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Farhad Elmi

Publications and source records attributed to Farhad Elmi.

3 recordsLinked to original sources

Inverted T waves on electrocardiogram: myocardial ischemia versus pulmonary embolism.

Electrocardiogram (ECG) is of limited diagnostic value in patients suspected with pulmonary embolism (PE). However, recent studies suggest that inverted T waves in the precordial leads are the most frequent ECG sign of massive PE (Chest 1997;11:537). Besides, this ECG sign was also associated with the best sensitivity, specificity, and positive and negative predictive values for diagnosing PE. We report 2 cases with similar ECG findings that were referred to us as unstable angina. Both were hemodynamically stable and had moderate-size pulmonary emboli. The ECG findings reverted to normal within a week of anticoagulation treatment. Our observation suggests that even a moderate-size PE can cause these ECG changes.

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Natural history and predictors of temporary epicardial pacemaker wire function in patients after open heart surgery.

STUDY OBJECTIVES: To assess the short-term reliability of temporary epicardial pacing wires in patients after open heart surgery and to determine the influence of preoperative factors on the performance of these wires. PATIENTS AND METHODS: In this prospective, longitudinal cohort study, 60 patients (41 men) with a mean age of 66.8 +/- 8.9 years were studied for 5.3 +/- 1.1 days postoperatively. Each patient's history, physical findings, hemodynamics and echocardiographic data were analyzed. Postoperatively, capture threshold, the electrogram amplitude and slew rate, and the lead impedance were determined daily in both chambers. RESULTS: Both atrial and ventricular thresholds increased significantly (p < 0.001) by the 4th postoperative day. The P-wave amplitudes were consistently less than half of the R-wave amplitudes. Both P- and R-wave amplitudes deteriorated significantly by the 2nd postoperative day (p < 0.001 and p < 0.02, respectively). Atrial and ventricular slew rates and lead impedance decreased significantly during the observation period (p < 0.002). CONCLUSION: Although both atrial and ventricular temporary epicardial leads are reliable for short-term use, their function deteriorates on a daily basis. Perioperative factors are generally not helpful in predicting the performance of temporary epicardial pacing wires.

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