PubMed Health⌕ Search

Biomedical subjects

F Bellocci

Publications and source records attributed to F Bellocci.

At least 55 records · Page 3Linked to original sources
PubMed1981

Catheter induced distal intra-Hisian right bundle branch block in a patient with persistent proximal intra-Hisian complete A-V block.

We describe a patient with complete intra-Hisian A-V block and narrow QRS who developed catheter-induced right bundle branch block during an electrophysiological study. Selective His bundle pacing was performed during complete intra-Hisian A-V block and right bundle branch block pattern; the distal His bundle pacing normalized the QRS complex, while a more proximal His bundle stimulation showed a right bundle branch block configuration with the persistence of the proximal intra-Hisian lesion responsible for the complete A-V block. These electrophysiological findings suggest that the catheter-induced right bundle branch block in our patient was due to a focal lesion in the distal part of the main His bundle. To our knowledge, this is the first report of documented multilevel lesions within the His bundle in man.

Aged↗
PubMed1981

[Mexiletine in treatment of chronic ventricular refractary arrhythmias (author's transl)].

We studied the antiarrhythmic effect of oral Mexiletine in 20 patients with stable high-frequency ventricular arrhythmias refractory to therapeutic doses of conventional antiarrhythmic therapy. Arrhythmias were classified according to modified grading system of Lown and Wolf. The efficacy of Mexiletine was assessed with use of both the arrhythmic modified classification of Lown and Wolf and count of premature ventricular beats (PVB) from 24 hours ambulatory electrocardiographic recordings. The dose of Mexiletine was 300 mg every 8 hours; 24 hours ECG recordings were obtained in each patient on days 5,15 and 20 during Mexiletine therapy. The worst of tracings before and during Mexiletine therapy was compared. Mean decrease in PVB was 57% (P less than 0.001). The decrease in PVB was more than 80% in 11 patients. Comparison of the grade of arrhythmias disclosed a favorable effect of Mexiletine in 13 patients, a worsening in 1, and no effect in 6. Classification of the most severe arrhythmia revealed a significant decrease from an average grade of 3.05 to 1.75 (P less than 0.01). Before Mexiletine therapy, 40% of our patients were in Class 0 to II and 60% were in Class III or V, whereas during Mexiletine therapy the corresponding proportions were 75% and 25% respectively. Side effects (confusion, tremors, gastro-intestinal complaints) prompted reduction of the dose in 3 patients. Three additional patients had transient minor side effects (dizziness, nystagmus and gastrointestinal disorders) that did not necessitate a change in therapy and 14 patients reported no side effects. In conclusion our data suggest that Mexiletine is an effective agent in the long-term treatment of serious ventricular arrhythmias refractory to other agents. Since Mexiletine therapy is not associated with severe long-term side effects, it should now be possible to determine its role as a first-line drug for treating ventricular arrhythmias.

Adult↗
PubMed1981

[Hypertrophic cardiomyopathy: ECG-VCG abnormalities in absence of the echocardiographic markers in a family (author's transl)].

We report a family, in which two members, the propositus and his father had an left ventriculography highly indicative of non-obstructive or labile mild obstructive hypertrophic cardiomyopathy. In these two members the M-mode and the two dimensional echocardiography did not reveal the features of the hypertrophic cardiomyopathy, i.e. the increased thickness of the interventricular septum and the asymmetric septal hypertrophy, whereas the electrocardiogram and the Frank vectorcardiogram showed an increase of the QRS anterior forces voltage in the transverse plane. In a third relative, the younger brother of the propositus, a similar discrepancy between the VCGraphic and the echocardiographic data was present. The presence of significant ECG-VCGraphic abnormalities in subjects with documented hypertrophic cardiomyopathy and slightly increased septalto-free wall ratio has been previously reported by other Authors. However, the interest of our observation is in the presence of this discrepancy in many members of the same family. Although the ventriculographic pattern was not consistent in our subjects with that found by Yagamuchi et al. in patients with apical non-obstructive hypertrophic cardiomyopathy, a prevailing obliteration of the apical portion of the left ventricular chamber at end-systole was evident in both our cases. This finding however was not revealed by two-dimensional echocardiogram. Although it was not possible exclude on firm grounds that cases described were a normal variant, our observation seems to confirm that the echocardiography does not offer the unique "gold standard" for the non-invasive identification of the hypertrophic cardiomyopathy.

Adolescent↗
PubMed1980

[Orthogonal ECG and a statistical system for computer diagnosis with ECG in chronic obstructive pneumopathy].

