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At least 199 records · Page 11Linked to original sources
PubMed2001

Effect of long-term application of Crataegus oxyacantha on ischemia and reperfusion induced arrhythmias in rats.

The effect of long-term application of Crataegus oxyacantha on ischemia and reperfusion induced arrhythmias was investigated in Wistar rats on the heart in situ and on Langendorff preparations. Seventeen rats were fed for 8 weeks with 0.5 g/kg b.w. Crataegus extract per day, standardised to 2.2% flavonoids. Twenty age-matched untreated rats served as controls. In the hearts in situ as well as in the Langendorff preparations the left anterior descending coronary artery (LAD) was ligated for 20 min and subsequently reperfused for 30 min. ECG was continuously recorded and the time spent between start of ischemia and onset of arrhythmias was measured. In addition, during ischemia and reperfusion the number of ventricular premature beats and bigemini and the duration of salvos and ventricular flutter and fibrillation were determined. The ischemic area was evaluated in all experiments and coronary flow was measured in Langendorff preparations. In the present experiments, no cardioprotective effects of Crataegus oxyacantha could be detected, neither in the heart in situ nor in the Langendorff preparations. Although the ischemic areas were identical, arrhythmias occurred even earlier in the Crataegus collectives than in the controls. Also the number and duration of ischemia and reperfusion induced arrhythmias tended to occur longer and more frequently in the Crataegus collectives, whilst coronary flow remained unchanged. The phenomenon that Crataegus rather aggravates than prevents arrhythmias may be reduced to a Crataegus induced increase in intracellular Ca(2+)-concentration proven true for the positive inotropic effects of Crataegus.

Animals↗
PubMed1992

[Subarachnoid hemorrhage with pulmonary edema and electrocardiographic changes. The differential diagnosis of myocardial infarct].

A 32-year-old man (weight 132 kg, height 190 cm) suddenly became unconscious and cyanosed with an unrecordable pulse and ventricular flutter on ECG. After resuscitation, the blood pressure was 200/100 mm Hg; the patient moved his arms and legs at times, but he did not regain consciousness. Focal neurological signs and meningism were not demonstrable. Subsequent ECGs showed a raised ST segment, followed later by terminal T wave inversion; marked pulmonary oedema was present clinically and radiologically. The creatine kinase activity was 344 U/l. As lateral myocardial infarction was suspected, the patient received heparin (1000-1700 IU/h) and nitroglycerin intravenously. Because the CK-MB isoenzyme failed to rise significantly and there was no reduction of R wave on the ECG, a CT scan of the brain was performed: this showed brain oedema as well as severe subarachnoid haemorrhage in the basal subarachnoid space, the posterior horn of the lateral ventricles and over the cerebral hemispheres. Despite implantation of an epidural pressure gauge, hyperventilation and administration of dexamethasone, osmotic diuretics and thiopental, the patient died 14 days after collapsing. At autopsy the heart showed no signs of myocardial infarction. The cause of the subarachnoid haemorrhage was a ruptured aneurysm of the anterior communicating artery.

Adult↗
PubMed2002

Cardiac rhythm and symptomatic arrhythmia in right atrial isomerism.

