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Biomedical subjects

G F Percoco

Publications and source records attributed to G F Percoco.

7 recordsLinked to original sources

Italian multicenter study on a single lead VDD pacing system using a narrow atrial dipole spacing.

Since November 1988, 514 patients with advanced atrioventricular (AV) block and normal sinoatrial function have received the single lead VDD pacing system Twinal 30 Lem/CCS in 30 Italian centers. At implantation, particular attention was paid to the correct positioning of the atrial dipole in the mid- to mid-high right atrium and to the atrial electrogram characteristics. The follow-up included a chest X ray, to be performed before discharge of the patient from the hospital, telemetric evaluations of the endoatrial potential, provocative tests for interferences by myopotentials, 24-hour ambulatory EGG recordings, and where possible, exercise stress tests. The mean follow-up duration was 15.2 months, ranging from 1 to 42 months. A very low percentage of chronic atrial fibrillation, loss of atrial sensing, and system replacement was reported, most of the patients (93.5%) being paced in VDD mode. All investigations indicated an excellent overall system performance, stable AV synchrony, and infrequent myopotential interference, and a low complication rate throughout the follow-up period.

Aged

Role of sinus node artery disease in sick sinus syndrome in inferior wall acute myocardial infarction.

This study was undertaken to evaluate a possible role of sinus node (SN) artery disease in the pathogenesis of sick sinus syndrome (SSS) in patients with an inferior wall acute myocardial infarction (AMI). Coronary angiography and electrophysiologic studies of the SN, both in the basal state and after pharmacologic autonomic blockade, were performed in 23 study patients (mean age 60 years) with SSS and a previous inferior wall AMI and in another 23 control patients (mean age 57 years) with normal sinus rate and a previous inferior AMI. Stenosis of the SN artery (or that proximal to its origin) greater than 50% was present in 13 study patients (56%) and in 8 control patients (34%) (p less than 0.05). In the study group, the intrinsic heart rate was abnormal in 5 of the 6 patients (83%) with severe SN artery stenosis (greater than or equal to 75% narrowing), in 3 of the 7 (43%) with moderate stenosis (50 to 75% narrowing) and in 3 of the 10 (30%) with insignificant stenosis (less than 50% narrowing). In the study group, the correlation between the SN measures (heart rate, corrected SN recovery time and sinoatrial conduction time) and the severity of SN artery stenosis was good after autonomic blockade (r between 0.59 and 0.64) and poor in the basal state. These data provide evidence for a role of SN artery disease in the pathogenesis of SSS in patients with an inferior wall AMI.

Angiography

AV delay and exercise stress tests: behavior in normal subjects.

In normal subjects the atrioventricular (AV) conduction is accelerated during exertion. The relationship between heart rate and AV delay is usually described as "linear". Looking at the increasing importance given to an appropriate AV synchrony in permanent dual chamber and P synchronous pacing we present the results of an investigation performed to study the correlation between AV conduction time and heart rate under stress conditions, and disclose some new aspects of this matter, which will possibly be useful for a further improvement of pacemaker technology.

Adult

A new single lead VDD pacing system.

In 24 patients with advanced heart block and normal sinus node function, a new single lead VDD pacing system was implanted. At implantation, the endoatrial, bipolar electrogram was recorded in all patients. The lead position was checked by means of chest X-ray. At discharge and after 1, 3, and 6 months, testing for myopotential inhibition, telemetric evaluation of the endoatrial potential, and Holter recordings were made. After discharge, 18 patients performed two cardiopulmonary exercise tests at two different rate-matched AV intervals. All investigations showed good AV synchrony and a lack of interferences by myopotentials. The maximum rate-matched AV interval provided a significantly improved exercise capacity, which was more evident in patients with signs of myocardial failure.

Aged