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E Curtiss

Publications and source records attributed to E Curtiss.

3 recordsLinked to original sources
PubMed1998

Interrelations between QRS morphology, duration, and HV interval changes following right bundle branch radiofrequency catheter ablation.

Interrelations between QRS morphology, duration, and HV interval changes in a model of "complete" bundle branch block following right bundle branch radiofrequency ablation have not been subjected to systematic study. This article describes these interrelations in patients who underwent right bundle ablation. Over a period of 42 months, 16 patients underwent radiofrequency ablation of the right bundle for treatment of bundle branch reentrant tachycardia. All 16 patients had prolonged HV interval at baseline (minimum = 60 ms; mean = 68 +/- 8 ms). After ablation, one patient developed complete heart block; the remaining 15 patients developed complete right bundle branch block (RBBB) and further prolongation of the HV interval (increment = 24 +/- 16 ms). In 14 of these 15 patients, QRS duration was 138 +/- 26 ms before ablation and increased to 168 +/- 13 ms after ablation. In the remaining patient, the QRS duration was 160 ms before ablation and shortened to 144 ms following ablation despite further HV prolongation. Larger increases of HV interval after ablation were associated with smaller or negative changes in QRS duration (r = -0.77). Three was a direct relationship between QRS duration at baseline and the increment in HV interval after ablation (r = 0.70), and an inverse relationship between QRS duration before and after ablation (r = 0.84). Radiofrequency ablation of right bundle may be associated with an increase in HV interval and QRS duration. However, HV interval prolongation is not necessarily associated with QRS duration widening. A large change in HV interval is more likely to be associated with an already prolonged QRS duration before ablation and a lesser increase or even decrease in QRS duration after ablation. A shorter QRS duration before ablation is associated with a smaller HV interval increase following ablation but a greater increment in QRS duration. These findings are consistent with the concept that narrowness of QRS duration is due to synchronized activation of ventricular endocardium; whereas, QRS duration widening seen with His-Purkinje damage is due to reduced synchronization of endocardial activation.

Bundle of His↗
PubMed1996

Isolated pulmonary hypertension in systemic sclerosis with diffuse cutaneous involvement: association with serum anti-U3RNP antibody.

OBJECTIVE: To describe a group of patients with systemic sclerosis (SSc) and diffuse cutaneous (dc) involvement with isolated pulmonary hypertension (IPHT) and to compare them to 2 other SSc patient groups, i.e., one with limited cutaneous (lc) involvement with IPHT and another with dcSSc without IPHT. METHODS: The Pittsburgh Scleroderma Databank was screened to identify appropriate patients. SSc specific serum autoantibodies were determined using published methods. Chi-squared tests and Kaplan-Meier survival analysis were performed. RESULTS: During the period 1975-92, 60 of 580 (10%) consecutive new patients with lcSSc and 14 of 677 (2%) with dcSSc have developed IPHT (p < 0.0001). The patients with IPHT did not differ from their parent dc or lc groups by age, race, sex, or cutaneous manifestations. All 14 patients with dcSSc IPHT had minimal or no pulmonary interstitial fibrosis on chest radiograph. The 12 tested had a striking reduction in DLCO (mean 50% of predicted normal), similar to results for patients with lcSSc with IPHT. Of note, 5 of these 14 patients had survived "scleroderma renal crisis" 1.3 to 10.7 (mean 5.5) years before onset of IPHT. Six of 13 (46%) patients with dcSSc with IPHT were positive for serum anti-U3RNP antibody by immunoprecipitation, and one had the typical nucleolar staining pattern of anti-U3RNP, but was not tested for U3RNP by immunoprecipitation. In contrast, only 13 (6%) of the 244 patients with dcSSc without IPHT (p < 0.0001) had anti-U3RNP antibody. Survival from the first reported symptom consistent with pulmonary hypertension (usually dyspnea on exertion) was uniformly poor in both IPHT groups, with the vast majority of patients dying during the first 2 years. CONCLUSION: Patients with SSc with dc involvement can develop severe, fatal isolated pulmonary arterial hypertension. This complication occurs disproportionately more often in patients with serum anti-U3RNP antibody.

Adult↗