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A Both

Publications and source records attributed to A Both.

At least 37 records · Page 2Linked to original sources
PubMed1976

His bundle recordings in a case of complete atrioventricular block combined with pre-excitation syndrome.

In a patient with complete A-V block suffering from attacks of dizziness an intermittent A-V conduction with a short P-R interval and a delta wave of the conducted ventricular complex were observed. After accelerating the sinus rate by atropine and by exercise, one-to-one conduction was established with QRS complexes of WPW type A configuration. His bundle recordings revealed a complete block within the normal conduction system at the level of the A-V node. A slow junctional rhythm with a normal H-V interval was activating the ventricle. During atrial pacing a one-to-one conduction through an accessory pathway could be documented at cycle lengths between 800 and 380 msec. sandwiched in between zones of complete block at smaller or longer cycle lengths. During ventricular stimulation no retrograde V-A conduction could be observed. The findings support the thesis of at least two functionally different A-V pathways in patients with pre-excitation syndrome.

Arrhythmias, Cardiac↗
PubMed1976

[Surgical management of acquired tricuspid insufficiency--valvular replacement or annuloplasty? (author's transl)].

61 patient underwent operative repair of acquired tricuspid insufficiency (T.I.) during correction of multiple valvular disease. 45% presented a relative T.I. through annular dilatation, while organic lesions of the tricuspid valve were found in 56% of the patients. A tricuspid valvular replacement was carried out in 17, and a tricuspid annuloplasty in 44 patients. We believe that during surgical management of multiple valvular lesions, all tricuspid insufficiencies of even when only of a slight to moderate degree - should be corrected aggressively. Tricuspid valvular replacement should be avoided if possible and a tricuspid annuloplasty should be performed.

Adolescent↗
PubMed1976

The effect of atropine on calculated sinoatrial conduction time in man.

This study investigates the effect of atropine on the length of the return cycles after premature atrial stimulation in man. On the assumption that sinus node automaticity is not changed by premature depolarization of the sinus node, sinoatrial conduction time (SACT) was calculated from the differences between the length of the return cycles and the spontaneous cycle length. 11 patients were studied before and after the injection of atropine. In all cases atropine caused an increase in heart rate. In 8 patients the return cycles exhibited a typical behavior. In 6 patients without signs of sinus node dysfunction, the mean calculated SACT was 109 msec, whereas 2 patients with a sick sinus syndrome (SSS) had a mean calculated SACT of 190 and 225 msec, respectively. 3 patients with SSS demonstrated an atypical pattern of the postextrasystolic pauses. In 6 patients without sinus node dysfunction, atropine caused a reduction of calculated SACT about 35%. In 2 patients with SSS the reduction was 38 and 49% of the control value, respectively, whereas in the remaining 3 patients with SSS who had an atypical return cycle pattern, a normalization occurred after the administration of atropine. We conclude that, besides its effects on sinus node automaticity, atropine has also a marked effect on sinoatrial conduction, even in patients with the sick sinus syndrome.

Arrhythmia, Sinus↗
PubMed1975

[Clinical value of His bundle electrography (author's transl)].

Methodical problems, indication and clinical implication of His bundle electrography are discussed. In 200 successive patients undergoing His bundle electrography and atrial stimulation the indication was as follows: Intraventricular conduction defects in 24%, A-V block in 21%, sick sinus syndrome in 20%, preexcitation in 17%, and complex arrhythmias in the remaining cases. In 38% of the patients did the HBE prove to be of help by providing information not available after analysis of the surface ECG. In 22% this technique contributed essentially to the management of these patients. In spite of dificiencies of our knowledge of the basic mechanisms, specific therapy, and prognosis of various arrhythmias His bundle electrography is clinically useful in selected patients. Therefore, this method has become a routinely used clinical tool.

Arrhythmias, Cardiac↗
PubMed1975

[Diagnostic and prognostic value of endomyocardial biopsy in patients with congestive cardiomyopathy (author's transl)]rdiomyopathy(author.

