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Biomedical subjects

C Neel

Publications and source records attributed to C Neel.

11 recordsLinked to original sources
PubMed1985

Effect of i.v. and oral tiapamil in the treatment of paroxysmal supraventricular tachycardia.

Eleven patients, with recurrent paroxysmal supraventricular tachycardias (PSVT) underwent programmed electrical stimulation of the heart to evaluate the efficacy of intravenous (i.v.) and oral tiapamil in these arrhythmias. The tachycardia circuit was confined to the atrio-ventricular (AV) node in 8 cases (group 1), and involved an overt or concealed accessory pathway for retrograde conduction in the 3 others (group 2). An i.v. bolus containing 2 mg kg-1 body weight of tiapamil converted 6 of the 8 cases in group 1 from PSVT to normal sinus rhythm (NSR) within a few seconds, but failed to do so in any of the three patients in group 2. Both the oral and i.v. preparations significantly lengthened the shortest cycle length maintaining 1:1 AV conduction. I.v. administration also lengthened the corresponding value for 1:1 VA retrograde conduction. The oral and i.v. preparations were equally effective in preventing induction of PSVT in 6/8 patients in group 1, but failed in group 2. The efficacy of oral tiapamil in preventing such induction was also accurately predicted from the effect of the i.v. tiapamil on conversion to NSR. After the first week, the six successfully treated patients continued taking 1.2 to 1.5 g day-1 tiapamil for 9.7 +/- 4 months. Complete suppression of their symptoms was observed in 5 cases.

Administration, Oral↗
PubMed1983

[Auriculo-ventricular block in the Kearns-Sayre syndrome. Apropos of a case].

A 21 year old patient was operated for bilateral ptosis and external ophthalmoplegia at 13 years of age. At this time there were no signs of retinitis pigmentosa or atrioventricular block, features of the Kearns and Sayre Syndrome (1958) which were detected five years later. His bundle recording showed an intrahisian block (1 degree proximal and a complete distal block) with a trifascicular block, the latter persisting alone during a brief return to sinus rhythm. This is one of the rare cases of the Kearns and Sayre Syndrome with documented His bundle recordings and the only reported case with intrahisian block. The patient also suffered from bilateral neural deafness. The patient's condition remains stable after implantation of an isotopic cardiac pacemaker and he now leads a normal life. A review of 52 previously published cases shows that this rare condition appears to be caused by a mitochondrial abnormality, which, for an unknown reason, affects only the neuromuscular and cardiac conduction systems. The prognosis is poor when swallowing and respiration are affected, but this does not occur in all cases. As cardiac conduction abnormalities are the other life-threatening complication, cardiac pacing has greatly improved the prognosis of these patients.

Adult↗
PubMed1980

[Paroxysmal sinoatrial tachycardia. Apropos of 44 cases].

44 cases of paroxysmal sinoatrial tachycardia (PAT) due to reentry within the sinus node or between the sinus node and the atrium are reported; these tachycardias are usually quite well tolerated clinically as the rhythm is rarely faster than 140/min and they are often degraded by functional AV block. They can be triggered and terminated by one (or two) atrial stimuli, and reduced by carotid sinus massage but relapse in the short term. They often alternate with a disturbance of atrial excitability in patients who also have binodal disease. Their diagnosis implies endocavitary investigation showing sinusal anterograde atrial activation and atrial and ventricular stimulation to differentiate them from other types of paroxysmal tachycardia, especially those due to reentry involving concealed right sided Kent bundles. Studies of sinus node function by atrial extrastimulus techniques in 38 patients usually showed an isolated and prolonged Zone I followed, without a transitional plateau, by a Zone IV of sinus echos during which the tachycardia could be triggered. This type of tachycardia, without doubt as common as junctional tachycardia, may respond to treatment with Quinidine, Amiodarone, Verapamil, or beta-blockers, associated with permanent pacing in cases of binodal block.

Adult↗
PubMed1980

[Retrograde ventriculo-auricular heart conduction in 126 patients with or without supra-ventricular paroxysmal tachydardia, with or without ventricular preexcitation].

Ventriculo-atrial (VA) conduction was studied by ventricular stimulation at increasing rate and atrial mapping in 126 patients either without ventricular preexcitation (WPW) and supraventricular tachycardia (SVT) (Group I: 60 cases) or with the WPW syndrome with or without SVT (Group II: 30 cases) or with SVT without WPW (Group III: 53 cases) or with short PR intervals (Group IV: 3 cases). In Group I, 22 patients had VA block, 10 had concealed accessory pathways and 28 had nodal VA conduction. In Group II, 2 patients had VA block, 6 had nodal VA conduction and 22 had preferential retrograde conduction through the Kent bundle. In Group III, 9 patients had concealed Kent bundles and 24 had nodal retrograde conduction. In Group IV, the results were varied. The characteristics of retrograde VA conduction are therefore often different from those of anterograde conduction. 52 attacks of SVT were recorded; in the 18 cases of Group II, 5 septal, 3 right lateral, 8 left lateral Kent bundles and 2 intranodal reentries were demonstrated. In the 33 cases of SVT without overt WPW (Group III) a concealed accessory pathway was demonstrated in 9 cases. In all, approximately a half (25 out of 52) of all SVT were due to reentry involving an accessory pathway which was concealed in about one third of cases (9 out of 25) and more often situated on the left border than on the right or in the septum.

Adolescent↗