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Biomedical subjects

F Veit

Publications and source records attributed to F Veit.

16 recordsLinked to original sources
PubMed2000

Successful treatment of idiopathic left ventricular outflow tract tachycardia by catheter ablation or minimally invasive surgical cryoablation.

Idiopathic right ventricular outflow tract tachycardia is readily amenable to radiofrequency catheter ablation. However, treatment modalities for left ventricular outflow tract tachycardia are not well defined. Out of 37 patients with idiopathic outflow tract tachycardia referred for catheter ablation, in 3 patients tachycardia originated from the left ventricular outflow tract. On the surface ECG, all left ventricular tachycardias exhibited an inferior axis with a predominant negative QRS complex in lead I. Heart rate during tachycardia ranged from 115 to 170 beats/min. During electrophysiological testing, 1 patient had inducible tachycardia on orciprenaline challenge, 1 patient had inducible tachycardia at baseline, and 1 patient had incessant tachycardia. In two patients, earliest ventricular activation was recorded from the endocardial left ventricular outflow tract at an anterolateral and an anterior site, respectively. A distinct high frequency spike preceded the QRS onset by 66/78 ms. Application of radiofrequency energy successfully eliminated tachycardia at these sites. In one patient, tachycardia originated from the epicardial left ventricular outflow tract. Mapping of the anterior interventricular vein revealed a fractionated low amplitude signal occurring 46 ms before QRS onset. After failure of catheter ablation from the corresponding endocardial site, successful minimally invasive surgical focal cryoablation of the epicardial target region was performed. During a follow-up period ranging from 7 to 12 months, all patients remained free of tachycardia. In conclusion, ventricular tachycardia arising from the left ventricular outflow tract may require endo- and epicardial mapping. Successful treatment is achieved by radiofrequency catheter ablation or minimally invasive surgical cryoablation.

Adult↗
PubMed2000

Influence of positive airway pressure on the pressure gradient for venous return in humans.

To study the effect of positive airway pressure (Paw) on the pressure gradient for venous return [the difference between mean systemic filling pressure (Pms) and right atrial pressure (Pra)], we investigated 10 patients during general anesthesia for implantation of defibrillator devices. Paw was varied under apnea from 0 to 15 cmH(2)O, which increased Pra from 7.3 +/- 3.1 to 10.0 +/- 2.3 mmHg and decreased left ventricular stroke volume by 23 +/- 22%. Episodes of ventricular fibrillation, induced for defibrillator testing, were performed during 0- and 15-cmH(2)O Paw to measure Pms (value of Pra 7.5 s after onset of circulatory arrest). Positive Paw increased Pms from 10.2 +/- 3.5 to 12.7 +/- 3.2 mmHg, and thus the pressure gradient for venous return (Pms - Pra) remained unchanged. Echocardiography did not reveal signs of vascular collapse of the inferior and superior vena cava due to lung expansion. In conclusion, we demonstrated that positive Paw equally increases Pra and Pms in humans and alters venous return without changes in the pressure gradient (Pms - Pra).

Aged↗
PubMed1999

Hepatitis infection among adolescents resident in Melbourne Juvenile Justice Centre: risk factors and challenges.

OBJECTIVE: To describe patterns of infection with, and risks for, hepatitis A, B and C viruses (HAV, HBV, and HCV) in male adolescents detained in the Melbourne Juvenile Justice Centre (MJJC). METHODS: A cross-sectional serosurvey for HAV, HBV, and HCV among 90 male adolescents aged 15-18 years who were resident in MJJC for more than 1 week in 1996. RESULTS: Nine percent had been exposed to HAV, 8% were positive or equivocal for exposure to HBV, and 21% were antibody positive for HCV. All those with hepatitis markers except one positive for HAV had been injection heroin users for more than 1 year. Of those who were not HBcAb positive, only 28% were immune to HBV. For most respondents, sexual and drug-using risks began in the early teens and were associated with leaving school prematurely. CONCLUSIONS: Respondents were vulnerable to exposure to blood-borne viruses from an early age, posing a challenge for health education programs. An opportunity exists for harm minimization and prevention of spread of blood-borne viruses within the first year of injection drug use in this population.

Adolescent↗
PubMed1998

[Sub-pectoral implantation of defibrillators: intraoperative data and long-term outcome].