BACKGROUND: The conduction system in right atrial isomerism may be complicated by the presence of paired sinus nodes and twin atrioventricular nodes. With a large cohort of infants and children with right atrial isomerism, we sought to investigate the nature of atrial rhythm, its prevalence, factors predisposing patients to symptomatic cardiac arrhythmia, and the relation of arrhythmia to long-term morbidity and mortality. METHODS: Standard 12-lead baseline electrocardiograms were performed in 110 infants and children with right atrial isomerism at a median age of 1 day, and their clinical records were reviewed. The type, timing, and precipitating factors of symptomatic cardiac arrhythmia that occurred in 15 patients, among a cohort of 85 patients who had or were awaiting surgical interventions, were noted. RESULTS: All patients except 1 had a sinus rhythm with intact atrioventricular conduction. Of these, 87% (95/109) had single P-wave morphology, whereas 13% (14/109) had multiple P-wave morphologies. For patients with a single P-wave morphology, the frontal P-wave axis was between 0 degrees and 90 degrees in 62% (59/95), 90 degrees and 180 degrees in 23% (22/95), and superior in 15% (14/95). There was no relation between either P-wave axis or morphology and cardiac anatomy. Symptomatic cardiac arrhythmia occurred in 15 of 85 patients (18%); 11 of the 15 patients had supraventricular tachycardia, and 1 patient each had atrial tachycardia, atrial flutter, ventricular tachycardia, and congenital complete heart block. The arrhythmias occurred before surgery in 4 patients, early after surgery in 5 patients, and late after surgery in 6 patients. Although 3 of the 7 patients who died suddenly had a history of symptomatic arrhythmia, arrhythmia was the documented cause of mortality in only 1 of the 32 fatalities (3.1%). Freedom from arrhythmia at 1, 5, 10, 15, and 20 years was 93% +/- 3%, 86% +/- 4%, 80% +/- 6%, 73% +/- 9%, and 48% +/- 15% (mean +/- SE), respectively. No risk factors for symptomatic arrhythmia were identified by means of logistic regression. CONCLUSIONS: The atrial pacemaker varies in location within and between patients with right atrial isomerism. Although symptomatic cardiac arrhythmias are not uncommon, they do not seem to relate to the overall high mortality rate and occurrence of sudden death in this patient group. Nonetheless, detailed assessment and aggressive management of cardiac arrhythmias once they occur are warranted because of the precarious single ventricular hemodynamics.

Arrhythmias, Cardiac↗
PubMed1976

Cardiac monitoring during exercise tests in the horse. 3. Changes in the electrocardiogram during and after exercise.

Changes that occur in the equine ECG during and after exercise have been described and compared with resting ECG's obtained from the same horses. When the speed of work equals or is greater than "three-quarter pace" (i.e. "even time" or 200 metres in 15 seconds) the high heart rates developed cause the loss of ECG waveforms that are readily discernible at rest. Although differences in the waveforms between horses with normal and abnormal resting ECG's have been observed, the more definitive useful information is the fact that abnormal horses showed significantly higher heart rates than normal horses at a particular speed of work. When this occurs in combination with a resting ECG classified as borderline or abnormal and the exercise ECG shows positive, low amplitude, broad rounded T waves or transient bursts of sine-waves suggestive of ventricular flutter, racing performance is likely to be impaired. Although more work needs to be done and improvements in technology are necessary, the exercise ECG has potential for improving understanding of physical fitness and the significance of resting cardiac abnormalities.

Animals↗
PubMed1993

Emergency percutaneous transluminal coronary angioplasty for intractable ventricular arrhythmias associated with acute anterior myocardial infarction.

A previously fit marathon-running 54 year old man was admitted as an emergency having collapsed with chest pain caused by an acute transmural anterior myocardial infarction. He was initially resuscitated by his general practitioner then had recurrent episodes of ventricular flutter and fibrillation requiring continuing cardiopulmonary resuscitation and repeated defibrillation. During ambulance transfer and in the hospital emergency department he received appropriate intravenous antiarrhythmic drug treatment and a total of 63 transthoracic DC shocks, with good cardiac output between shocks. After his condition failed to stabilise in intensive care, an intra-aortic balloon pump was inserted and coronary angiography showed a proximal occlusion of the left anterior descending branch. Coronary angioplasty successfully re-opened the vessel with an excellent angiographic result. The intra-aortic balloon pump was withdrawn the following day and he was well enough to be discharged 7 days later. At 4 weeks he performed a satisfactory maximal exercise test and remains in New York Heart Association functional class I.

Angioplasty, Balloon, Coronary↗
PubMed1983

Responses to ligation of a coronary artery in conscious rats and the actions of antiarrhythmics.

