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Biomedical subjects

A Neugebauer

Publications and source records attributed to A Neugebauer.

At least 73 records · Page 4Linked to original sources
PubMed1982

[Occurrence of repetitive ventricular responses in programmed right ventricular stimulation].

In 30 patients with various disturbances of rhythm (17 males, 13 females) at the age of 16-72 years during a conduction analysis a programmed stimulation relating to the right ventricle was carried out and the occurrence of repetitive ventricular responses was evaluated. 9 patients did not show any repetitive ventricular responses. In 14 patients with various disturbances of rhythm a V3-phenomenon was evoked which as an interventricular reentry is a physiological phenomenon. In 6 patients with myocardial scar and extreme bradycardia, respectively, apical torsades were observed via a V3-phenomenon with transition into an intraventricular reentry (one persisting interventricular reentry) and like 2 provoked ventricular tachycardias (one with, one without observation of apical torsades) were valuated as a reference to the electric instability of the ventricular myocardium. The obtainability of apical torsades as well as of V3 was possible only in a minimal retardation of the conduction to His's bundle depending upon the frequency of stimulation and precociousness of S2. Only in a transition into an intraventricular reentry apical torsades speak for, non-evokable apical torsades do not speak against an increased electric instability of the ventricular myocardium, but for existing and not existing, respectively, suitable distal conduction conditions to the stimulation reentry.

Adolescent↗
PubMed1982

[Treatment of ventricular arrhythmias with mexiletine].

The development of new antiarrhythmic drugs allows to a certain extent the performance of a differential therapy and prophylaxis. This also concerns the lidocaine-like substance mexiletine, which according to Vaughan-Williams is to be classified into class I B of the antiarrhythmic drugs with direct membrane effect. It is effective in disturbances of the ventricular rhythm also in oral therapy, which in most cases are more life-endangering than the supraventricular ones. In own examination in 21 of 26 patients a complete or far-reaching suppression of accumulated extrasystoles and particularly of ventricular tachycardias could be achieved by an oral long-term therapy with 600--800 mg mexiletine. In the acute experiment short-term infusions were not effective in patients with ventricular tachycardias, since apparently no sufficient plasma level was obtained, wherefore also a following permanent drop infusion is recommended. The rate of side-effects was insignificant and in no case led to a withdrawal of the therapy.

Administration, Oral↗
PubMed1981

[Possibilities of electrotherapy in tachycardial rhythm disorders].

The pacemaker therapy of tachycardiac disturbances of rhythm used a great number of different methods which are applied according to the kind of disturbance of rhythm. A specialised intracardiac diagnostics is frequently necessary in order to select the suitable stimulation technique. A short survey of the different technical stimulation methods is given which are known from literature and for which own experiences are present. In the perspective a high value is ascribed to the pacemaker therapy in tachycardias.

Cardiac Pacing, Artificial↗
PubMed1980

[Clinical value of the refractory period behavior of the atrioventricular transconduction].

Issuing from the estimation of the maximum 1 : 1-transconduction in rapid stimulation of the atrium (so-called maximum isorhythmia) as a suitable parameter for the refractory behaviour of the atrio-ventricular transconduction the estimation of the refractory periods of the atrio-ventricular transconduction by means of programmed stimulation of the atrium is discussed and particularly the dependence on frequency of all refractory periods of the atrioventricular transconduction is shown. It is emphasized the peculiarity of the effective refractory period of the atrioventricular node to grow longer with increasing frequency of stimulation. It renders the atrioventricular node to the frequency limiting segment of the atrioventricular transconduction, to the so-called "gate" of the atrioventricular transconduction. Apart from the prolongation of the individual refractory periods recognizable by the maximum isohythmia the establishment of a deviating behaviour of the atrioventricular transconduction which depends on frequency is of clinical importance. This is shown as an example for sinus bradycardia, sinus tachycardia and for investigations of medicaments in general (here for cordanum and obsidan) as well as in therapy studies in the individual patient (here for alupent).

Adult↗
PubMed1980

[Myocardial scintigraphy using technetium-99m-diphosphate in combination with selective coronary perfusion scintigraphy and coronary angiography].

The findings of the scintigraphy of the myocardium with Technetium-99m-diphosphonate (Tc-99m-DP) of 45 patients with nearly exclusively ischaemic heart disease were compared with those of the selective coronary angiography and those of the selective coronary perfusion scintigraphy. 12 patients exhibited an enlargement of the activity in the myocardium (positive scintigramme). These cases were particularly described in this paper. The levocardiogramme proved disturbances of the motility of the walls in 6 patients. In 5 patients a positive scintigramme of the myocardium was registered. Therefore, the scintigraphy of the myocardium with Tc-99m-DP is regarded as a supplementing, non-invasive method for the diagnosis of more pronounced disturbances of the motility of the heart wall. Furthermore, positive scintigrammes of the myocardium were registered in angina pectoris, condition after aorto-coronary bypass-operation, cardiomyopathy and myocarditis. Since the scintigraphy of the myocardium with Tc-99m-DP is a sensitive method for the poor of cell lesions of the myocardium, it allows a judgment of the floridity of the myocardial process. From this among other results that the scintigraphy of the myocardium may be a help for the indication to the aorto-coronary bypass operation. Clear relations between the scintigraphy of the myocardium, the number of the coronary-sclerotically changed heart vessels and the development of stenosation are not to be established. An immediate connection between the size of the disturbance of the perfusion and the results of the scintigraphy of the myocardium is also not to be recognized.

Adult↗
PubMed1979

[Abnormal myocardial blood flow distribution with a normal coronarogram in angina pectoris and after myocardial infarction].

