PubMed Health⌕ Search

Biomedical subjects

C M Vasu

Publications and source records attributed to C M Vasu.

13 recordsLinked to original sources
PubMed1990

Effect of empiric antiarrhythmic therapy in resuscitated out-of-hospital cardiac arrest victims with coronary artery disease.

The effect of empiric antiarrhythmic therapy with quinidine and procainamide on long-term mortality was examined in 209 patients with coronary artery disease resuscitated after out-of-hospital cardiac arrest. The antiarrhythmic agent used was determined by the patient's private physician without knowledge of the study ambulatory electrocardiogram. Of the 209 patients, procainamide was prescribed in 45 (22%), quinidine in 48 (23%) and no antiarrhythmic therapy in 116 (55%). Digoxin therapy was initiated in 101 patients. The 2-year total survival rate for the quinidine, procainamide and nontreated patients was 61, 57 and 71% (p less than 0.05), and for sudden death was 69, 69 and 89% (p less than 0.01), respectively. These observations suggest that empiric antiarrhythmic therapy in survivors of out-of-hospital cardiac arrest did not affect total mortality and was associated with an increased frequency of sudden death.

Aged↗
PubMed1988

Predictive value of ventricular arrhythmias in resuscitated out-of-hospital cardiac arrest victims.

Twenty-four hour ambulatory electrocardiograms recorded in 103 survivors of out-of-hospital cardiac arrest were analyzed to find those characteristics of the ventricular premature complex (VPC) which provide the best combination of sensitivity, specificity, and predictive accuracy for subsequent mortality. VPC characteristics were grouped as: (1) frequent (greater than or equal to 25 h-1), (2)bigeminal, (3) multiform, (4) early coupled, (5) pairing, (6) repetitive greater than or equal to 2, (7) repetitive greater than or equal to 3, (8) repetitive greater than or equal to 6, (9) the combination of frequent and repetitive, or (10) complex defined as any multiform, early, bigeminal or repetitive VPC. In an average follow-up period of 43 months, 42 deaths occurred, 17 of which were classified as sudden. Each characteristic was a significant predictor for all causes of subsequent death except early coupled VPCs and repetitive VPCs greater than 6. None of the characteristics reached significance as predictors for sudden death. The number of repetitive VPCs when stratified to none, greater than or equal to 2 and greater than or equal to 3 successive VPCs correlated with mortality in an incremental fashion. The combination of frequent VPCs and repetitive VPCs provided the best combination of sensitivity, specificity and predictive accuracy for death from all causes within five years.

Arrhythmias, Cardiac↗
PubMed1988

Clinical characteristics and survival experience of out-of-hospital cardiac arrest victims without coronary heart disease.

Of 270 patients successfully resuscitated from out-of-hospital cardiac arrest, 16% had no evidence of coronary heart disease. In these 43 patients, other forms of heart disease were found in 81% (35/43): cardiomyopathy in 18 patients, valvular disease in six, congenital heart disease in two, and primary arrhythmia in nine. Seven patients had evidence of only pulmonary disease and one had pancreatitis as his precipitating event. Nineteen of the 43 patients (44%) had serum potassium less than 3.6 mEq l-1 in the initial blood sample after cardiac arrest. One- and two-year mortalities were 30% and 43%, respectively, for the group, which is similar to one-year (20%) and two-year (35%) mortalities of the 227 resuscitated patients with coronary heart disease. Patients who survive a sudden death experience and who have no evidence of coronary artery disease are a unique but heterogeneous group who usually have identifiable cardiac or pulmonary disease.

Cardiac Complexes, Premature↗
PubMed1986

Analysis of cardiac symptoms preceding cardiac arrest.

Prodromal symptoms and cardiac history were examined in 227 patients with coronary artery disease who were successfully resuscitated after out-of-hospital cardiac arrest. Cardiac arrest was sudden--with either no symptoms or symptoms for less than 1 hour--in 71% of the patients. Nonsudden death--death occurring after more than 1 hour of symptoms--occurred in 29% of the patients. A history of cardiovascular disease was present in 85% of patients with sudden cardiac arrest and in 83% with nonsudden arrest. Cardiac arrest occurred without symptoms in 38% of the patients with sudden cardiac arrest and was the first expression of coronary artery disease in 4% of the entire study group. This study indicates that cardiac arrest usually occurs with symptoms and almost always in the setting of a history of cardiovascular disease.

