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Biomedical subjects

W Steinbrunn

Publications and source records attributed to W Steinbrunn.

At least 55 records · Page 3Linked to original sources
PubMed1981

[Technic and long term results of pacemaker treatment with atrial electrodes].

A new implantation technique in the upper lateral part of the right atrium has reduced the complication rate of atrial electrodes to less than 4% at 11 months' follow-up. P-wave amplitude and acute and chronic threshold are in the order of conventional ventricular electrodes. In 10 of 56 patients with atrial-triggered ventricular pacemakers the cardiac output at rest and during exercise was found to be respectively 8% and 17% higher than with fixed-rate ventricular pacing. This hemodynamic benefit is longlasting, in contrast to findings with non-atrial synchronized pacing.

Adult↗
PubMed1981

[Surgical treatment of heart rhythm disorders].

Six patients underwent cardiac surgery for refractory tachyarrhythmias. Four had Wolff-Parkinson-White syndrome and 2 ventricular tachycardias after myocardial infarction. The results of preoperative electrophysiologic studies corresponded in 5 cases to intraoperative findings of epicardial and pace-mapping. These patients were free of symptoms for the 4-16 months' follow-up. In one patient with divergent results, tachycardia and preexcitation returned two months postoperatively. In the light of the foregoing the authors suggest surgical treatment for 1. preexcitation with life-threatening arrhythmias, 2. refractory ventricular tachycardias with coronary artery disease and 3. preexcitation in patients undergoing open heart surgery for other reasons.

Adult↗
PubMed1981

[Differentiated pacemaker therapy].

17 patients were treated by atrial (AAI) or atrial-triggered ventricular pacing (VAT). The atrial electrode was placed using a new endocardial screw-in technique. No complications occurred during a follow-up period of 3 months. Cardiac output at rest was measured in 12 patients before pacemaker implantation and was 3.571/min with VVI pacing at a heart rate (HR) of 70/min and 3.97 l/min (HR 75/min) with AAI or VAT pacing (p less than 0.001). Measurement of cardiac output was repeated in 7 patients with AV-block III degrees 10 weeks after pacemaker implant and the result was 4.40 l/min (HR 77/min) on VAT stimulation. During dynamic exercise in 5 patients, cardiac output under VAT pacing was 20% higher than with VVI pacing. This difference remained unchanged after 10 weeks. It is concluded that atrial electrodes can be placed reliably by the new technique. In contrast to VVI pacing, the hemodynamic benefits of atrial-triggered ventricular pacemakers appear to be long lasting.

Adult↗
PubMed1980

[Results of in-patient rehabilitation after myocardial infarction].

431 of 435 patients with recent myocardial infarction completed our clinic's 4-week rehabilitation program in 1979. 235 presented with post-infarction angina pectoris (a.p.). Of these patients, 152 achieved a decrease of one or more a.p. functional classes, 70 remained in the same class and in 12 the symptoms worsened by one or more classes. The mean physical work capacity under maximal bicycle-stress test increased by 19 Watt. Overall ventricular arrhythmia frequency under stress remained unchanged from beginning to end of our program. Individual arrhythmia frequency, however, varied widely with or without antiarrhythmic drug therapy. During exercise training, 3 nonfatal cardiac events occurred. There were no fatalities. It is concluded that our training program can be performed relatively safely and that physical work capacity can be increased during the rehabilitation program.

Adult↗
PubMed1980

[Importance of electrophysiologic heart investigation in accessory atrio-ventricular pathway].

In 13 patients with Wolff-Parkinson-White syndrome (WPW) the findings from electrophysiologic studies have been correlated with the patients' histories. Four patients had had syncopes with tachycardia and at least one episode of cardiac resuscitation (group 1). Five patients with tachycardias had never had syncope (group 2). Group 1 and group 2 had anterograde conduction over an accessory atrio-ventricular pathway (AAVP) during investigation, while 4 patients had concealed pathways (group 3). Age, localization of AAVP, duration of tachycardia history and heart rate during regular tachycardia did not differ in the three groups. Atrial and anterograde effective refractory period of AAVP was shorter in group 1 (280 +/- 10 msec) than in group 2 (328 +/- 15 msec). Shortest RR-interval during atrial fibrillation was 230 +/- 30 msec in group 1 versus 295 +/- 10 msec in group 2. It is concluded that potentially dangerous tachyarrhythmias are due to short refractory period of AAVV. Patients with syncope and WPW-syndrome should undergo electrophysiologic investigation and be selected for controlled antiarrhythmic treatment or surgical dissection of AAVP.