A method for ligating the left anterior descending coronary artery in conscious rats and measuring the resultant cardiovascular responses, arrhythmias, cardiac tissue loss, electrocardiogram (ECG), and mortality is described. Analyses of such responses identified statistically acceptable measures for which precision and interrelationships were defined. Responses to ligation were a variable function of the amount of ligated myocardial tissue. For example, arrhythmia score was a linear function of the square root of the occluded zone size. To test the ability of the model to detect beneficial drugs, verapamil, lidocaine, disopyramide, and quinidine were given. Low doses of verapamil (0.2 mg/kg i.v. + 0.3 mg X kg-1 X h-1), and of disopyramide (10 mg/kg) had few antiarrhythmic, or other actions, whereas high doses of verapamil (20 mg/kg) and disopyramide (40 mg/kg i.v. repeated) were markedly antiarrhythmic as measured by all indices. Quinidine (20 mg/kg i.v. repeated) was also antiarrhythmic but less so than high dose disopyramide and verapamil. Lidocaine (10 mg/kg i.v. + 5 mg X kg-1 X h-1) reduced the incidence of ventricular flutter and fibrillation. High-dose verapamil and quinidine, but not disopyramide, increased the number of nonarrhythmic deaths and the incidence of atrioventricular conduction defects.

Animals↗
PubMedDate not supplied

Complications of pediatric cardiac catheterization: 18-month study.

Pediatric cardiac catheterization may be indicated under certain conditions, but is associated with some risk. The purpose of the study was to evaluate the complications associated with diagnostic and interventional catheterization procedures done over an 18-month period in our laboratory. Of the 230 cardiac catheterizations, 204 were solely diagnostic in nature. Eleven percent were interventional catheterizations including aortic and pulmonary valvuloplasties and balloon atrial septostomy. Six percent of the patients constituted grown-up congenital heart disease (GUCH). The median age was 34 months excluding the GUCH group. There was one death below one year of age (0.4% mortality) occurring six hours after the diagnostic catheterization; it was attributed to the underlying disease. There were eight complications (3.4%) that we would consider serious, including atrial flutter, ventricular tachycardia, severe hypercyanotic spell, seizure, transient complete heart block, peripheral vascular injury which resulted in pseudoaneurysm formation of the femoral artery requiring surgical intervention, and transient pulse loss. When catheterization is necessary, it should be carried out as efficiently as possible with awareness of conditions that probably increase the risk of a clinically important event. Although patients undergoing cardiac catheterization are now younger and have more complex cardiac abnormalities, the procedure seems to have become safer when compared to previous literature.

Adolescent↗
PubMedDate not supplied

Data compression for storage of resting ECGs digitized at 500 samples/second.

Data compression of resting electrocardiograms (ECGs) digitized at 500 samples per second (sps) is presented. Tradeoffs between the fidelity of reconstructed data and the overall compression are examined. Data of the median (average) complexes are retained at 500 sps and full resolution and encoded only to reduce redundancy. The raw data for rhythm analysis are evaluated for lowpass filtering and down-sampling (decimation) and requantization. After subtracting the medians from the raw data, the resulting residue signal is examined in detail for data reduction and encoding. Various options for compression of the residue signal are presented. Specific issues examined are the acceptable decimation and requantization of the residue signal. Another important aspect evaluated is the bimodal decimation of the QRS and the rest of the cardiac complex. Here, the QRS complexes are kept at 500 sps and the rest of the data decimated to lower sampling rates. This novel approach reduces data distortion while achieving significant compression. Details of the compression scheme and its evaluation on uncompressed 500-sps ECGs from the European Common Standards for Electrocardiography (CSE) database (128 ECGs with normal sinus rhythm, atrioventricular blocks, atrial fibrillation and flutter, ventricular arrhythmias, and excessive noise) are elucidated. Performance indexes [root mean square (RMS) error, percent RMS difference, normalized RMS difference, maximum peak error, and compression ratio] are computed. To validate the compression method, qualitative evaluation was performed by two physicians overreading the ECGs by comparing the reconstructed waveforms with the original uncompressed data. The median data are retained at 500 sps and full precision. For rhythm data, the bimodal decimation of the residue signal to 125 sps at 10 microvolts resolution preserved the fidelity of the ECG signals well, while giving good data compression. Abnormal atrial activity was well preserved and the QRS was retained without distortion. The average size of a 10-sec compressed ECG with the medians is around 4.5 kilobytes.