UNLABELLED: The present study examined the perioperative mortality and morbidity and lead-related complications in patients who had a defibrillator with a transvenous lead system and subpectoral implantation of the generator. Fifty-four out of 57 consecutive patients (95%) received a transvenous lead system. One patient had an acceptable defibrillation threshold with an additional subcutaneous patch whereas no sufficient defibrillation threshold was found in another 2 patients. Two patients died due to congestive heart failure after implantation. Perioperative complications were observed in 4 patients (7%) including pericardial effusion, pocket hematoma, injury of the plexus brachialis and a pneumothorax. None of these complications required surgical intervention. Fifty-five patients were discharged from the hospital. During 27 +/- 10 months none of these patients died. Lead-related complications were observed in 3 patients (5.5%) including microdislocation in two and a outer conductor fracture in one of the lead. CONCLUSION: Technical advancement such as a non-thoracotomy lead system and smaller devices have made the onc-incision approach and subpectoral implantation of the ICD generator clinical routine. Nevertheless complications related to the lead system can occur. Therefore frequent controls of patients with ICD are necessary.

Adult↗
PubMed1998

Serostatus for vaccine-preventable diseases in residents at Melbourne Juvenile Justice Centre.

There are concerns in Australia about inadequate rates of childhood immunisation, an important preventive measure to reduce infectious diseases. The population passing through the Melbourne Juvenile Justice Centre (MJJC) comes from a background at high risk for inadequate immunisation and outbreaks can occur in residential institutions. MJJC residents were invited to participate in a study by completing a medical officer-administered risk behaviour questionnaire and/or giving a blood sample. Ninety residents completed the questionnaire; 83 gave blood samples. Sera were tested for measles, mumps, rubella and hepatitis A, B and C markers using standard commercial assays. Diphtheria and tetanus were tested with an ELISA in a public health laboratory familiar in the technique. Sixty four per cent (53/83) of participants were non-immune to at least one component of MMR and 44.6% (37/83) non-immune to either tetanus or diphtheria. Despite 61.1% of participants reporting injecting drug use, only 28.2% had protective levels of anti-HBs, 6.1% were positive for anti-HBc (2.4% equivocal), 22.9% were anti-HCV positive and 9.6% had markers of exposure to hepatitis A virus. These results show suboptimal levels of immunity in this institutional setting with the potential for disease outbreaks. Many residents miss adolescent school-based programs for immunisation because of truancy and early school leaving. Despite considerable risk of blood-borne viruses, many MJJC residents are inadequately vaccinated against hepatitis B.

Adolescent↗
PubMed1995

Trends in the use of fundoplication in children with gastro-oesophageal reflux.

OBJECTIVE: To document changing trends in the indications for fundoplication in children with gastro-oesophageal reflux and to identify the main shortcomings and complications of the procedure. METHODOLOGY: Retrospective review of 405 consecutive children undergoing fundoplication between 1978 and 1992 inclusive. RESULTS: Trends in the indications for fundoplication related to broadening of its use in those with severe neurological impairment and uncontrolled reflux, and to changes in the management of patients in the neonatal period. Complications included unwrapping with recurrence of reflux, hiatal hernia, adhesive small bowel obstruction, dumping syndrome, post-operative persistence of oesophageal stricture, excessively tight wrap and poor oesophageal clearance (mostly in oesophageal atresia patients). CONCLUSIONS: This study identified those patients most likely to develop complications following fundoplication. This may assist in the pre-operative assessment of the likely benefit of fundoplication in children who often have other complex problems.

Adolescent↗
PubMed1995

Cardioverter discharges following sensing of electrical artifact due to fluid penetration in the connector port.

We report a unique case of fluid penetration, 3 months after implantation, in the connector port of an automatic implantable cardioverter defibrillator (ICD) with transvenous subcutaneous lead system. The patient had coronary artery disease and recurrent episodes of ventricular fibrillation, the fluid caused electrical signals interpreted as ventricular fibrillation by the device, which triggered shock delivery.

Aged↗
PubMed1995

[Efficacy of the implantable cardioverter-defibrillator in patients on the waiting list for heart transplantation].

8 of 122 patients receiving an implantable cardioverter defibrillator (ICD) in our department since 1985 for the treatment of ventricular tachyarrhythmias were considered candidates for cardiac transplantation. In 6 of 8 patients, at least one successful ICD discharge (range 1-378 discharges) was documented in the follow up time until transplantation. These therapies included cardioversions/defibrillations as well as overdrive stimulation in sustained monomorphic ventricular tachycardia. 1 patient died shortly before receiving a compatible organ. The remaining 7 patients survived successful heart transplantation undertaken 7-34 months after implantation of the cardioverter defibrillator. Cardiac transplantation was not complicated in any of these patients by the previous ICD management. Our results show the high efficacy of ICD as "bridge to transplant" therapy unit cardiac transplantation.

