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Biomedical subjects

B Stancák

Publications and source records attributed to B Stancák.

At least 19 recordsLinked to original sources
PubMed1994

[Transesophageal ventricular stimulation and ventricular tachycardia in the period before implantation of a cardioverter-defibrillator].

The administration of an implantable cardioverter-defibrillator (ICD) is the method of choice in life-threatening ventricular tachyarrhythmias. This effective non-pharmacological intervention was a great advance in the prevention of sudden cardiac death. As to ventricular tachycardias, relapsing ventricular tachycardias based on ischaemic alone need not influence ventricular tachycardia. The mechanism of ventricular tachycardia in ischaemic heart disease is reentry and therefore this arrhythmia can be terminated not only by a defibrillation discharge but also by antitachycardiac stimulation. Various types of antitachycardiac stimulation are part of modern types of ICD. Evidence of the effectiveness of antitachycardiac stimulation (electrophysiological examination) permits to use it also by the transoesophageal approach. This treatment can be very effective and we can thus overcome the period before the definite administration of an ICD, as indicated by the case described.

Aged↗
PubMed1994

[Ultrasonic indicators of left ventricular function and elasticity of large vessels in newly diagnosed hypertensive patients].

The authors investigate the degree of alteration of large vessels in newly detected not treated hypertension, using a series of non-invasive indicators of vascular function and their association with selected parameters of systolic and diastolic left ventricular function in a group of 23 hypertonic patients and 23 subjects with normal blood pressure. The mean age of the examined subjects was 51.1 +/- 16.6 years. In the echocardiographic indicators a significant difference was found between the groups as regards the weight of the LV and in the ratios of amplitudes and time integrals of waves E and A of the Doppler record of transmitral flow. Comparison of functional and morphological indicators of large vessels revealed significant differences between groups as regards tension in the aortic arch, value of the elastic module (EMp), rate of pulse wave (RPVcf) and relative systolic rate of the arteriovelocitogram. Correlation analysis revealed positive relations between age, blood pressure and weight of the LV on the one hand and EMp, diameter of the femoral artery and RPVc on the other hand. The ratio of E/A waves and their time integrals displayed the same correlation with the pulse change and the tension of the aortic arch, with the peak and relative systolic rate of the arteriovelocitogram and a negative correlation with the EMp values. These results provide evidence of a reduced elasticity of the large vessels in the group of newly detected hypertonics, associated with left ventricular hypertrophy and a reduction of its diastolic function. This finding implies the necessity to focus treatment not only on normalization of blood pressure readings but to consider also other components of the hypertensive syndrome.

Adult↗
PubMed1994

[Factors affecting the vulnerability of the left atrium during rapid transesophageal atrial stimulation].

Atrial fibrillation (AF) is associated with a higher morbidity and mortality because of the risk of systemic or pulmonary embolism as well as the negative impact on cardiac function. The authors investigate in the submitted paper factors influencing the vulnerability of atria during transoesophageal atrial stimulation (TESP). The group comprised 68 patients with a sinus rhythm, mean age 56.9 +/- 17.9 years. Depending on the response to rapid atrial stimulation, the patients were divided into three groups. In group I (small disposition to AF) they revealed a significantly lower age, the relative thickness of the left ventricular wall assessed by echocardiography and the dimension of the left atrium, as compared with groups with a medium increased (II) and high disposition (III) for AF. In group III hypertonic changes on the fundus were found more frequently, as well as anamnestic data on hypertension, diabetes and pathological values of the recovery period of the sinoatrial node. At the same time significantly lower values of the rate of the E wave were observed and of the ratio of amplitudes and E/A integrals from the Doppler record of the mitral valve. The weight of the left ventricle and its index by groups increased, however the changes did not attain statistical significance. Indicators of left ventricular systolic function did not differ. The authors conclude that the main independent factors which determine the response to provoked AF by the TESP method are the diastolic left ventricular function documented by the Doppler method, the diameter of the left atrium, the automation of the SA node. Less important factors are left ventricular hypertrophy and age.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1993

[The effect of aminophylline on the sinoatrial node].