Diagnosis, Computer-Assisted↗
PubMed1988

[Mechanical emergency stimulation in asystole and extreme bradycardia].

Repetitive precordial thumping is the simplest method of temporary cardiac pacing. In 90 patients out of 100 with witnessed cardiac arrest because of asystole or marked bradycardia the critical situation could be effectively bridged over by this until a sufficient spontaneous rhythm returned or electrostimulation was ready to function. 69 patients were conscious during the stimulation. During the mechanical pacing only in 2 patients there occurred ventricular flutter or fibrillation, which was stopped by electric defibrillation. The existence of the myocardial contractility is the presupposition for effective mechanical and electrical pacing.

Adolescent↗
PubMedDate not supplied

Continuous arteriovenous hemofiltration as emergency procedure in severe hyperkalemia.

Severe hyperkalemia due to acute renal failure occurred in a preterm infant of a diabetic mother. Despite infusions of calcium gluconate, sodium bicarbonate, glucose, and insulin, the rapidly increasing serum potassium concentration resulted in ventricular flutter. After cardiac resuscitation, continuous arteriovenous hemofiltration was started for potassium elimination. Within 3 h of extracorporeal renal replacement therapy, serum potassium was lowered from 9.4 to below 7 mEq/l. Because of persisting oliguria continuous arteriovenous hemofiltration was continued for 60 h. The infant was discharged from the hospital at the age of 4 weeks with normal physical and neurological findings.

Acute Kidney Injury↗
PubMed1986

[Familial idiopathic congestive cardiomyopathy in 2 brothers with a similar course].

The course of idiopathic congestive cardiomyopathy in two full brothers is described. The diagnosis was made on the base of the existing cardiomegaly, gallop rhythm and congestive cardiac insufficiency, in the absence of any connection with some of the well known causes for hypertrophy and dilation of the heart. It was confirmed at necropsy in one of the brothers. A similarity was established in their case history, namely: considerable physical activity until the first signs of cardiac insufficiency, advancement of decompensation at the same age (20 years) with an already existing cardiomegaly, identical complaints--rhythm disturbances and pulmonary thromboembolism, similar electrocardiographic changes with formation of "pseudoinfarct" image, ventricular flutter--immediate cause for the death of one of the brothers, sudden death--for the other. The origination of the disease cannot be associated with the effect of exogenous morbid factors. There are no data on advancing of autoimmune process. With the genealogical study, covering four generations, the family was established to have a stillborn child, no other sick members of the family, no data about multiple deaths. The cytogenetic analysis showed no chromosomal aberrations. The possibility the disease to be transmitted via autosomal recessive mode or via autosomal-dominant gene with a low penetration is discussed.

Adult↗
PubMed1984

[Deterioration in ventricular arrhythmia caused by anti-arrhythmia preparations].

Study of the efficacy of some antiarrhythmic drugs in 92 patients with frequently occurring ventricular premature heart beat including high grades has demonstrated that in an insignificant number of patients these drugs produce an arrhythmogenic action. Such an action is observed after intake of the common therapeutic drug dose and is not accompanied by subjective symptoms pointing to the drug intolerance. The arrhythmogenic action of the drugs results in a dramatic increase in the number of ventricular premature heart beats and in the appearance of high grades of such beats including the development of ventricular flutter.

Adolescent↗
PubMed1984

[Diagnosis of syncopes in suspected arrhythmias].

Several mechanisms lead to attacks with unsuspected sudden and intermittent loss of consciousness. A major cause for such syncopes are arrhythmias. Only in rare cases it is possible to register an ECG during a typical attack despite many newer methods as long-term ECG (LT-ECG), exercise stress test and electrophysiologic investigations. LT-ECG does not record the ECG only during symptomatic periods (syncopes, dizziness, palpitations etc), but also registers asymptomatic AR, which can be precursors of SY. Carotid sinus massage is a valuable tool for the detection of a cardio-inhibitory Carotid-Sinus-Syndrome, which can be treated with PM-implantation. Exercise stress testing induces ventricular arrhythmias, which also indicates AR as underlying cause for SY. Using the invasive electrophysiologic investigation methods the importance measuring supraventricular parameters (SNRT, SA-, AH-interval) or parameters of the AV-nodal conduction (AH-, HV-interval) decreased in contrast to the ventricular stimulation techniques. With these invasive procedures ventricular tachycardias, ventricular flutter or fibrillation can be induced in selected patients, which indicates also a possible arrhythmogenic substrate for SY. In a suspected arrhythmogenic genesis of SY it has to be recommended to perform LT-ECG, carotid sinus massage, exercise stress testing and -- in selected patients -- electrophysiological investigations in addition to the routine-ECG to exclude or confirm arrhythmias as possible substrate for SY.

