Biomedical subjects

B Bienstein

Publications and source records attributed to B Bienstein.

2 recordsLinked to original sources

PubMed1993

[Reproducible ventricular flutter during programming of a DDD pacemaker].

A bipolar DDD pacemaker system was implanted in a 51-year-old woman with a 2 degrees (Mobitz type) atrioventricular block. The first postimplantation control was unremarkable, but she collapsed 9 weeks later with dyspnoea, tachycardia and profound perspiration. Ventricular flutter occurred twice during routine ambulatory pacemaker function tests one week later. The first episode was terminated by a precordial blow with a fist, but the second required electrical defibrillation. During the subsequent hospitalization abnormal electrolyte balance and digitalis intoxication were excluded. Left-heart catheterization with coronary angiography showed normal left-ventricular function at rest and normal coronary arteries. There was no evidence for an arrhythmogenic right ventricle. Electrophysiological testing with programmed ventricular stimulation provoked ventricular tachycardia with torsade de pointes and transition to ventricular fibrillation. Antiarrhythmic treatment with sotalol, 160 mg twice daily by mouth, failed to suppress the episodes of torsade de pointes. But further programmed ventricular stimulation was uneventful after the sotalol dosage had been increased to 160 mg three times daily.

Female↗

PubMed1993

[Congenital fistulas of the coronary arteries. A review with case presentations].

Coronary artery fistulas are rare atypical communications between a coronary artery and a cardiac chamber or other great vascular structure and usually congenital in origin. Many are detected accidentally by the use of coronary angiography. These fistulas often have minor hemodynamical significance and the course is primarily from the proximal left coronary artery to the pulmonary artery. Though symptoms are rare they should be observed carefully in aspect of possible complications. In contrast sometimes coronary artery fistulas are found when searching for the cause of cardiac murmurs or clinical symptoms. Great amounts of shunted blood can result in cardiac volume overload and myocardial ischemia may occur by coronary steal. Surgical closure of these fistulas is the treatment of choice. In our laboratory we found in a series of 3,000 coronary angiographies a 53 year old man with an abnormal communication from the right coronary artery to the right atrium and a 68 year old woman with a fistula from the proximal left anterior descending artery to the pulmonary artery.

Aged↗