Biomedical subjects

Franco Mascia

Publications and source records attributed to Franco Mascia.

3 recordsLinked to original sources

PubMed2004

Methods for testing automatic mode switching in patients implanted with DDD(R) pacemakers.

The assessment of automatic mode switching (AMS) algorithms is impossible in vivo, due to a low chance of seeing the patient at the onset of a spontaneous episode of atrial fibrillation (AF). As the induction of AF to test AMS has clinical concerns, three alternative and non-invasive techniques may be proposed for this purpose: myopotentials, chest wall stimulation, and an external supraventricular arrhythmia simulator. The first method is simple and does not require additional equipment, even though in some patients adequate signals cannot be generated with a soft effort such as handgrip or hand compression. The main advantage of the chest wall stimulation method is the possibility that it be performed in every implanting center, since it is based on the use of standard devices for cardiac stimulation. The method based on the external supraventricular arrhythmia simulator allows the most detailed of the ECG traces, but it needs a dedicated electronic device.

Atrial Fibrillation↗

PubMed2002

The role of blood volume reduction in the genesis of intradialytic hypotension.

BACKGROUND: The aim of this multicenter prospective study was to investigate the role of relative blood volume (RBV) reduction on intradialytic hypotension. METHODS: One hundred twenty-three patients on chronic hemodialysis therapy were considered a priori normotensive (reference group A), intradialytic hypotension prone (group B), and hypertensive (group C). RBV was continuously monitored, and diastolic and systolic blood pressure (SBP) and heart rate (HR) were measured at 20-minute intervals during three dialysis sessions. RESULTS: Intradialytic RBV reduction was -13.8% +/- 7.0% and similar in the three groups (P = 0.841). SBP and RBV decreased during dialysis, with a sharp initial decrease (in the first 20 minutes for SBP and the first 40 minutes for RBV), followed by a slower decrease. The lying bradycardic response before dialysis was less in group B than group A (a decrease of 3 +/- 7 versus 9 +/- 9 beats/min; P < 0.001). When symptomatic hypotension occurred, RBV reduction was not significantly different from that recorded at the same time during hypotension-free sessions (-13.9% +/- 6.4% versus -12.7% +/- 5.2%; P = 0.149). Group, baseline plasma-dialysate sodium gradient, RBV line irregularity, and early RBV and HR reduction during dialysis influenced the relative risk for symptomatic hypotension with a sensitivity of 80% versus 30% for RBV alone. CONCLUSION: We found no difference in reduction in RBV in the three groups and no critical RBV level for the appearance of symptomatic hypotension. With variables easily available within 40 minutes of dialysis, RBV monitoring increases the prediction of symptomatic hypotension.

Aged↗

PubMed2002

[Variations in QRS duration and axis with different sites and intervals of right ventricular pacing].

BACKGROUND: The aim of this study was to achieve left ventricular resynchronization by means of right ventricular pacing. METHODS: We studied 12 patients (9 males, 3 females, mean age 61.7 +/- 19.5 years), with syncope, II degree atrioventricular block or ventricular arrhythmias, without intraventricular conduction disturbances. Single and dual site pacing, synchrony or at different delay, was made in the right ventricular, outflow tract from the apex, and midseptal areas. RESULTS: In all patients we obtained the shortest QRS duration with synchrony or delayed bisite pacing (standard ventricular apex pacing 170 +/- 20 ms; bisite pacing 137 +/- 13 ms). CONCLUSIONS: Our data demonstrate that appropriate right ventricular pacing can lead to left ventricular resynchronization.

Adult↗