Adult↗
PubMed1995

Adolescent suicide attempts: a general practice perspective.

General practitioners have a vital role in recognising, assessing and managing the suicidal adolescent. The GP's knowledge of the local community and services allows them to intervene effectively to prevent future suicidal behaviour. This may also involve the care and follow-up of survivors of youth suicide.

Adolescent↗
PubMed1994

Dumping syndrome after Nissen fundoplication.

Dumping syndrome is infrequently reported in children, but has significant morbidity. It may be difficult both to diagnose and manage. Two children are reported who developed dumping syndrome after Nissen fundoplication. Symptoms occurred soon after the operation and included post-prandial pallor, sweating, lethargy and diarrhoea. Failure to thrive was a prominent feature. Typical biochemical changes included hyperglycaemia shortly after meals, followed by hyperinsulinaemia and reactive hypoglycaemia. Effective treatment was only achieved with continuous enteral feeding. Children undergoing fundoplication should be closely monitored for episodes of hypoglycaemia and unresponsiveness. The incidence of dumping syndrome after fundoplication may be underestimated, particularly in children.

Child, Preschool↗
PubMed1994

[Complications in transvenous and transvenous-subcutaneous implantable defibrillator systems].

Due to technical improvement using the transvenous-subcutaneous approach for lead fixation for cardioverter-defibrillator implantation, the incidence of device implantation has extended enormously. While a significant lower perioperative mortality in transvenously implanted systems compared to epicardially fixed implantable cardioverter-defibrillator (ICD) has been proven, perioperative as well as complications during follow-up are not analyzed systematically. In 59 patients, in whom transvenous-subcutaneous ICDs had been implanted, 3 patients showed bleeding complications in the subcutaneous patch area, 1 patient showed a bleeding in the device pocket, and in 1 patient a seroma in the subcutaneous patch region was observed necessitating surgical revisions. During follow-up of 10 +/- 7 months, lead dislocations were observed in 6 patients, in another 6 patients patch crinkling was observed. There was 1 patient with a lead fracture as well as 1 patient with a bleeding in the subcutaneous patch region. Despite the high efficacy of this therapy used in patients with life-threatening ventricular arrhythmias, these potential complications have to be considered.

Adult↗
PubMed1993

[Implantation of defibrillators with transvenous-subcutaneous electrode systems].

In 23 patients an integrated pacemaker-defibrillator-system with transvenous-subcutaneous lead system was implanted. Two transvenous electrodes were positioned, one in the right ventricle for sensing, pacing and defibrillation and one in the superior vena cava for defibrillation alone. Another electrode was positioned subcutaneously near the ventricular apex for defibrillation. In 22 patients (96%) the lead system could be implanted without a major complication. The defibrillation threshold for ventricular fibrillation was 16 +/- 5 joules. During follow up of 6 +/- 4 months all spontaneous tachyarrhythmias were successfully terminated. There were three complications during follow up. In 2 patients the transvenous electrode dislocated and one patient showed a sensing malfunction. In conclusion the non-thoracotomy approach is effective, reduces the perioperative risk and represents therefore a great advantage compared to peri-/epicardial lead system.

Aged↗
PubMed1992

[Presumed "successful" fibrinolysis in unrecognized acute aortic dissection].

Thrombolysis (1,500,000 IU streptokinase during 60 minutes and 500 mg acetylsalicylic acid was started in a 43-year-old woman with Turner's syndrome who had chest pain lasting for more than 45 min accompanied by ST elevations of 0.2 mV or more in leads II, III, aVF and V1-V5. Pain disappeared within an hour and the ST segments became isoelectric. Severe back and upper abdominal pain occurred 24 hours later. Computed tomography revealed an aortic dissection from the aortic valve to the descending aorta. Intraoperatively the rupture was found to extend to an apparently single left coronary ostium. The aortic valve was bicuspid and incompetent. After aortic valve replacement, resection of the ascending aorta and implantation of a vascular prosthesis the patient's condition gradually improved and she was discharged from hospital.

Acute Disease↗
PubMed1992

[Non-drug therapy of ventricular tachycardia/ventricular fibrillation].

In the majority of patients with ventricular tachycardia/fibrillation drug treatment is not effective. The non-pharmacological treatment of this high-risk patients is of increasing importance. In Austria about 900 patients per year need non-pharmacological treatment of malignant ventricular arrhythmias. For this purpose 4 or 5 specialized centers would be necessary.

Anti-Arrhythmia Agents↗