PubMed Health⌕ Search

Biomedical subjects

G Ansalone

Publications and source records attributed to G Ansalone.

At least 37 records · Page 2Linked to original sources
PubMed1981

An unusual ECG pattern: left posterior fascicular block obscuring a right ventricular conduction defect?

A 23-year-old man with a history of palpitations and a single syncopal attack is described. Results of the physical examination were negative. The ECG showed a marked right axis deviation, a QRS duration of 0.13 sec. and an rS pattern from V1 to V6. In the high right precordial leads an rsR' pattern was recorded. The VCG (Frank system) showed a rightward dislocation of QRS vectors, a clockwise inscription of the QRS loop in the frontal and transverse planes and a slowing of the rightward and posterior terminal vectors. The X-ray film and the echocardiogram were negative. Neither intra-cardiac shunts nor pressure abnormalities were detected at the heart catheterization. The basal His bundle electrogram showed an H-V prolongation. Atrial pacing caused a progressive increase of the QRS duration and the appearance of an R configuration in the V1 lead, without axis shifting. We propose that the electrocardiographic pattern was suggestive of a left posterior fascicular block masking in the standard right precordial leads an associated right ventricular conduction defect.

Adult↗
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

[Computer evaluation of hemodynamic changes during mechanical ventilation with a body respirator].

The Authors study the variations of the cardiac output (C.O.), of the mean pulmonary arterial pressure (mPAP) and of the pulmonary vascular resistance (P.V.R.) in fine patients, affected by chronic respiratory failure, during the mechanical ventilation with a body respirator. In all the patients a reduction of the mPAP and of the CO are present. The PVR varies proportionally to the improvement of the respiratory indices. The Authors conclude that the haemodinamic changes are not exclusively due to the mechanical effect of the body respirator, but also to the correction of the respiratory situation and particularly due to the intra-alveolar pressure.

Aged↗
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

[Systolic time intervals at rest in subjects under prolonged stress: a computerized analysis].

Systolic time intervals were measured in 21 endurance-athletes (middle and lung distance runners) with a computerized method. Data from athletes were compared with that obtained in 27 age-matched normal untrained subjects. Endurance athletes showed significantly inferior values than normal untrained subjects of heart rate, total ejection time (TET), rapid ejection time (TER), electromechanical systole duration (QS2). Authors suggest that these results, particularly the reduction of TER at rest, could be due to a more rapid ejection rate primary or secondary to a left ventricular after-load reduction, following the cardiovascular adaptations induced by training in these athletes.

Adolescent↗
PubMed1980

Transient right bundle branch block unmasking anteroseptal infarction concealed by left posterior fascicular block.

A case of acute anteroseptal myocardial infarction (MI) associated with transient right bundle branch block (RBBB) and a probably persistent left posterior fascicular block is reported. When the RBBB disappeared, small initial r waves were present in the right precordial leads concealing the evidence of MI. Finally, the electrocardiographic pattern evolved to an atypical form of incomplete left bundle branch block. An hypothetic role of the middle septal fascicle in this electrocardiographic evolution is discussed.

Bundle-Branch Block↗
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↗
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↗