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Biomedical subjects

D I Peretz

Publications and source records attributed to D I Peretz.

At least 19 recordsLinked to original sources
PubMed1985

Management of cardioinhibitory hypersensitive carotid sinus syncope with permanent cardiac pacing--a seventeen year prospective study.

Sudden and unannounced syncope due to increased vagal tone as manifested by hypersensitivity of the carotid sinus mechanism is not uncommon. A 17 year prospective study of 89 patients with cardio-inhibitory (Type 1) hypersensitivity showed that males outnumbered females 4.5:1. The age range at the onset of symptoms was 37 to 88 years with an average of 63 years. Hypersensitivity of the right carotid sinus was 7:1 compared to the left. These patients had unilateral hypersensitivity in 71% and bilateral in 29%. A new classification of Hypersensitive Carotid Sinus Syncope incorporating sinoatrial node (Type 1A) and atriaoventricular node (Type 1B) suppression in the Type 1 syndrome is presented. Many forms of treatment for cardioinhibitory Hypersensitive Carotid Sinus Syncope have been forthcoming but in our hands in these 89 patients over 17 years, there has been no single case of recurrence of syncope after implantation of a permanent VVI electronic cardiac pacemaker. Type 2 (vasodepressor) Hypersensitive Carotid Sinus Syncope is rare, occasionally seen combined with the cardioinhibitory (Type 1) response and it is not helped with cardiac pacing.

Adult↗
PubMed1983

Complications of coronary arteriography.

In a prospective study of coronary arteriography with Judkins' technique the rate of major complications in 713 patients was 2.1%, a rate similar to or lower than those reported from other studies, even though more major complications were considered in this study. No deaths occurred. Although the rate of "other" complications was noted as part of the quality care survey, it cannot be compared with that in other studies, since the latter did not consider events such as hematoma or incomplete catheterization. The low complication rate may be related to expeditious procedures, familiarity with the Judkin's technique and the operators' experience. Local quality care assessment or clinical review committees should formally evaluate the complication rates for operative and invasive procedures performed in their own institutions.

Angiography↗
PubMed1983

The structure and function of the pulmonary vasculature in mild chronic obstructive pulmonary disease. The effect of oxygen and exercise.

The structure and function of the pulmonary circulation was investigated in 17 patients requiring pulmonary resection. All 17 performed pulmonary function tests and 13 underwent right heart catheterization preoperatively. The surgical specimens of the lung were analyzed with respect to the severity of the emphysema, the severity of the airways disease, and the hypertensive changes in the small pulmonary arteries and arterioles. The data show that pulmonary artery (Ppa) and pulmonary artery wedge (Ppaw) pressures and cardiac output were normal at rest. However, patients with more severe disease showed greater increases in Ppa and Ppaw with exercise than did patients with minimal or no disease. Oxygen breathing had no effect at rest but lowered Ppa and Ppaw during exercise in the patients with more severe disease. Histologic studies showed that greater degrees of emphysema and small airways disease were associated with hypertensive changes in the pulmonary vasculature. We conclude that patients with moderate obstructive lung disease have elevated pulmonary vascular pressures during exercise and structural changes in the pulmonary arteries consistent with pulmonary hypertension when compared with patients with minimal or no disease. Although there are several possible explanations for the increased vascular pressures seen with exercise, we favor gas trapping leading to increased alveolar and pleural pressures, with oxygen breathing preventing this response by shortening the time constants of the peripheral lung units.

Aged↗
PubMed1973

Permanent demand pacing for hypersensitive carotid sinus syndrome.

Ten patients with proved hypersensitivity of one or both carotid sinuses and with symptoms of recurrent lightheaded spells and syncope had implanted a permanent transvenous demand pacemaker. In a follow-up course ranging from 6 to 55 months there has been no recurrence of lightheadedness or syncope in any of the patients. Six of the ten have had their battery packs replaced owing to routine battery exhaustion.

Aged↗
PubMed1967

Advanced heart block during acute myocardial infarction treated with an electrode pacing catheter.

The mortality rate is high from advanced atrioventricular block associated with acute myocardial infarction. There is reason to believe that if in these patients the hearts are electrically paced with an endocardial pacing catheter, the mortality rate can be considerably decreased. Five patients in second- and third-degree heart block associated with acute myocardial infarction were paced with a considerable lowering of the expected mortality rate. Twenty-three cases from the literature are also presented and discussed. A silastic bipolar electrode catheter was used in these five cases. Four of the five cases returned to normal sinus rhythm within the first 10 days. The average duration of pacing was 6.7 days. It is the opinion of the author that second- and third-degree heart block associated with acute myocardial infarction should have a pacing catheter introduced at the earliest possible moment for continuous or demand endocardial pacing.

Adult↗