Angina Pectoris↗
PubMed1985

The effect of bystander CPR on survival of out-of-hospital cardiac arrest victims.

The effect of bystander cardiopulmonary resuscitation (CPR) was studied in 2142 emergency medical service (EMS) cardiac arrest runs. When bystander CPR was administered to cardiac arrest victims, 22.9% of the victims survived until they were admitted to the hospital and 11.9% were discharged alive. In comparison, the statistics for cardiac arrest victims who did not receive bystander CPR were 14.6% and 4.7%, respectively (p less than 0.001). A critical factor in patient survival was the amount of time that elapsed before the EMS personnel arrived and administered CPR. Patients who received bystander CPR were more likely to have ventricular fibrillation when the EMS arrived. Other factors relating to patient survival were the location of the victim at the time of the cardiac arrest and the age of the victim. Understanding these factors is important in developing community strategies to treat patients with cardiac arrest out of hospital.

Adult↗
PubMed1985

Predictive survival models for resuscitated victims of out-of-hospital cardiac arrest with coronary heart disease.

Resuscitated victims of cardiac arrest with coronary heart disease represent a group of patients with an accelerated mortality rate. Among 227 such patients in our follow-up study, 20% had died at 1 year and 50% were dead in slightly over 3 years. Predictors of death were related to use of digitalis, elevated blood urea nitrogen, cerebral vascular accident, previous myocardial infarction, and age. In a subset of 103 patients in whom ambulatory electrocardiographic recordings were available within 3 months of the arrest event, the presence of complexity and high-frequency ventricular premature beats (VPBs) (greater than or equal to 25/hr) were added to the mortality predictors of digitalis and diuretic therapy and elevated blood urea nitrogen. An almost equal number of patients died suddenly and nonsuddenly. Predictors of sudden death were treatment with quinidine and paired VPBs. Occurrence of arrhythmias was an important addition to the previous mortality predictors related to left ventricular dysfunction.

Actuarial Analysis↗
PubMed1981

Characteristics of the resuscitated out-of-hospital cardiac arrest victim with coronary heart disease.

The clinical entry characteristics and medical history of 142 resuscitated out-of-hospital cardiac arrest victims with coronary heart disease were studied in order to identify factors that affect their long-term survival. The cardiac arrest event was classified as being secondary to an acute myocardial infarction (AMI) in 44% (62 of 142), an ischemic event (IE) in 34% (49 of 142) and a primary arrhythmic event (PAE) in 22% (31 of 142). The majority of patients in all groups had a history of angina pectoris. Twenty-seven percent of the AMI, 55% of the IE, and 71% of the PAE patients had a history of infarction. Ten percent of the AMI, 31% of the IE, and 55% of the PAE had used digitalis before their cardiac arrest. Cardiac arrest was the first cardiac event in 35% of the AMI, 16% of the IE and 6% of the PAE patients. One year after arrest, 89% of the AMI, 80% of the IE and 71% of the PAE were alive (p less than 0.01). Covariate analysis for more than 40 variables indicates that a high-risk group included 22% (31 of 142) of the cardiac arrest victims had 1- and 2-year survival rates of 71% and 55%, respectively, and was characterized as having used digitalis before arrest, experiencing blood urea nitrogen elevation and pulmonary congestion during the hospitalization for the event, and classification of the cardiac arrest event as a PAE. A low-risk group comprised 78% (111 of 142) of the survivors and had 1- and 2-year survival rates of 85% and 69%, respectively. These data indicate that cardiac arrest due to coronary heart disease is secondary to several mechanisms related to subsequent survival.

Acute Disease↗
PubMed1975

Aneurysm of saphenous vein bypass graft to coronary artery.

A few cases of aneurysmal dilatation of autogenous vein grafts to peripheral arteries have been reported. However, to our knowledge, no case of this complication in coronary artery vein bypass grafts have been found. We are presenting a case of a vein graft aneurysm which appeared 6 months postoperatively. The patient had had an aortic valve replacement and a vein bypass graft to the right coronary artery.

Adult↗