The objective of the submitted prospective study was to assess the influence of intravenously administered aminophylline on the sinoatrial node. The authors examined by electrophysiological methods 20 patients (16 without dysfunction of the sinoatrial node and 4 with dysfunction of the sinoatrial node). From the investigation patients were eliminated with an apparent and obvious cause of elevated uric acid serum levels and patients where on electrophysiological examination limited values of the corrected recovery time of the sinoatrial node were found (from 650 ms to 999 ms). To all 20 patients 240 mg aminophylline were administered by the i.v. route with in 2 mins. The following parameters were recorded: age, serum level of uric acid, basal heart rate in ms, corrected recovery time of the sinoatrial node in ms, heart rate and corrected recovery time of the sinoatrial node 5 min after completed administration of aminohpylline in ms. As regards age and uric acid serum levels there was no significant difference between dysfunction of the sinoatrial node and normal function of the sinoatrial node. Intravenously administered aminophylline hastened significantly the heart rate in patients without dysfunction of the sinoatrial node (p < 0.05). The value of the corrected recovery time of the sinoatrial node was shorter but the difference was not statistically significant. In patients with dysfunction of the sinoatrial node aminophylline did not affect the heart rate and corrected recovery time of the sinoatrial node.

Adult↗
PubMed1992

[Rapid continuous stimulation of the atrium (overdrive) in the treatment of refractory supraventricular tachycardia].

In 71 patients, divided into four groups by the type of supraventricular tachycardia (SVT) during electrophysiological examination, 918 stimulations were implemented by the method of rapid continuous stimulation of the atria (overdrive) in order to interfere with a SVT paroxysm. In addition to characteristics of tachycardia the authors evaluated parameters of overdrive stimulation, i.e. the duration of the stimulation cycle (CL STIM), the ratio CL STIM/CL SVT, the number of stimuli required to terminate tachycardia (N STIM) and their mutual relations. In the group of atrioventricular reciprocal tachycardias (WPW, n = 17) the effectiveness was 50.4%, CL SVT 334 +/- 43 ms, the ratio CL STIM/CL SVT 78.3 +/- 12%, the median of N STIM 14 +/- 6. In the group of AV nodal tachycardias (AVNR, n = 26) the effectiveness is 53.1%, CL SVT 356 +/- 70 ms, CL STIM/CL SVT 77 +/- 8.6%. In the group of atrial tachycardias (AT, n = 5) the effectiveness was 62.3%, CL SVT 348 +/- 24 ms, CL STIM/CL SVT 73.7 +/- 7.5%, N STIM 6 +/- 4. In the group of atrial flutter (AFL, n = 23) the effectiveness was 9.2%, CL SVT 226 +/- 29 ms, CL STIM/CL SVT 84.5 +/- 8.2%, N STIM 22.5 +/- 9. The effectiveness of overdrive stimulation in AFL is significantly lower than in other groups of SVT. The regression correlation in the entire group of tachycardias for calculation of a suitable duration of CL STIM--0.855 x CL SVT--28 (ms), the median number of stimuli N STIM 14 +/- 7.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

[Echocardiographic indicators in various stages of hypertension and their relation to the incidence of dysrhythmia].

The authors present a group of 143 hypertonic patients divided into three subgroups by the stage of hypertension (WHO). The objective was to detect an association between the incidence of cardiac dysrhythmias and the stage of hypertension and left ventricular (LV) morphological and functional parameters resp. which were assessed by echocardiography (ECHOCR). The authors investigated the systolic pressure (BPs) and diastolic pressure (BPd) on admission and the following ECHOCR parameters: weight of the left ventricle, tension of the LV wall during end systole, maximum tension of the LV wall, fractionated shortening of the Lv wall and the relative width of the LV wall. Comparison of clinical and ECHOCR parameters in groups revealed significantly lower values of BPs on admission in patients in the first stage of hypertension (p less than 0.01), the tension of the LV wall during end systole was in the third stage of hypertension significantly higher (p less than 0.01). In patients in the first stage there was a positive correlation between systolic pressure on admission and the fractional shortening of the LV (r = 0.568, p less than 0.025) and between diastolic pressure and the maximum tension of the LV wall (r = 0.572, p less than 0.025). They did not reveal an association between different stages of hypertension and the incidence of dysrhythmias. The group of patients with chronic atrial fibrillation had significantly larger dimensions of the left atrium, as compared with other groups of dysrhythmias. The authors were unable to reveal an association between the assessed morphological and functional parameters of the LV in different stages of hypertension and the incidence of dysrhythmias.

