Long-term amiodarone therapy and antithyroid antibodies.
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Biomedical subjects
Publications and source records attributed to H B Machado.
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Standardization of electrocardiographic interpretive statements is a goal of various coding systems, but word processing has not usually been considered. A simple, easily memorized system for clinical electrocardiography has been developed and used for approximately 60 000 interpretations. It takes the form of a "menu", in which boxes stand for various interpretive statements; the boxes are identified by mnemonics and marked by the interpreter when appropriate. The results provide better standardization, significant decreases in the numbers of descriptive statements and words per interpretation and considerable saving in typing time. Acceptance by the interpreters has been good. Features of the system allow for word processing as part of a polarcardiography computing system.
The 12-lead electrocardiogram (ECG) derived from the Frank xyz signals was compared with the conventional 12-lead ECG using the Telemed computer system. In 100 cases studied. Telemed's interpretations were essentially similar in 77, but substantially different in 23. In the 23 cases, interpretations of the derived tracings tended to be more accurate in 14 cases, and less accurate in four cases. In the diagnosis of infarction the probability that the interpretation of the derived tracing will be correct more often was 90%. The better performance may have been related to closer agreement with the vectorcardiogram (VCG). As a substitute for the conventional ECG, the derived ECG offers the prospect of a computerized system that is more practical and more versatile than most currently used systems.
Electrophysiologic studies including His bundle recording, atrial, and ventricular stimulation, were performed in three symptomatic patients with persistent atrial standstill of unknown etiology. The rhythm was junctional in two cases and ventricular in one. In two cases, evidence suggestive of associated impairment of the His bundle conduction system was found. The atria were inexcitable at multiple sites and no retrograde conduction to the right atrium could be elicited by ventricular pacing. Follow-up in the three cases, respectively for 48, 42 and 12 months after pacemaker implantation, revealed no return of spontaneous atrial electrical activity.
Systolic time intervals and heart sounds were studied in twenty patients with left bundle branch block. A definite cause for the organic heart disease was not ascertained. Abnormal duration of the electromechanical systole (Q-A2), due to a prolongation both of the preejection period (PEP) and of the Q-M1 intervals, was found to exist in all. Prolongation of Q-M1 was due to lengthening either of the electromechanical interval (EMI) or of the pre-isovolumetric contraction time (PICT). Isovolumetric contraction time (ICT) was prolonged in thirteen patients only. There was a good correlation between LVET/ICT ratio and the duration of ICT intervals. Six patients showed a first heart sound of normal intensity and duration. There was no correlation between the duration of the systolic time intervals and the characteristics of the first and second heart sounds.