Biomedical subjects

A Fajuri

Publications and source records attributed to A Fajuri.

At least 19 recordsLinked to original sources

PubMed1992

[Arrhythmogenic dysplasia of the right ventricle: clinical presentation and long-term course].

The clinical findings and follow up in 10 patients with arrhythmogenic dysplasia of the right ventricle were analyzed. Presentation occurred at a mean age of 35 +/- 12(SD) years and all patients presented with ventricular tachycardia and a left bundle branch block pattern. Physical examination was normal. T waves were inverted in right precordial leads in all and late depolarization were seen in 7. Global or segmental dilatation of the right ventricle was shown by echocardiogram in all patients and by right ventricular angiography in 8. After a mean follow up of 6.6 years (+/- 3), 70% had recurrence of ventricular tachycardia in spite of adequate antiarrhythmic therapy. Mortality was only 10%. Surgery was performed in 4 patients. Two patients had focal right ventricular fibrosis and resection lead to cure of arrhythmia.

Adult↗

PubMed1992

[DDD dual chamber pacemakers. Initial experience].

Our preliminary experience with dual-chamber DDD pacemakers is reported. Technological innovations of the device, atrio-ventricular electrode stability and sequential stimulation have contributed to improve the conditions of patients previously submitted to VVI pacemaker implantation. Primary indications for DDD pacemaker implantation in our series included 7 patients with complete atrio-ventricular (A-V) block, 3 with Mobitz type II second-degree A-V block and 2 with sick sinus syndrome. In six of the 12 patients (50%) additional indications included: ventricular tachycardia in 4 patients, atrial fibrillation in one and pacemaker syndrome in one. Other cardiac conditions were diagnosed: dilated cardiomyopathy in 3 patients, ischemic heart disease in 2 patients, valvular heart disease in 2 patients, congenital heart disease in 1 patient and hypertrophic cardiomyopathy in one patient. The implanted pacemakers were: 5 Genesis, 4 Ultra CPI and 3 Versatrax. J-shaped atrial electrodes were used in 8 patients and in 4 instances a screw-in electrode was employed. Improvement of hemodynamic function was achieved by frequent follow up and reprogramming of DDD pacemaker in every patient. While 4 patients died with progressive deterioration of cardiac function, eight patients survived with adequate sequential stimulation. We conclude that DDD pacemakers are reliable and afford symptomatic relief in a broad spectrum of patients.

Adult↗

PubMed1992

[Radiofrequency fulguration in patients with reciprocating tachycardias].

The use of radiofrequency for catheter ablation of accessory pathways and dual AV nodal pathways has been recently introduced. In this paper the results obtained in 5 patients are reported. Three patients had accessory pathways and 2 a dual AV nodal pathway. After a complete electrophysiologic study, a 7F Door Knob catheter coupled to a Radionics radiofrequency generator delivering a maximum of 16 watt at 480 KH was used to ablate the abnormal pathway. Success was obtained in every patient at times varying from 30 sec to 3 min, using 3 to 17 energy deliveries. These results include the first successful ablation of a left lateral bundle with radiofrequency using an energy of only 16 Watt.

Adolescent↗

PubMed1991

[Sudden unexpected nocturnal death: report of a case and review of the literature].

Sudden death usually affects individuals with severe heart disease. A more dramatic phenomenon is the sudden unexpected death of individuals with no evidence of heart disease. It has been described mainly in young healthy males under severe stress. We present a 32 year old man who presented ventricular fibrillation during sleep and was resuscitated by his wife. Recurrent episodes of VF occurred in the following hours. The study, including coronary angiography, revealed a normal heart. Endomyocardial biopsy showed minimal alterations with scarce areas of atrophy and fibrosis. Electrophysiologic evaluation showed an extremely short refractory period of the right ventricle, but the arrhythmia could not be induced by electrical stimulation. An internal cardioverter defibrillator was implanted since the risk of recurrent VF was high. A review of the literature concerning this unusual entity is offered.

Adult↗

PubMed1990

[Wolff-Parkinson-White syndrome: late results of surgical treatment].

We followed 25 patients operated on for Wolff-Parkinson-White syndrome between August 1985 and October 1989. Their mean age was 37 +/- 12 years and arrhythmia had been present for 5 to 30 years. A mean of 3.3 +/- 1.2 antiarrhythmic agents had failed in controlling recurrences. Tachycardia was orthodromic in 21 patients and antidromic in 1, while 3 patients presented rapid atrial fibrillation with hemodynamic deterioration. Drug refractoriness (n = 23) or intolerance (n = 2) were the main surgical indications. The location of accessory pathways was lateral in 19 patients, anteroseptal in 3, posteroseptal in 2, postero lateral in 1 and right lateral in 1 patient. One patient had a double pathway. There was no surgical mortality. After a follow-up period ranging from 1 to 50 months recurrence of arrhythmia was observed in one patient and electrophysiologic evaluation showed persistence of a left lateral pathway in another. The remaining 24 patients are free of symptoms at the end of follow up. Thus, surgical treatment is a curative therapy for most patients with WPW.

