Biomedical subjects
Publications and source records attributed to C Luca.
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A case of intermittent left bundle branch block is presented. Simultaneous recording of right and left ventricular monophasic action potentials allowed a more accurate demonstration of delayed left ventricular activation during intermittent left bundle branch block. His bundle electrogram was also of great help in the interpretation of infrahisian conduction in the patient studied. These methods may be useful in the complex electrophysiologic investigation of certain cases.
An original technique is presented, used for the approach of the vein in the delto-pectoral space with the aid of an electrode floated through the arm veins of patients being prepared for cardiac pacemaker implantation by an endovenous route. The method is useful in those patients in whom the vein cannot be detected in the delto-pectoral space with the aid of the usual methods. This method allows to discover the vein with great ease, avoiding additional incisions, as well as long manoeuvers involving some risks for the patient.
A case with transient WPW syndrome during silent acute myocardial infarction is presented. Although the clinical picture and laboratory data were non contributory and the surface electrocardiogram showed delta and not Q waves, myocardial perfusion scintigraphy showed typical area of acute necrosis. Abnormal accessory connections probably occur or latent such pathways become functional during acute myocardial ischemia.
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Two cases with atrial flutter and conversion to sinus rhythm using right atrial pacing are presented. In the first case sinus rhythm was obtained by using overdrive suppression while in the second case sinus rhythm took place after delivering a single electric stimulus in the right atrium.
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In 16 patients with critical condition due to severe heart failure associated with digitalis toxicity, the effects of potassium canrenoate (AldactoneR) administered intravenously were studied. Rhythm and conduction disturbances disappeared or improved in all instances. This effect was well correlated with an increase of serum potassium concentration. In 13 patients, after 1-2 days of Aldactone therapy, heart failure improved, which could be explained by a diuretic effect and by a possible inotropic action of aldactone. It is concluded that intravenous Aldactone is useful in patients with severe heart failure and digitalis toxicity in whom diuretics are often ineffective and even dangerous.
Patients with acute inferior myocardial infarction (IMI) and complete atrioventricular block (CAVB) have a wide range of mortality rate. This raises the question whether there is no other risk factor that interferes in this particular situation. In our study, mortality rate in patients with acute IMI and CAVB was significantly greater than in patients without conduction disturbance, but the occurrence of right ventricle myocardial infarction (RVMI) enhanced the mortality rate regardless of the presence or absence of CAVB.
The case of a 75-year-old man with acute myocardial infarction is presented. Two ventricular parasystolic foci, one in the right bundle branch, the other in the left bundle branch system were demonstrated with the aid of a His bundle recording, in the presence of atrial fibrillation.