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Biomedical subjects

G S Butrous

Publications and source records attributed to G S Butrous.

28 records · Page 2Linked to original sources

Five-year follow-up of 101 elderly subjects by means of long-term ambulatory cardiac monitoring.

Long-term follow-up of 101 healthy elderly subjects living independently in the community has been undertaken by means of clinical examination, resting ECG and 24-hour ambulatory cardiac monitoring. It appears that the finding of ventricular premature complexes at the rate of 10 per hour or greater is associated with a significant increase in mortality. The prevalence of atrial fibrillation, initially found to be 11%, rises with age to 17% by the age of 84 years. Long-term ambulatory monitoring is essential in the proper documentation of paroxysmal atrial fibrillation. Bundle branch block also occurs in over 10% of elderly people and the prevalence rises steeply with age, so that at the end of this study more than one quarter of the survivors had evidence of His-Purkinje disease. Over 5% of our subjects had definite indications for pacing during the period of follow-up and lends support to the opinion that the current pacemaker implantation rate in the United Kingdom is below the optimal level.

Aged↗

The effect of power frequency high intensity electric fields on implanted cardiac pacemakers.

Thirty-five patients fitted with 16 different pacemaker models (from 6 manufacturers) were exposed to 50 Hz electric fields up to a maximum of 20 kV/m. Four different response patterns were encountered: (1) normal sensing and pacing in all Medtronic and some Vitatron units; (2) reversion to the fixed (interference) rate in all Telectronics, all Pacesetter, some Vitatron and CPI units; (3) slow and irregular pacing in one CPI and in all Cordis units; (4) mixed behavior over a critical range of field strengths in which slow and irregular pacing preceded reversion to fixed-rate, in some Telectronics and Pacesetter units. The field strengths required to induce such behavior varied from unit to unit and from model to model, with Telectronics being the most sensitive. In general, the interference threshold depended on the magnitude and distribution of induced body current relative to the pacemaker as well as field strength and thus varied with patient height, build and posture. While only a small proportion of pacemaker patients are likely to encounter electric fields strong enough to interfere with pacemaker behavior, this possible hazard should be recognized.

Adult↗

Interference with the pacemakers of two workers at electricity substations.

Pacemaker function was tested in two electricity substation workers exposed to high tension electric fields. High intensity electric fields induced reversion to the interference mode, producing in one case competitive rhythm and in the other inappropriately slow pacing which resulted in asymptomatic pauses of up to 2.5 s. A suit designed to shield the body from the effects of high intensity electric fields was tried and proved to be effective in protecting the pacemaker, allowing it to function normally in the substations.

Adult↗

Effects of high-intensity power-frequency electric fields on implanted modern multiprogrammable cardiac pacemakers.

The effect on an implanted, multiprogrammable pacemaker of power-frequency (50 Hz) electric fields up to an intensity (unperturbed value measured at 1.7 m) of 20 kV/m were assessed in ten paced patients. Radiotelemetric monitoring of the electrocardiogram allowed supervision of the electrocardiogram throughout exposure to the alternating electric field. Displacement body currents of up to 300μA were achieved depending on the position and height of the patient. None of the pacemakers was inhibited, triggered or reverted to fixed rate operation during the exposure. The programmable functions, programmability or output characteristics were not affected. Small changes in cardiac rate and rhythm elicited the correct pacemaker responses. Unlike earlier models of pacemaker, this modern implanted pacemaker, which represents `the state of the art', is not affected by 50 Hz electric fields likely to be encountered when standing underneath power lines.

Aged↗

Quantitative analysis of the electrocardiogram among healthy adult Iraqi males.

12-lead electrocardiography was studied in 522 healthy Iraqi males selected randomly between the ages of 20-50 years. The measurements performed included intervals, amplitude and QRS axis. Their relations to body build and blood pressure were evaluated. The distribution mean value was studied and compared with similar data from Western populations. There is no change in QRS axis within the age groups studied. The R-and T-waves are significantly higher than corresponding waves from Western populations. Therefore, many of left ventricular hypertrophy patterns on voltage criteria could not be applied accurately. This study shows some difference in the electrocardiographic pattern of a Middle Eastern population which can be of value in the assessment of cardiovascular epidemiology.

Adult↗

Software control of sensing and stimulation for cardiac electrophysiological study.

A software-controlled cardiac stimulator for clinical investigations is described. The stimulator is programmed by the user at a keyboard, while current status and values of parameters are presented on a visual display screen. A menu of predefined cardiac electrophysiological tests is available for user selection. Validity checks on data keyed in by the user and internal checks on safe pacing limits are incorporated in case of malfunction or user error. The system consists of a separate relatively simple isolated sensing and stimulation unit which communicates, via a standard digital input output interface, with a controlling microcomputer. All timing and control functions are performed in software by the computer. The use of high-level FORTRAN as the main programming language provides the system with a high degree of adaptability.

Computers↗