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At least 19 recordsLinked to original sources
PubMed1977

Ventricular arrhythmias in acute myocardial infarction. A comparative study on some tests for ventricular arrhythmias.

A continuous ECG recording has been made in 31 myocardial infarction patients during the first 24 hours after admission to hospital. The number and severity of ventricular arrhythmias were recorded in great detail. Before discharge from hospital the patients were submitted to 20 hours of ECG tape recording, an exercise test on a bicycle ergometer and a static work test (handgrip). Another exercise test was performed one month after discharge. During the first day in the Coronary Care Unit (CCU) all 31 patients had ventricular arrhythmias and in 27 of them the arrhythmia was classified as major (calling for treatment according to Lown's criteria). At the exercise tests 23 patients showed ventricular arrhythmias, 12 of them considered as major. No antiarrhythmic therapy was given during the investigation. No correlation was found between the degree of arrhythmia during the first day in the CCU and during the exercise tests. Tape-recorded ECG's appeared to be inferior to dynamic exercise tests in the ability to disclose a latent tendency to ventricular arrhythmia. Static work did not provoke any ventricular arrhythmias. At a 2-year follow-up 5 patients had died, 4 of them suddenly. Examination of additional material on 11 patients with ventricular tachycardia or ventricular fibrillation during the CCU stay, showed that 2 had died, but only one suddenly. Frequency and severity of arrhythmias during the first day after the infarction seemed to correlate poorly to a persistent tendency to arrhythmias during the first day after the infarction seemed to correlate poorly to a persistent tendency to arrhythmias or to the risk of sudden death during the following 2 years. A dynamic exercise test performed before discharge would appear to be more effective in selecting patients in need of long-term prophylaxis. However, very few patients seem to need such a specific antiarrhythmic prophylaxis.

Acute Disease↗
PubMed1979

[Quantitative evaluation of the efficacy of anti-arrhythmia agents in chronic ventricular arrhythmia].

The authors describe a computer system for the analysis of ventricular arrhythmias and its use in the evaluation of anti-arrhythmic drugs. Provided the arrhythmia is stable, this method allows an estimation of the onset and duration of action of the drug and gives guidelines for the choice of an appropriate drug regimen. Using this system, a comparison can be made between different drugs based on quantification of their efficacy.

Amiodarone↗
PubMed1976

[Arrhythmia analysis--arrhythmia control (comparative studies of 4 small computers for automatic electrocardiography control)].

Four arrhythmia computers presently available on the market were tested with respect to their efficiency in identifying abnormal QRS-complexes. A considerable variation for the calculated sensitivity and specificity has been found with a highest value for sensitivity (92.9%) combined with a low specificity (72.4%), and a highest value for specificity (100%) combined with a very low sensitivity (36.6%). The best results were obtained by a computer with a sensitivity of 90.9% and a specificity of 98.5%. For the routine use of these computers in the CCU common artifacts (e.g. muscle potentials) must influence their performance in a practical way: neither should minor artifacts stop the function completely nor should the computer continue to measure with a high level of "noise". Based upon the results of these test series suggestions for the concept of arrhythmia computers for CCU are presented.

Arrhythmias, Cardiac↗
PubMed1975

Electrophysiology and pharmacology of cardiac arrhythmias. III. The causes and treatment of cardiac arrhythmias. Part B.

Studies on the electrophysiologic mechanisms responsible for disturbances of cardiac rate, rhythm, and conduction, and studies on the actions and mechanisms of action of antiarrhythmic and other drugs, permit the development of an apparently reasonable approach to treatment of cardiac arrhythmias. Some of the rules derived from an appreciation of cardiac electrophysiology are generally applicable. Others appear to require further testing. There are many discrepancies between what can be predicted or expected and what happens; these discrepancies result from many factors. It is likely that cardiac disease in humans has effects on the electrical activity of cardiac cells which have not been reproduced in the laboratory. It is likely, also, that disease modifies the response of cardiac cells to drugs in ways that have not yet been discovered. Nevertheless, some progress has been made and further experiment and thought may provide both better understanding and new and better therapeutic agents.

Arrhythmias, Cardiac↗
PubMed1975

The reliability of intermittent ECG sampling in arrhythmia detection.

Although intermittent ECG sampling is a commonly used method for arrhythmia detection there are no controlled studies of its efficiency. In the present study a continuous ECG was recorded for three hours in 52 patients with ventricular tachyarrhythmias. All ECGs were interpreted minute to minute to get the true arrhythmia content. Intermittent ECG samples were simulated by analyzing the first two and first five minutes of every 15 minutes in the ECG material. Two minute long ECG samples were also used every 30 minutes. The 15 and 30 minute long periods were classified as containing arrhythmias or not according to the arrhythmia content of the samples. These findings were subsequently compared with the true arrhythmia content. The arrhythmia detection rate depends on the sampling time and true arrhythmia occurrence. The distribution of arrhythmias within the periods was also of importance. With a five minute long ECG sample about 80% of the intervals containing any type of ventricular tachyarrhythmia will be detected. This is reduced to about 50% when one minute long ECG strips are used. Infrequent types of VPCs such as R on T or ventricular tachycardia are very poorly detected also when sampling as much as one-third of the total time. The study also included a comparison between the results obtained from the clinical material and the results obtained by the use of computerized arrhythmia models. It is concluded that intermittent ECG sampling besides a low detection rate for infrequent arrhythmias and short ECG samples, also brings a risk of underestimating or overemphasizing the arrhythmia occurrence depending on a periodic type of arrhythmia distribution among the patients. These factors make intermittent ECG sampling an unsuitable method for evaluating antiarrhythmic drugs.

Adult↗
PubMed1977

[Prognostic significance of arrhythmias in acute myocardial infarction (author's transl)].

Ventricular arrhythmias represent a common precursor of ventricular fibrillation in acute myocardial infarction in man. Frequent ventricular ectopic beats (greater than 5/min), multifocal ectopic beats, ventricular bigeminy, ventricular salvoes, ventricular tachycardia, and the R-on-T phenomenon have been considered as warning arrhythmias. However, recent studies have given rise to some doubt concerning the value of warning arrhythmias as predictors of ventricular fibrillation. In many a case there is no warning arrhythmia prior to ventricular fibrillation or these arrhythmias do not fulfill the criteria of warning arrhythmias. In other cases the warning arrhythmias develop so briefly before ventricular fibrillation that no prophylactic measure can be instituted. Warning arrhythmias may occur at equal frequency in patients with and without consecutive ventricular fibrillation. This also applies to the R-on-T phenomenon as a warning arrhythmia and as the initiating mechanism of ventricular fibrillation. In nearly half the cases ventricular fibrillation is initiated by a late ventricular ectopic beat. In view of these data of the literature, the so-called warning arrhythmias seem to have lost their predictive value. They represent a common phenomenon in acute myocardial infarction in man. However, ventricular fibrillation may also occur without any prior ventricular arrhythmias, above all during the first day of acute myocardial infarction. The frequency of ventricular fibrillation decreases in the course of infarction. Therefore the time during acute myocardial infarction may be a better guide whether to institute prophylactic antiarrhythmic therapy than the occurrence of ventricular arrhythmias. To date, the beneficial effect of prophylactic administration of lidocaine has remained controversial though a recent double-blind study has strongly suggested that lidocaine is able to prevent ventricular fibrillation. If these results should be confirmed by others, this would ask for routine administration of lidocaine in each case with acute myocardial infarction during the first day.

Acute Disease↗