Arrhythmias, Cardiac↗
PubMed1998

[A patient with disopyramide intoxication rescued by percutaneous cardiopulmonary support].

A 28-year-old man was admitted to our hospital in a hypotensive state 2 hours after taking 8,400 mg disopyramide. Infusion of catecholamine and gastric lavage restored normal blood pressure. However, 8 hours after taking the disopyramide he became hypotensive again and electrocardiographic findings revealed bizarre ventricular complexes resulting in ventricular flutter. Although standard cardiopulmonary resuscitation was not effective, his circulatory status was maintained by percutaneous cardiopulmonary support (PCPS). After 36 hours electrocardiography showed sinus rhythm, and his cardiac function became normal. Patients with severe cardiac dysfunction or cardiac arrest caused by disopyramide intoxication can be supported by PCPS until cardiac function is restored.

Adult↗
PubMed1976

Flutter of left ventricular structures in patients with aortic regurgitation, with special reference to patients with associated mitral stenosis.

Echocardiography was performed in 45 patients with aortic regurgitation. Forty showed a high frequency diastolic flutter of the mitral valve, which was holodiastolic in all but the patients with associated mitral stenosis. Of four patients with coexisting mitral stenosis, mitral flutter was absent in two; in the other two, in atrial fibrillation, mitral flutter occurred, but only during a fixed interval after mitral valve opening, irrespective of cycle length. A fine flutter of similar frequency was observed on the left ventricular aspect of the ventricular septum in 12 patients. In six of these it was of slight degree and restricted to early diastole and the high septum; in four others (three of whom had associated mitral stenosis), the septal flutter was more marked, holodiastolic, and present over all parts of the septum scanned; in two, it was holodiastolic over the high septum but early diastolic at lower septal levels. Aortography performed in 19 patients showed that septal flutter was present in seven of 12 patients in whom the regurgitant aortic jet was directed forward to the ventricular septum, whereas in the other seven patients with no septal flutter, the jet was directed away from the septum. Septal flutter is useful as an echocardiographic sign of aortic regurgitation, especially in the presence of mitral stenosis when mitral flutter may be absent or exceeded by septal flutter in both amplitude and duration, and when the mitral valve has been replaced by a prosthetic valve. Vibration of the septum appears to be attributable to the regurgitant aortic jet impinging on it and may contribute to the production and radiation of the characteristic diastolic murmur of aortic regurgitation.

Adolescent↗
PubMed1997

Inappropriate discharge of an implantable cardioverter defibrillator during atrial flutter and intermittent ventricular antibradycardia pacing.

INTRODUCTION: Inappropriate discharges of an implantable cardioverter defibrillator (ICD) are troublesome to the patient and sometimes a difficult task for the physician trying to identify and treat the cause. METHODS AND RESULTS: For the first time, we report a mechanism of inappropriate ICD discharges during episodes of atrial flutter with a slow ventricular response and intermittent antibradycardia pacing. The episodes occurred in two patients and were triggered by the unique sensing algorithm of the Ventritex Cadence V-100 in combination with the tripolar CPI Endotak 072 transvenous defibrillation lead, which provides integrated bipolar sensing. CONCLUSION: Besides treatment of the underlying arrhythmia, reprogramming of the device, an electrode position far away from the atria, and true bipolar sensing will enhance the performance of ICD systems with respect to the episodes described here. In addition, more flexible sensing algorithms may, in the future, prevent this overall rare complication.

Aged↗