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Biomedical subjects

D G Benditt

Publications and source records attributed to D G Benditt.

150 records · Page 9Linked to original sources
PubMed1978

Characteristics of atrioventricular conduction and the spectrum of arrhythmias in lown-ganong-levine syndrome.

Electrophysiological characteristics of atrioventricular (A-V) conduction and refractoriness were examined in 12 patients with Lown-Ganong-Levine (LGL) syndrome referred for assessment of the following arrhythmias: (group I) regular narrow QRS tachycardia 6/12 (50%), (group II) atrial fibrillation (AF) 2/12 (17%), group III) ventricular tachycardia (VT) 4/12 (33%). A-V node refractory periods were shorter, and enhanced A-V conduction more frequent (7/12, 58% vs 7/28, 25%) in LGL patients compared to similar studies in 28 normal controls. During laboratory study reciprocating tachycardia (RT) due to re-entry within the A-V node occurred in 4/12 (33%) LGL patients, and exhibited a shorter cycle length (294 +/- 60.4 msec) than did the same arrhythmia in 11/28 (39%) controls 372 +/- 51.8 msec, P less than 0.05). Similarly, RT utilizing a concealed accessory pathway had a shorter cycle length (228 +/- 3.5 msec) in 2/12 (17%) LGL patients than in 11/28 (39%) controls (314 +/- 24.3 msec, P less than 0.001). In AF, the shortest R-R intervals in 4/12 (33%) LGL patients (2 group I, 2 group II) were shorter than in 15/28 (54%) control patients (254 +/- 42.2 msec vs 325 +/- 64.2 msec, P less than 0.05). The mean R-R internvals did not differ significantly (LGL 372 +/- 89 msec vs control 428 +/- 82.6 msec). This study suggests that the characteristics of A-V conduction and refractoriness may permit development of more rapid heart rates during certain arrhythymias in LGL patients compared to normal controls. Furthermore, the occurrence of VT in patients with LGL sydrome indicates that symptomatic arrhythmias require specific diagnosis.

Adolescent↗
PubMed1978

Electrophysiologic testing in patients with sinus pauses and/or sinoatrial exit block.

28 symptomatic patients with documented episodes of sinus pauses and/or sinoatrial exit block underwent electrophysiologic study. Abnormal responses to electrophysiologic testing were observed in 23/28 patients (82%). Abnormal prolongation of the maximum sinus node recovery time (SNRT max) occurred in 17/28 (61%) patients, of postpacing cycles 2.10 (secondary pauses) occurred in 21/28 (75%), and of estimated sinoatrial conduction time occured in 15/28 (54%). The incidence of abnormal responses to rapid atrial pacing (prolonged SNRT max or secondary pauses) (22/28, 79%) was higher than the incidence of abnormal responses to premature atrial stimulation (15/28, 54%) (P less than 0.005). Life-threatening cardiac arrhythmias were observed, prior to electrophysiologic study, in 5 out of 28 (18%) patients. Symptomatic patients with sinus pauses and/or sinoatrial exit block frequently (23/28, 82%) showed abnormal responses to electrophysiologic testing and have a relatively high incidence of life-threatening arrhythmias.

Adult↗
PubMed1976

Analysis of secondary pauses following termination of rapid atrial pacing in man.

The first ten cycles following cessation of atrial pacing were evaluated in 44 control subjects (mean age 52.9 +/- 14.88 yr) and 39 patients (mean age 62.9 +/- 15.41 yr) suspected of having sinus node dysfunction (SND). The maximal cycle length for each postpacing cycle following several pacing periods in each control subject was determined, and was normalized by dividing it by the subject's mean spontaneous control cycle length (SCL). Using the control group, a normalized maximal post-pacing response pattern (mean and SD) was derived. For each SND patient, a composite SD for each post-pacing cycle was calculated by adding the patient's SCL variance to the variance determined for each post-pacing cycle in the control group. Two composite SD above the mean value for each post-pacing cycle was selected as the upper limit of the normal recovery response and used to identify abnormal post-pacing responses in the 39 SND patients. Abnormally prolonged cycle lengths subsequent to the first escape cycle (secondary pauses) were found in 16/39 (41.0%) patients, of whom 11/39 (28.2%) had a prolonged SNRTmax. Of importance, 11/12 (91;7%) patients with documented SA block or sinus pauses prior to electrophysiologic study, demonstrated secondary pauses, while only 7/12 (58.3%) had a prolonged SNRTmax. Criteria are derived for the identification of secondary pauses during the postpacing period, and a close association between secondary pauses and the presence of spontaneous SA block or sinus pauses prior to electrophysiologic study is demonstrated.

Aged↗
PubMedDate not supplied

Altered calcium uptake by the sarcoplasmic reticulum following cardiac transplantation in humans.

Abnormalities in the diastolic properties of the heart have been described following human cardiac transplantation and may reflect, at least in part, decreased Ca2+ uptake by the sarcoplasmic reticulum. This possibility was evaluated by obtaining serial myocardial biopsies in 13 patients who underwent cardiac transplantation for severe heart failure. Oxalate-supported Ca2+ uptake by the sarcoplasmic reticulum was measured in homogenates of 83 ventricular biopsies from transplanted hearts. Biopsies from seven subjects with normal cardiac function and morphology served as controls. In the transplanted hearts, there was a tendency for Ca2+ uptake rate to decline with time so that 4-5 months postoperatively, it was significantly lower (4.5 +/- 0.5 nmoles Ca2+/mg/min) compared to controls (5.6 +/- 0.5 nmoles Ca2+/mg/min, p less than 0.01). Plasma norepinephrine levels fell from the high preoperative values (689 +/- 50 pg/mL) towards normal (215 +/- 7 pg/mL) within 30 days after transplantation. Subsequently, however, there was a tendency for norepinephrine levels to increase (369 +/- 55 pg/mL at 4 months). In four patients for which serial observations were available, there was an inverse relationship between myocardial Ca2+ uptake and plasma norepinephrine levels. These results indicate the feasibility of obtaining reproducible serial measurements of Ca2+ uptake in human cardiac biopsies. The decline in sarcoplasmic reticulum function following cardiac transplantation may be, in part, the biochemical basis for the reported impairment in diastolic relaxation.

Biopsy↗