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Biomedical subjects

C S Chakko

Publications and source records attributed to C S Chakko.

4 recordsLinked to original sources
PubMed1989

Multiform ventricular complexes: a transitional arrhythmia form?

This study was undertaken to better characterize the role of multiform premature ventricular complexes in the classification of ventricular arrhythmias based on form and frequency. Twenty inpatients with organic heart disease and multiform ventricular complexes underwent continuous electrocardiographic monitoring with full disclosure analysis of the number and morphology of single premature ventricular complexes, of repetitive forms of greater than or equal to 2 premature ventricular complexes, and of the variability of coupling intervals (greater than or equal to 40 msec). Multiform premature ventricular complexes were of 3 +/- 1.4 (mean +/- S.D.) different QRS morphologies. Nineteen patients (95%) had repetitive forms of greater than or equal to 2 premature ventricular complexes; 18 patients (90%) showed variable coupling (125 +/- 29 msec). Repetitive forms or variable coupling were present in each (100%) of the 20 patients studied. These data suggest that multiform premature ventricular complexes may be a transitional arrhythmia, since repetitive forms almost always coexist. Variability in coupling, rather than just form and frequency, may be an electrocardiographic characteristic linking single and repetitive forms.

Adult↗
PubMed1985

Ventricular arrhythmias in severe heart failure: incidence, significance, and effectiveness of antiarrhythmic therapy.

Forty-three patients receiving maximal medical therapy for severe chronic heart failure from dilated cardiomyopathies (28 ischemic, 15 idiopathic) and ventricular premature beats (VPBs) on the 12-lead ECG had baseline 24-hour ambulatory ECG monitoring. Complex VPBs (multiform, repetitive--couplets, R on T phenomenon) and asymptomatic, nonsustained ventricular tachycardia were present in 38 patients (88%) and 22 patients (51%), respectively. Twenty-three patients (group I) were placed on long-term antiarrhythmic therapy (20 patients received procainamide and the remaining quinidine). Twenty patients (group II) did not receive antiarrhythmic therapy. At baseline, no significant differences between the two groups were noted for age, functional class, type of cardiomyopathy, medical therapy for heart failure, cardiothoracic ratio, radionuclide ejection fraction, or rate and complexity of the ventricular arrhythmias on the 24-hour ambulatory ECG tracings. At a mean follow-up period of 16 months (range 1 to 37), there were 16 deaths, 10 (62%) of which were sudden and unexpected. No significant differences in the incidence of sudden death and overall mortality were noted between the two groups. Among patients with nonsustained ventricular tachycardia, those who died suddenly had a lower mean left ventricular ejection fraction (0.15 +/- 0.01) when compared to the survivors (0.23 +/- 0.02; p less than 0.01). It is concluded that patients with severe heart failure have a high mortality from both sudden and nonsudden cardiac death, incidence of complex VPBs is very high, sudden death is more common when the left ventricular function is severely compromised, and apparently, therapeutic plasma levels of conventional antiarrhythmic drugs do not protect this group of patients from dying.

Ambulatory Care↗