Aged↗
PubMed1992

[Uric acid and sinoatrial node function].

In a retrospective investigation comprising 54 patients the authors assessed the relationship between the function of the sinoatrial node and raised serum uric acid levels. The function of the sinoatrial node was expressed by the maximal value of the corrected recovery time of the sinoatrial node. No statistically significant correlation was found.

Adult↗
PubMed1990

[Does the left atrial dimension predict the short-term effect of electric cardioversion?].

The authors evaluate in their retrospective investigation the influence of the left atrium, assessed by echocardiography, on the short-term effect of electric cardioversion in auricular fibrillation. The group comprises 44 patients divided into four groups: ischaemic heart disease, cardiomyopathy and specific myocardial affection, mitral stenosis and idiopathic fibrillation. The authors did not find a significant difference between the left atrial diameter in patients with successful electric cardioversion (ECV) (44.4 +/- 8.2 mm) and patients with not successful ECV (43.4 +/- 6.7 mm). The authors did not prove the influence of age and aetiology of fibrillation on the effect of ECV. The size of the left atrium alone does not possess a significant predictive value when estimating the short-term effect of ECV.

Adult↗
PubMed1990

[Paroxysmal atrioventricular block].

The authors analyzed paroxysmal atrioventricular blocks which were not frequency-dependent. It was a clinical, electrocardiographic and electrophysiological evaluation. The authors draw attention to the pitfalls of diagnosis and emphasize that the problem of interpretation of atrioventricular (intraventricular) conductivity is unequivocally associated with the problem of indication of permanent cardiac pacing. Based on their own experience, the authors describe the procedure used for establishment of the diagnosis of paroxysms of atrioventricular blocks. What are the main conclusions? 1. In the first place it is necessary to pay attention to the history of syncopes. 2. On the conventional ECG we find usually disorders of atrioventricular and intraventricular conductivity. 3. Electrophysiological examination should be always supplemented also by pharmacological intervention, using Gilurytmal by the i.v. route.

Aged↗
PubMed1990

[Experience with permanent cardiac pacemakers in the East Slovakian Region 1978-1987].

The authors present a group of patients where in the course of the 10-year period of 1978-1987 a permanent pacemaker was implanted. 587 primary implantations were made and 327 exchanges of cardiac pacemakers. The mean age in the group of primary implantations was 70.4 +/- 10.3 years, in the group of exchanges 70.4 +/- 10.6 years. n 98.8% pacemakers VVI and VOO made in Czechoslovakia were implanted. Indications for primary implantation were in 64% atrioventricular block (AV) grade III, in 11% AV block grade II, in 22% disease of the sinoatrial node and in 4% other dysrhytmias. The age category above 60 years accounts for 85.5% in the group of primary implantations. A positive feature is the low incidence of complications of surgical and technical nature. An unfavourable feature is that almost all implanted devices were the simplest single electrode systems where the frequency cannot be adapted and where other parameters cannot be changed.

Adolescent↗
PubMed1990

[Atypical ventricular tachycardia and atrioventricular blockade].

The authors submit a clinical and electrocardiographic analysis of five patients with atypical ventricular tachycardia with atrioventricular block of an advanced degree. The incidence is relatively rare--cca 1% patients with atrioventricular block are threatened by this type of tachycardia. In these patients there are always reduced serum potassium levels and a longer QT interval, as compared with patients without tachycardia. In two instances there was an association with the use of drugs (Furosemide and Thioridazine) and these patients developed tachycardia even during permanent pacing. Correction of the internal environment and discontinuation of drugs proved therefore decisive, as permanent pacing alone did not always suffice to prevent tachycardia. Without medication atypical ventricular tachycardia develops, in the author's opinion, most probably when bradycardia has persisted for a prolonged period.

Aged↗
PubMed1989

[Löffler's endocarditis].

The authors describe Loeffler's endocarditis and the treatment of this clinical entity. Among diagnostic methods which drew attention to a cardiac affection associated with eosinophilia, non-invasive examination methods were of decisive importance. They comprised conventional electrocardiographic examination, X-ray of the chest and two-dimensional echocardiography.

Endocarditis↗