Biomedical subjects

Abdel J Fuenmayor

Publications and source records attributed to Abdel J Fuenmayor.

6 recordsLinked to original sources

PubMed2005

Six mechanisms of supraventricular tachycardia in the same patient: report of a case.

An 18-year-old girl had been suffering from palpitations for 3 years. After a normal and asymptomatic pregnancy, she became highly symptomatic with more than 6 tachycardia paroxysms a week, many of them requiring emergency hospitalizations because of hemodynamic collapse. The electrophysiological evaluation revealed dual A-V nodal pathways and the presence of 4 accessory pathways (3 in the left A-V ring: lateral, posterior, and posteroseptal, 1 right posteroseptal) with 5 types of atrioventricular tachycardia and atrial flutter. The 4 accessory pathways and the slow A-V nodal pathway were successfully ablated, and the patient has been asymptomatic for 12 months without taking antiarrhythmic drugs.

Adolescent↗

PubMed2005

Inter-atrial conduction time shortens after blood pressure control in hypertensive patients with left ventricular hypertrophy.

UNLABELLED: Assuming that blood pressure control could induce a shortening of the inter-atrial conduction time and prevent atrial fibrillation occurrence, we studied the inter-atrial conduction time in hypertensive patients with left ventricular hypertrophy. METHODS: Sixty-eight (26 male) 58.34+/-8.08-year-old patient participated in the study. All were in sinus rhythm and had abnormal blood pressure (163+/-18/95+/-9 mm Hg). Their cardiac mass index was increased (151+/-43 g/m(2) SC) and their left atrial dimension was normal (3.67+/-0.54 cm). The inter-atrial conduction time was measured in the echocardiogram from the beginning of the electrocardiographic P wave to the beginning of the A wave in the mitral Doppler signal and was corrected for heart rate. Heart rhythm disturbances were monitored clinically and by means of a Holter. Most patients were treated with angiotensin antagonists. RESULTS: It was found that arterial blood pressure decreased significantly after treatment and that the P-A interval was significantly reduced (71.4+/-14.5 vs. 63.9+/-11.5 ms). During the follow-up, no patient complained of arrhythmia symptoms or exhibited atrial fibrillation in the Holter recording. CONCLUSION: In this selected group of patients with hypertensive heart disease (left ventricular hypertrophy), an effective blood pressure control was accompanied by a significant decrease in the inter-atrial conduction time. It is possible that these effects prevent atrial fibrillation.

Aged↗

PubMed2004

Bedside programmed ventricular stimulation for sudden death risk stratification.

BACKGROUND: Patients with myocardial infarction and left ventricular dysfunction are at risk for sudden death. This research was conducted to determine the applicability and safety of a bedside programmed stimulation protocol to determine the risk for sudden death in these patients. METHODS: Four hundred and twelve patients with acute myocardial infarction were studied. Left ventricular ejection fraction was evaluated by means of an echocardiogram. Ventricular arrhythmia, late potentials and heart rate variability were determined by means of Holter recordings. Fifty patients (60 +/- 14-year-old; 85% male) presented a left ventricular ejection fraction lower than 0.40 (0.36 +/- 0.10) associated with late potentials, low heart rate variability or ventricular arrhythmia greater than Lown I. After a central venous access was placed under fluoroscopy guidance and ECG monitoring, a quadripolar catheter was advanced to the right ventricular apex to perform programmed ventricular stimulation with up to three extrastimuli. The patients were followed-up to determine in-hospital morbidity and/or mortality. RESULTS: No patient suffered complications. Ventricular tachycardia or ventricular fibrillation was induced in six patients. All of them received amiodarone and in five an automatic cardioverter-defibrillator was implanted. After a 22 +/- 6 month follow-up, five patients had received appropriate discharges from the implanted device and none had suffered from arrhythmic sudden death. CONCLUSION: Bedside programmed stimulation is a safe and useful means for sudden death risk stratification in post myocardial infarction patients. It moreover presents the advantage of being cheaper than conventionally used procedures.

Death, Sudden↗

PubMed2002

QT interval and final portion of T wave: measurements and dispersion in infants born at high altitude.

BACKGROUND: This research was conducted to determine whether the depolarization and repolarization cardiac process of children born at high altitude differs from that of children born at lower altitudes. METHODS: We studied three groups of 30 healthy newborns in the Venezuelan Andes. Group 3500 m consisted of infants born at 3500 m above sea level; Group 3000 m of infants born at 3000 m above sea level and Group 1600 m of infants born at 1600 m above sea level. Conventional 12-lead electrocardiograms were recorded in the 90 newborns. Corrected QT interval, duration from the peak to the end of the T wave, dispersion of QT interval and of the final portion of T wave and heart rate were computed in each subject. RESULTS: The findings of the present study show that infants born at high altitude (Groups 3500 and 3000 m) had a significantly longer corrected QT interval and a significantly shorter peak-to-end of T wave interval. Neither the heart rate nor the indexes of dispersion of the depolarization-repolarization process revealed abnormal values or significant differences among the groups. CONCLUSIONS: These results suggest that the depolarization and repolarization cardiac process of infants born at high altitude differs from that of children born at lower altitudes.

Altitude↗

PubMedDate not supplied

Validation of inter-atrial conduction time measurement by means of echo-Doppler.

BACKGROUND: Little is known about the correlation between the inter-atrial conduction time (IACT) measured at the electrophysiology laboratory and the interval measured from the beginning of the electrocardiographic P wave to the initiation of the A wave in the mitral Doppler signal (P-A interval). HYPOTHESIS: IACT can be assessed by means of echo-Doppler. METHODS: We studied 21 patients who were referred to our arrhythmia clinic for evaluation of supraventricular tachycardia. During the electrophysiological study, the IACT was measured from the first rapid deflection of the A wave recorded with the high right atrial catheter to the A wave recorded with the coronary sinus catheter. An independent observer measured the P-A interval. Both the electrophysiological and echo-Doppler measurements were corrected for heart rate. RESULTS: P-A interval was slightly longer than IACT (83.36 +/- 23.91 vs 80.77 +/- 24.11 msec; p = 0.042), but a very good correlation was found between both measurements (r2 = 0.94). CONCLUSIONS: IACT can be non-invasively assessed by measuring the P-A interval.

Adult↗

PubMedDate not supplied

[Usefulness of simple scheme for the diagnosis of cardiac arrhythmias].

OBJECTIVE: To determine whether an algorythm designed at our Electrophysiology Unit could facilitate the electrocardiographic diagnosis of tachyarrhythmias. METHODS: Twenty two first-year cardiology residents, general practitioners and last-year medical students attended an electrophysiology course. One hundred ECG of tachyarrhythmic patients were distributed to the participants who were then randomly divided into 2 groups. Group A analyzed the ECG with the help of the algorythm, whereas Group B analyzed them without it. Results were compared to those obtained by an electrophysiologist. RESULTS: Group A diagnosis coincided with that of the electrophysiologist in 41% of the cases. In Group B the concordance reached 64% (p = 0.0000013). There was no between-group difference regarding the type and number of uninterpreted ECG. CONCLUSIONS: The decision tree increases diagnostic accuracy in less expert hands. This could in turn entail an improvement in the therapeutic measures applied to the study of arrhythmias.

Algorithms↗