Adult↗
PubMed1980

[Therapy of ventricular tachyarrhythmia with disopyramid phosphate].

A controlled multicenter study has been carried out in 46 patients with ventricular tachyarrhythmias to define the antiarrhythmic effect of disopyramide phosphate. Monitoring of cardiac rhythm was performed during the whole study period by ambulatory Holter recording. The daily dose of disopyramide was 600 mg. It was found that disopyramide caused a reduction of at least 80% in the number of premature ventricular beats in 72% of the patients. Episodes of ventricular tachycardia were effectively suppressed in 65% of the patients. In 24 patients there was a reduction in the severity of the observed ventricular arrhythmias of at least one class in the classification of Lown. Analysis of the results showed a relationship between the antiarrhythmic effect and group mean plasma concentration of disopyramide.

Adult↗
PubMed1977

[Surgical treatment of myocardial aneurysms. Indications and results].

The long term results of 95 left ventricular aneurysmectomies are presented. In 47 patients simultaneous aorto-coronary bypass surgery was performed. 53 patients presented preoperatively with congestive heart failure; 8 out of these died within the first postoperative month, while 5-year survival rate (actuarial method) was 52%. Two thirds of this patient group improved. None of the 42 patients without preoperative congestive heart failure died early. 5-year survival rate was 93% and subjective improvement was recorded in one half of this subgroup. Comparison of pre- and postoperative angiograms (40 patients) revealed an increase in left ventricular ejection fraction reflecting the removal of the non-contracting segment. The ejection fraction of the contracting segment of the left ventricle improved after aneurysmectomy, especially in patients with preoperative congestive heart failure. In conclusion, aneurysmectomy improves left ventricular function and the symptoms of heart failure; moreover, it prevents perforation of false aneurysms. Its effect on arrhythmias could not be determined conclusively. Angina may be improved by simultaneous aorto-coronary bypass surgery.

Angina Pectoris↗
PubMed1976

[The spontaneous course of coronary disease].

The natural history of coronary atherosclerotic heart disease was studied in a retrospective analysis of 160 patients, who underwent coronary arteriography from 1965 to 1969. All had at least one angiographically documented significant stenosis of more than 50%; the survivors were followed for at least 5 years and a maximum of 9 years. For the entire group, 5-year survival was 81%. Subdivided into single, double or triple vessel disease categories, the 5-year survival rates were 91, 85 and 63% respectively.

Angiography↗
PubMed1976

[Work load hemodynamics before and after aortocoronary bypass].

Left ventricular enddiastolic pressure (LVEDP) was studied during exercise in 22 patients pre- and postoperatively under an identical work load. 13 patients showed improvement of LVEDP (normalization in 5), LVEDP was unchanged in 5 (w.n.l. in 2), and had deteriorated in 4. These results suggest that improvement or normalization of LVEDP under exercise following aortocoronary bypass surgery can be assumed if there is complete revascularization, if all grafts are functioning well, if there is no progression of the underlying disease, and if preoperative LV angiography is normal or shows only ischemic (reversible) hypokinesis.

Angina Pectoris↗
PubMed1976

["Impending infarct". Clinical, ergometric and angiographic pre- and postoperative results in 12 emergency operated patients. Preliminary report].

Pre- and postoperative results are presented in 12 patients who underwent emergency aortocoronary bypass. Operative mortality was zero. 1 patient died 8 months after surgery. Postoperative follow-up averaged 12.5 months (2-37 months). Postoperatively, 7 patients were totally angina-free, 1 was considerably improved and 3 were unchanged.

Coronary Artery Bypass↗