disease of the sinus node can be determined in the presence of atrioventricular dissociation or total sinus arrest, and that determination of the recovery time of the subsidiary pacemakers may be useful in identifying symptomatic patients with sinus nodal dysfunction.

Adult↗