Adolescent↗

PubMed1990

[Sudden death in the young adult without demonstrable cardiopathy: the clinical and electrophysiological characteristics in 3 cases].

We report 3 young adult males who developed spontaneous ventricular fibrillation in the absence of demonstrable heart disease. Extensive clinical and electrophysiologic evaluation failed to disclose a cause for the arrhythmia. Antiarrhythmic drugs were empirically used in all patients but 2 of them eventually died. Thus, unexplained ventricular fibrillation without demonstrable heart disease carries a serious short-term prognosis. An implantable cardio-vector-defibrillator may be the therapy of choice in these cases.

Adult↗

PubMed1990

[The identification and localization of multiple accessory pathways in patients with recurrent tachycardia].

Approximately 15% of patients with Wolff Parkinson White's syndrome who undergo electrophysiologic study have more than one accessory pathway. We describe the electrophysiologic testing and findings in 2 patients with multiple pathways. Identification of these is highly relevant since successful surgical therapy depends on section of all pathway.

Adult↗

PubMed1989

[Acute cardiac rupture in myocardial infarction. A case report].

A 60 year old woman with a large anterior wall myocardial infarction developed severe hypotension 12 hr after admission to the coronary care unit. X rays showed an enlarged cardiac shadow and echocardiography signs of pericardial effusion. Swan Ganz catheterization revealed severe venous hypertension and no suggestion of ventricular septal rupture. Emergency surgery, initiated with partial cardiopulmonary bypass, showed a 1 cm tear of the anterior wall of the left ventricle, close to the left anterior descending artery. A successful repair was obtained by suture on teflon pledgets. After a difficult postoperative course, the patient was doing well 8 months after surgery.

Electrocardiography↗

PubMed1989

[Serum lipids, HDL2 and HDL3 cholesterol and apolipoproteins A1 and B as predictors of coronary artery disease diagnosed by coronarography].

Serum levels of total, HDL2 and HDL3 cholesterol, triglycerides and apolipoproteins A1 and B were compared in 100 Chilean males with (n = 80) or without (n = 20) coronary artery disease (CAD). The presence and severity of CAD was determined by an angiographic score. Discriminating power, sensitivity, specificity and positive predictive value for CAD were calculated for all variables. As an isolated factor, total cholesterol had the greatest discriminating power (p less than 0.002): 21% of patients with CAD had cholesterol levels below 200 mg/dl while no patient with cholesterol over 275 mg/dl was free of disease. Even though all cases with HDL cholesterol below 25 mg/dl belonged in the CAD group, this factor had no overall discriminating power. Total cholesterol/HDL cholesterol ratio had the greatest discriminating power (p less than 0.001) while total/HDL2 cholesterol had the best positive predictive value.

Adult↗

PubMed1989

[Idiopathic recurrent ventricular tachycardia: role of verapamil in its treatment].

Verapamil is a calcium channel blocker ideally suited for the treatment of A-V nodal reciprocating supraventricular tachycardia. Most types of ventricular tachycardia are refractory to treatment with verapamil since they depend on sodium channels. However, a few cases of recurrent ventricular tachycardia are refractory to Type I antiarrhythmic agents and may respond to verapamil. We report 2 such cases.

Adolescent↗

PubMed1989

[Atrial ectopic tachycardia. A variety of incessant tachycardia].

A 19 year old patient with incessant supraventricular tachycardia was submitted to electrophysiologic study. An ectopic left atrial focus was demonstrated. Intraoperative mapping localized the focus to the upper left atrial quadrant. Successful surgical isolation of the focus was possible. The patient is currently asymptomatic and arrhythmia free.

Electrocardiography↗

PubMed1988

Role of programmed electrical stimulation of the heart in risk stratification post-myocardial infarction.

Programmed electrical stimulation (PES) of the heart was evaluated as a method of identifying patients at risk of sudden death post-myocardial infarction (post-MI). Eighty-four patients (mean age, 56 +/- 10 years) underwent PES 6 to 8 weeks post-MI. PES was performed at the right ventricular apex at twice diastolic threshold. Prior to stimulation patients were studied with exercise stress testing, 24-hour Holter monitoring and radionuclide ejection fraction. The patients were placed into two groups, according to their responses to electrical stimulation. Group 1:65 patients in whom no arrhythmias were induced or who had repetitive responses that lasted less than six cycles; Group 2:19 patients in whom ventricular tachycardia was induced. At the end of follow-up (20 +/- 9 months) six patients from Group 1 had died. Complex ventricular ectopy and ventricular tachycardia were more frequently detected on Holter in Group 2 (9/19) than in Group 1 (14/65) (p less than 0.03). The results of exercise testing and radionuclide ejection fraction did not correlate with the response to PES. However all but one of the patients who died had a left ventricular ejection fraction (LVEF) under 40% and four out of six patients had ventricular tachycardia on Holter monitor. We draw the conclusion that PES did not contribute to the identification of high-risk patients post-MI, as none of the 19 patients in whom ventricular tachycardia was induced died during follow-up. In addition, high-risk patients were characterized by poor ventricular function and complex ventricular arrhythmias on Holter recording.

Electric Stimulation↗

PubMed1987