Endomyocardial biopsies were obtained from the right ventricle in 25 patients with the clinical diagnosis of congestive cardiomyopathy. The biopsies were subjected to virological and histological studies (light and electronmicroscopy) and the findings correlated with clinical data. Abnormal morphological findings were present in all patients. The presumed clinical diagnosis was confirmed in 19, the morphological changes not being consistent with the clinical diagnosis of CCM in six patients. Electronmicroscopy revealed cardiac storage disease in one patient and pathological changes secondary to previous myocarditis in the other five. Clinical follow-up studies of the five patients apparently confirmed the morphological results, because in no case was there clinical deterioration, three patients in fact being in a fairly normal cardiac state at present. Using a morphological scoring system, the 19 patients with morphologically confirmed diagnosis of CCM were subdivided into two groupds, those with four points or less (group I, n equal to 9), and those with five pints or more (group II, n equal to 10). During a mean follow-up period of nearly 12 months the first group had a low mortality rate (n equal to 2), while the other had a high one (n equal to 6). The occurrence of signs of degeneration and mitochondrial alterations, in particular, was associated with a poor clinical prognosis. This differentiation into two groupds could not be achieved by clinical means alone. Type B3 Coxsackie virus was isolated from one biopsy, but no patient had significant serological evidence of virological infection.

Adult↗
PubMed1975

[Banding for pulmonary artery and subsequent repair in large ventricular septal defect (author's transl)].

Banding of the pulmonary artery was performed in 233 children with large, non restrictive ventricular septal defects. The group of isolated large VSDs consisted of 95 patients, of whom 8 died (8,4 per cent). 32 patients were subjected to open-heart operation for closure of the VSD and debanding. In this "two-stage group" the mortality rate was 6,3 per cent. At the second operation the pulmonary artery always should be enlarged with a pericardial patch. Our recordings up to 6 1/2 years after correction show no gradients left in cases surgically treated in this manner. The time-interval between effective banding and debanding procedure may not be limited strictly; the subsequent operation however should be done within two or three years.

Age Factors↗
PubMed1975

[Diagnostic problems in the sinus node syndrome].

The sick sinus syndrome includes numerous arrhythmias due to various functional disorders of the sinus node, the atria and the A-V junctional tissue. These disturbances of impulse formation and conduction involve many diagnostic problems. If clinical methods as ECG monitoring are of no help, provocative tests are indicated. The best indirect test of the sinus node activity is the measurement of the sinus node recovery time after overdrive suppression. In addition, the sinu-atrial conduction time, the conduction velocity within the right atrium, the A-V node and the His-Purkinje system can be measured. In patients with the sick sinus syndrome abnormalities of conduction in the specialized cardiac tissue are common in addition to sinus node dysfunction. The results of the provocative tests are important for drug therapy or pacemaker implantation.

Arrhythmias, Cardiac↗
PubMed1975

[Atrioventricular conduction in the Lown-Ganong-Levine syndrome].

In 18 patients with LGL-syndrome His bundle electrography and atrial pacing were performed. In all cases the atrial conduction time was normal, the H-V interval within the lower limit (36 msec). The A-H interval was significantly shortened (58 msec). During rapid atrial pacing four different patterns of reaction could be distinguished: 1) A-H interval unchanged (1 case). 2) Sudden prolongation of the A-H interval at a critical rate (4 cases). 3) Continuous prolongation of the A-H time according to the driving frequency (9 cases). 4) Marked delay and block (4 cases). Verapamil had only little or no effect on the A-H interval in these patients. The results indicate, that only in a few cases with LGL-syndrome the shortened A-H time is due to a James bundle bypassing completely the A-V node.

Adolescent↗
PubMed1975

[Electrophysiological effects of the antiarrhythmia agents disopyramide and propafenone on human heart conduction system].

The effect of Disopyramide and Propafenone on intracardiac conduction and refractory periods was tested by means of His bundle electrography and atrial stimulation. Disopyramide (1,7 mg/kg) was administered in 10 patients. There was no significant change of heart rate and conduction time within the atrium and the AV-node. The conduction velocity within the His-Purkinje system was significantly slowed by 13% of the control value. The ERP of the atrium as well as the ERP and FRP of the AV node were prolonged. Propafenone (1,7 mg/kg) was tested in 18 patients. The heart rate was significantly slowed by 13% of the control value. The conduction velocity within all compartments of the heart was depressed uniformly. The all-over-all prolongation of the HBE-intervals was 15%. Furthermore the results are in favour of a prolongation of the ERP of the atrium and the ERP of the AV node. The results can only partially explain the antiarrhythmic effect of the drugs. However, the data are important for assessing the possible side effects during antiarrhythmic treatment especially in patients with disease of the conduction system.

Adult↗