In 92 patients affected from chronic obstructive pulmonary disease (C.O.P.) undergoing spirometric evaluation, the ability of the Pipberger computer program for electrocardiographic interpretation to predict the presence of pulmonary disease with or without right ventricular hipertrophy was compared with that of the manually measured conventional and orthogonal (Frank system) electrocardiogram. The patients were classified as having mild, moderate and severe C.O.P. on the basis of spirometric data. Each system predicted the presence of C.O.P. with low sensitivity. P voltage in D2 greater than or equal to 2 mm (27,1%) and R/S voltage ratio in V5-V6 greater than or equal to 1 (22,8%) were the single conventional criteria more frequently satisfied. Results for 3 lead manual readings were only slightly lower: recognition rate of the R/S voltage ration in x lead less than or equal to 1,3 was 15,7%. The Pipberger program probabilistic answers were divided in "completely" and "partially" correct. Combined completely or partially correct diagnoses were made by the program 14,3% of patients with mild C.O.P., 17,2% of moderate and 48,8% of severe C.O.P. These results suggests that the Pipberger program has at least similar ability to predict C.O.P. compared with the 12 lead and orthogonal manually measured electrocardiogram.

Aged↗
PubMed1980

[Surface recording technique of His bundle potential in man].

A method is presented for the non-invasive recording of His bundle electrical activity from the body surface in man. Several bipolar ECG leads were employed: precordial, Frank "x" and Frank "z". Signals were filtered (30-300 Hz), highly amplified (5 x 104) and averaged. Digital averaging was performed on line by a microcomputer (OTE Biomedica Neuroaverager mod. 1172). Surface investigation was performed in 10 patients affected by different conduction pathology simultaneously with HBE recordings for diagnostic purpose and in 5 normal volunteers only incruently. Highly repeatable electrical deflections (B waves) were recorded in the PR segment. In all patients a good correspondence between surface (B wave) and intracardiac (H wave) was found. Atrial pacing and pharmacological test were used in order to ascertain the real source of B wave.

Bundle of His↗
PubMed1980

[Automatic analysis of systolic time intervals using polygraphic examinations].

For clinical purpose, poligraphyc signals are analyzed: systolic time intervals (STI) and all other significative magnitudes are measured. A system of modular programs (ATS), in Assembler and Fortran IV languages, digitalizes, filters and analyzes three simultaneous analogical signals: ECG, PCK and CP. ATS, adapted polynomial and gonyometrics leats-squares smoothings to the signals for leaving-out spikes and drifts, employs algorhythms that, by a statistic knowledge of the thresholds of the fist derivative of each signal and of the globality of smoothed signals, converge to the measures of the required significative magnitudes. A statistic investigation (on 100 samples) showed that ATS is better than every manual analysis in terms of efficiency, speed and amount of information. In conclusion ATS program is suitable for clinical purposes.

Adult↗
PubMed1980

A computerized system for the analysis of the carotid pulse and apexcardiogram.

A computer program for the on-line analysis of the carotid pulse (CP) and of the apexcardiogram (ACG) is described. The program measures the absolute and the heart rate-corrected time intervals, the time intervals ratios, the amplitude absolute values, the quantitative ACG (DA/Dt), the ejection fraction and the circumferential fiber shortening velocity, according to Antani. Normalized amplitude and angular ACG items are also calculated. 80 normal subjects were examined to evaluate the reliability of the computer measurements in comparison with the manual measurements and to establish normal computerized values. No significant differences resulted in the comparison of the manual and computerized measurements. The normal computerized values are quite similar to those reported in the literature. The systolic time intervals (STI) were derived from the CP/phonocardiogram recording and directly from the ACG, utilizing the second peak of the first ACG derivative as marker of the onset of the ejection period. The left ventricular ejection time was 286.36 +/- 14 and 282.35 +/- 21.80 (no significant difference) and the pre-ejection period 87 +/- 14 and 93.16 +/- 23.16 (no significant) utilizing the CP/phonocardiogram and the ACG respectively. The results demonstrate a good reliability of the computer system and the usefulness of the system in the direct estimate of the STI from the ACG.

Adult↗
PubMed1980

[The sclerodermic cardiopathy. Infarction-like electrocardiographic picture and clinico-echocardiographic correlation in three observed cases (author's transl)].

