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At least 883 records · Page 49Linked to original sources
PubMed1999

Quality of life in patients with complete heart block and paroxysmal atrial tachyarrhythmias: a comparison of permanent DDIR versus DDDR pacing with mode switch to DDIR.

A prospective double-blind randomized crossover study was done in 15 patients with complete heart block and intermittent ATs. The pacemaker was randomly programmed to dual chamber inhibited rate responsive pacing (DDIR) and to DDDR with mode switch, for 1 month each. An event recorder was given to the patients and after each period, a QOL questionnaire was obtained. Based on telemetric data, all but two patients had AT during follow-up. The duration and frequency of these episodes were not related to mode settings. AV synchrony was better preserved in DDDR (P < 0.05). Most symptom-related event recordings during DDIR showed loss of AV synchrony; DDDR with mode switch caused symptoms due to tracking of ST. Overall the QOL score was not different between the modes. Fewer somatic complaints were noted during DDDR pacing than during baseline. DDIR stimulation showed no difference. Twelve patients preferred the period of DDDR pacing; one experienced severe symptoms during DDIR. In conclusion, patients with paroxysmal AT, DDDR with mode switch, and DDIR had no influence on the occurrence, nor on the duration of AT episodes. AV synchrony was better preserved in DDDR, which was also associated with fewer somatic complaints compared to the baseline. In DDDR, symptoms were observed when ST was tracked. QOL was comparable, although more patients preferred DDDR.

Adult↗
PubMed1985

Complete heart block in a fetus associated with maternal Sjögren's syndrome.

This report illustrates the case of a fetus who was diagnosed by M-mode echocardiography, at the twentieth week of gestation, as having a complete heart block. The mother had a positive antinuclear antibody test result with antibodies directed against the Ro (SSA) and La (SSB) antigen system consistent with the diagnosis of Sjögren's syndrome. Management and outcome of the pregnancy are discussed.

Adult↗
PubMed2006

Characterization of T-cell population in children with prolonged fetal exposure to dexamethasone for anti-Ro/SS-A antibodies associated congenital heart block.

The objectives of the study were to characterize the production, function and survival of T lymphocytes of children with prolonged fetal exposure to dexamethasone for anti-Ro/SS-A antibodies associated congenital complete heart block. The analysis of thymic function, studied by measuring the level of T-cell receptor excision circles, was performed by real time PCR, the composition of T-cell subpopulation was evaluated by flow cytometry and the T-cell diversity was assayed by heteroduplex analysis. T-cell competence was gauged at two functional levels by determining the proliferation and the number of T-cell divisions and by measuring gamma-interferon production after mitogenic stimulation. We observed that the thymic output, distribution of T-cell subsets, thymidine incorporation, number of T-cell divisions, and y-interferon production were comparable to those of age-matched control. On the contrary, heteroduplex analysis demonstrated the presence of both polyclonal and oligoclonal peripheral T-cell repertoires. In conclusion, the analysis of the T-cell compartment in children with prolonged intrauterine exposure to high dose dexamethasone did not disclose any relevant abnormality, except a restriction of T-cell receptor diversity in some patients.

Antibodies, Antinuclear↗
PubMed1994

Signal-averaged electrocardiographic late potentials in children with complete heart block.

The purpose of this study was to examine signal-averaged electrocardiographic (SA-ECG) late potentials to predict ventricular arrhythmias during intrinsic cardiac rhythm and during ventricular pacing in children with complete heart block (CHB). Recordings of SA-ECG were obtained from eight patients (aged 3-18 years) with documented CHB. The etiology of CHB was congenital in four cases and acquired in four cases. Six of these patients underwent permanent pacemaker implantation. Comparisons of the SA-ECG were made before and during ventricular pacing. Abnormalities of SA-ECG during intrinsic cardiac rhythm were noted in four patients, all of whom were older than 14 years. Although there was no significant difference in SA-ECG parameters between patients with congenital CHB and acquired CHB, abnormal SA-ECG was noted in one of four patients with congenital CHB and in three of four patients with acquired CHB. Two patients without permanent pacemaker implantation had normal SA-ECG, but four of six patients with permanent pacemaker implantation had abnormal SA-ECG. Three of the four patients had abnormal SA-ECG during ventricular pacing, but the abnormal SA-ECG in one patient had normalized during ventricular pacing. It is important to record SA-ECG before and during ventricular pacing to detect late potentials in patients with CHB. It may be useful to record SA-ECG while changing the pacing site to find ideal sites for electrode implantation for the potential prevention of ventricular arrhythmias.

Action Potentials↗
PubMed2001

[Therapeutic plasmapheresis for the prevention of congenital complete heart block associated with anti-SS-A/Ro antibody and anti-SS-B/La antibody].

OBJECTIVES: Neonatal lupus erythematosus is characterized by transient lupus abnormalities, various systemic and hematological abnormalities, and congenital complete heart block (CCHB). It is well known that anti-SS-A/Ro antibody (52 kD/60 kD) and anti-SS-B/La antibody are associated with CCHB. This study was conducted to evaluate the effects of the removal of anti-SS-A/Ro antibody (52 kD/60 kD) and anti-SS-B/La antibody from plasma in pregnant women whose fetuses are at a high risk of developing CCHB. MATERIALS & METHODS: Fifteen pregnant patients positive for anti-SS-A/Ro antibody and anti-SS-B/Laantibody were subjected weekly to double filtration plasmapheresis to remove both antibodies. Antibody titers were measured by double immunodiffusion (DID) and ELISA. RESULTS: As a result, all women gave birth to live babies, but CCHB was recognized in one baby. No transient lupus abnormalities were recognized in any of the babies. Fourteen patients showed decreased antibody titers by ELISA during plasmapheresis. However, the patient who was delivered of a baby with CCHB showed an increase of antibody titers by ELISA while the DID method showed a decrease of antibody titers. CONCLUSION: Our study suggested that plasmapheresis prevents CCHB associated with anti-SS-A/Ro and anti-SS-B/La antibody. Also, it is important to monitor the antibody titer regularly during the course of pregnancy, because it may increase due to worsening of the mother's primary disease.

Adult↗
PubMed1977

Coital (cardiac) convulsions: case report of a unique presentation of complete heart block.

A 55-year-old man presented with the acute onset of seizures occurring during the post orgasmic phase of sexual intercourse. Evaluation for brain neoplasm was negative. During the hospital stay, the patient developed status epilepticus during which electrocardiogram documented complete heart block. The seizure disorder was corrected with the insertion of a permanent epicardial pacemaker.

Coitus↗
PubMed2005

Unruptured sinus of Valsalva aneurysms manifesting as complete heart block.

We present a patient with bilateral unruptured sinus of Valsalva aneurysms involving both the left and right coronary sinuses. The large left sinus aneurysm protruded into the left atrium and the right sinus aneurysm extended into the interventricular septum, producing a transient complete heart block.

Adult↗