It is reported on the selective coronary perfusion scintigraphy in 47 patients with angina pectoris and condition after myocardial infarction, which was performed simultaneously with the coronary angiography. For the paper were interesting the cases with normal coronarogram, but pathological perfusion scintigram. 3 of 25 patients with condition of infarction showed coronarographically inconspicuous vessels. In all cases the perfusion scintigram shows disturbances of regional perfusion, which corresponded with the electrocardiographic localisation of the infarction. In 3 of 22 patients with angina pectoris with normal coronarogram in the scintigram regional changes of the terminal vascular system were established. In 2 cases simultaneously a disturbance of rhythm and stimulus conduction was present, which showed a conspicuous correlation to the perfusion lesions in the septum. In the small intramural vessels haemodynamically effective changes take place which are below the coronarogram. Therefore, the only coronarography is not enough to confirm or to refuse a genuine angina pectoris or an infarction. The selecitve coronary perfusion scintigraphy gives the possibility to prove disturbances of the distribution of regional blood supply without a greater additional load of the patient as to coronary angiography. However, it cannot give evidence on the genesis of disturbances in the terminal vascular system in the normal coronarogram

Adult↗
PubMed1979

[Programmed stimulation for the analysis of arrhythmias].

On the basis of the examination of a left bundle-branch heart block depending on frequency, of a paroxysmal tachycardia in functional conduction dissociation in the atrioventricular node and a WPW-syndrome of type A is shown that and how by means of programmed stimulation of the right atrium in order to establish the times of conduction and the refractory periods of all conduction sections of the conduction system of the heart also under influence of medicaments the diagnostic repertoire is enriched for the analysis of disturbances of the rhythm without comprehensively or finally estimating the clinical valency of the method.

Adult↗
PubMed1979

[Clinico-diagnostic criteria for the evaluation of social aspects in acquired heart valve diseases].

In spite of the retrogression of the acute rheumatic fever the acquired valvular defects still play an essential role for the morbidity and mortality above all for the younger and middle decenniums of life. In the preliminary diagnostics it is the task of the family doctor to diagnose the valvular defect, to differentiate it from non-organic findings and to estimate its degree of severity. The diagnosis of a carditis renders special difficulties, particularly in its chronic recurrent form. Certain situations of life do not demand only an actual analysis of the findings, but also an individual prognostic estimation. For the choice of profession, the ability for military service and driving a car general references and regularities must be taken into consideration. The indication to operation of the valvular defect is generally given in degree of severity and with restriction also in stage IV. A mitral stenosis is operated already in stage II, when stronger complaints and haemodynamic changes are present. Patients with degree of severity III and IV should avoid a pregnancy, in stage I and II under common control by the internist and obstetrician the pregnant patient may not have any scruples to carry to full term.

Abortion, Therapeutic↗
PubMed1978

[A programmed universal stimulator for the diagnosis and therapy of bradycardial and tachycardial arrhythmias].

Special kinds of electrostimulation, particularly the so-called programmed stimulation, are necessary for the specialised diagnostics of disturbances of nervous impulses of the heart and of the conduction system with intracardiac ECG (His-electrocardiography). A pacemaker using constituents of microelectronics is described which apart from fixed frequent, coupled, P/R-linked, bifocal and higher frequent atrial stimulation makes possible a programmed stimulation according to a preelected programme. Apart from the use for diagnostics the stimulator is suited for the therapy of bradycardic disturbances of the rhythm and for the termination of tachycardias.

Bradycardia↗
PubMed1978

[Clinical evaluation of the arterial system in hemophiliacs as a model for long-term anticoagulation].

Issuing from the question of the value of a prophylactic anticoagulation for the purpose of prevention of arteriosclerosis 25 patients with haemophilia were examined with the aim to detect possible connections between coagulation potential and arteriosclerosis taking into consideration factors of risk and age. Indeed, also in these patients who were "anticoagulated" from birth factors of risk and references to an existing arteriosclerosis were found. Correlation analyses, however, indicated tendencies, which suggest a protective influence of the hypocoagulability concerning factors of risk and arteriosclerosis.

Adult↗
PubMed1975

[Drug therapy of myocardial infarct in ambulatory practice].

For the practicing physician the medicamentous treatment of the patients with infarction is the main problem of the secondary prevention in the prehospital phase as well as in the after-treatment. In these cases in the acute phase not the myocardial insufficiency is in the centre of the out-patient care, but the therapy of the disturbances of cardiac rhythm, which mainly cause the high lethality in the early phase. Therefore, uncomplicated infarctions, in whch care must be taken only for a sedation of sympathico-adrenergic reactions and a volume reduction of the heart, should be differed from complicated cases. However, an immediate transport to the hospital must be guaranteed. If there appear a contraction insufficiency of the left ventricle or threatening disturbances of the rhythm, additionally glycosides and saluretics must be administered as well as an aimed antiarrhythmic therapy must be initiated. The necessary medicamentous measures are described dependent upon the diagnosis of brady- and tachycardiac disturbances of the rhythm. The author enters briefly the problems of volume substitution, treatment of acidosis as well as the administration of beta-sympathicolytics and gluco-corticoids. - In the after-treatment of infarctions anticoagulants are the only medicaments to be prescribed, when findings completely without complications are present. If, however, there are signs of activity of the coronary heart disease in the post-infarction phase, a basic therapy with a glycoside and anticoagulants as well as an individually to be varied additive therapy with nitro-preparations, beta-sympathicolytics, saluretics, anti-hypertensive agents and antiarrhythmic agents are necessary.

Acidosis↗