We present three cases of primary sclerodermic cardiopathy with an electrocardiographic picture of anterior myocardial infarction not preceded by chest pain. On one of the cases a coronary angiography was performed with negative results. The echocardiogram of case no 1 showed a pattern of congestive cardiomyopathy, while case no 2 showed a picture of an infiltrative cardiomyopathy. In case no 2 the electrocardiographic picture changed to that of a right bundle branch block with left posterior fascicular block and with the disappearance of the anterior infarction. The His bundle electrogram showed a prolongation of the HV interval, while hemodynamically no signs were shown of impaired mechanical heart function. The clinical and echocardiographic aspects of the sclerodermic cardiopathy are here discussed with particular reference to the possibility of the prevalent compromise of the conduction system that could explain the not uncommon incidence of sudden death.

Adult↗
PubMed1979

[Comparative echocardiographic and vectorcardiographic study of 17 patients with Duchenne muscular dystrophy (author's transl)].

Cardiac impairment in Duchenne muscular dystrophy (DMD) is well known since many years. Degeneration of myocardial fibers and progressive scarring of the left ventricle, especially in the postero-basal and lateral portions, represent the habitual cardiac pathologic features of post-mortem investigations. Nevertheless many questions about etiopathogenesis and pathophysiology of "DMD cardiomyopathy" are still debated. Clinical, vectorcardiographic (VCG) and echocardiographic (ECO) data of 17 patients suffering from DMD are here reported. Patients were subdivided in two groups according to age: A) subjects from 4 to 10 yrs. (mean 0.22 +/- 1.82 yrs.), 10 cases; B) subjects from 11 to 20 yrs. (mean 15.2 +/- 2.8 yrs.), 7 cases. Both patients groups were compared with age-matched normal controls (group A1 and B1). Our results show: 1) cardiac clinical symptoms and signs, even if is present in infancy, become more evident in adult age; 2) echocardiogram allows an early diagnosis and accurate follow-up of such cardiac pathology. Group A patients, in comparison with his own control group, exhibited a significant impairment of the left ventricular function indexes (PWE, IVSE, SV, Vcf, EF%, delta S%). Moreover the older group of patients (group B), besides the alteration of the above mentioned indexes, exhibited a significant decrease of the PWT and an impairment of DEVM. This, in agreement with other Authors, gives evidence to the progressive deteriorating of cardiac function in DMD. 3) A significant correlation between ECO and VCG data is lacking. Nevertheless VCG also displays a clear tendency to get worse with age. Vectorcardiographic features well agree with the post-mortem findings of a progressive but scattered myocardial fibrosis with elective localization in postero-basal and lateral (free wall) portions of left ventricle. 4) For the most part, in our patients, cardiological instrumental findings (ECO and VCG) are well in agreement with clinical data and natural history of "DMD cardiomyopathy". The afore said methods of investigation appear very useful in the diagnostic and therapeutic management of such patients.

Adolescent↗
PubMed1978

[Comparison between vectocardiogram and echocardiogram in the diagnosis of left atrial enlargement (author's transl)].

The purpose of this study was to evaluate the influence of atrial enlargement on P wave abnormalities in "primary" (mitral stenosis) and "secondary" (left ventricular involvement) forms of left atrial overload. Echocardiograms and Frank Vectorcardiograms were obtained from 42 subjects, including 12 patients with mitral stenosis (group I A), 4 with mitral insufficiency (group I B), and 26 with left ventricular disease. Good correlations were founded between left atrial dimension and the following vectorcardiographic criteria: magnitude of the positive P vector in lead Z, sum of the positive P wave in leads X and Z, P positive duration/PR segment ratio in lead Z. No specific difference has been found in the vectorcardiographic abnormalities of the "primary" and "secondary" left atrial enlargement. Separate analysis revealed that P wave duration or amplitude changes can be proposed in group I A as specific and sensible criteria of left atrial enlargement. In contrast, the same criteria are highly unspecific when applied to the patients with left ventricular disease, because they can reflect the influence of other variables (left atrial pressure, intra-atrial conduction defects). Comparison of our results with those of other studies of P wave analysis did not demonstrate the superiority of the vectorcardiogram over the conventional electrocardiogram in the diagnosis of left atrial enlargement.

Adolescent↗
PubMed1978

[3 cases of cardiac echinococcosis. Diagnostic considerations].

Three cases of cardiac hydatidosis are described, with emphasis on electro-vectorcardiographic, policardiographic and angiographic data. The cysts, plurime in two patients, were localized in different sites: in the first patient only one cyst was present in the interventricular septum; in the second one there were cysts in the right atrial wall and in the diaphragmatic ventricular wall; in the last one a multilocular disrupted sac involved the left ventricular wall partially occupying the left ventricular cavity. Multiple pericardial cysts were also present in this patient. The usefulness of different invasive and non invasive techniques is here discussed regarding topographic diagnosis of cardiac hydatidosis.

Adult↗