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Biomedical subjects

H Ector

Publications and source records attributed to H Ector.

70 records · Page 4Linked to original sources
PubMed1984

Treatment of life-threatening ventricular arrhythmias by a combination of antiarrhythmic drugs and right ventricular pacing.

Thirteen patients with intractable ventricular arrhythmias were studied; they underwent long-term treatment by a combination of antiarrhythmic drugs and ventricular pacing. Eleven patients had a history of tachycardia and two had torsade de pointes; eleven of thirteen had had cardioversion and/or defibrillation. Prior to permanent pacemaker implantation, temporary pacing in the VVI mode was used in combination with one or more of the following drugs: amiodarone, aprindine, digitalis, metoprolol, mexiletine, procainamide, pindolol, propranolol, or quinidine. Various pacing rates were tried; when permanent pacing was instituted, a unipolar system which was at least rate-programmable was used. Right ventricular VVI pacing, combined with drug therapy, was successful in ten of thirteen patients. Five of the ten patients are alive and free of arrhythmias after 78, 72, 72, 54, and 11 months, respectively. Although five patients died (after 60, 48, 30, 24, and 9 months, respectively), none of the deaths were related to arrhythmias. We suggest that in patients with ventricular arrhythmias refractory to conventional treatment, a therapeutic trial of right ventricular VVI pacing in combination with a drug regimen be used.

Adult↗
PubMed1983

Dynamic electrocardiography and ventricular pauses of 3 seconds and more: etiology and therapeutic implications.

A total of 2350 consecutive Holter recordings revealed that 53 patients had ventricular asystole of 3 seconds or more. The diagnoses based on the longest pauses were: sinus arrest in 19; AV block in 5; slow atrial fibrillation in 29. Symptoms occurred in 45 and were absent in 8 patients. Associated heart disease was present in only 33 cases. A pacemaker was implanted in 7 out of 8 asymptomatic patients. Ventricular asystole of 3 seconds or more is proposed as a definite indication for the implantation of a permanent pacemaker.

Adult↗
PubMed1982

The underlying heart rhythm in patients with an artificial cardiac pacemaker.

One-hundred forty-two patients with atrioventricular block (AVB) and 61 patients with sick sinus syndrome (SSS) were followed for an average of 50 months after permanent pacemaker insertion. Their underlying heart rhythms (UHR) were evaluated repeatedly by chest wall stimulation (CWS). A deficient UHR was defined as ventricular asystole lasting 4 seconds or longer. The underlying conduction disturbance increased in 14% of AVB patients, decreased in 14%, and remained constant in 68%. The occurrence of Adams-Stokes attacks before pacemaker implantation was associated with a higher incidence of deficient UHR both in AVB and SSS; a deficient UHR was seen more frequently in AVB than in SSS. Among AVB patients (1) atrial fibrillation, flutter or tachycardia and (2) sinus rhythm with incomplete AVB, especially Mobitz 1, when present before pacemaker implantation, were associated with a significantly lower incidence of deficient UHR during subsequent pacing in comparison with other AVB patients. CWS is a non-invasive method which allows the evaluation of UHR and which can contribute to the early recognition of pacemaker-dependent patients.

Aged↗
PubMed1980

Sick sinus syndrome in childhood.

The clinical and electrocardiographic findings in five children with the sick sinus syndrome and an otherwise normal heart are described. There were three boys and two girls. Their age at onset of either bradycardia or symptoms ranged from 1 day to 7 years. In one patient, the youngest ever reported with this syndrome, bradycardia was noted before birth. Four children presented with neurological symptoms--attacks of dizziness, fainting spells, or syncope. One boy, treated for epilepsy before the underlying arrhythmia ws diagnosed, died suddenly while playing. One child had near-fatal syncope caused by ventricular tachycardia. Continuous 24-hour electrocardiographic monitoring is the best method of assessing the severity of the condition. Sinus bradycardia, sinuatrial block, and periods of sinus arrest up to 4.8 seconds were recorded. Two patients had associated atrioventricular block and were therefore presumed to have binodal disease. Atrial fibrillation or flutter occurred in three patients. Isolated sick sinus syndrome may be a life-threatening condition in childhood for which, in selected cases, the insertion of a permanent pacemaker is indicated.

Child↗
PubMed1978

A new test for pacemaker leads: capacitance measurement.

A device has been developed which permits in man the measurement of the capacitance of a chronically implanted pacemaker lead at the moment of battery replacement. A large increase in capacitance suggests important body fluid penetration into the lead. This can be due to an insulation defect (caused by a suture or a guide wire during implantation) or to a degeneration of the insulation material or to the lead-design. This fluid penetration should be avoided since it can be responsible for some electro-chemical reactions. Calculated values for the capacitance of a system consisting of an inner and an outer conductor, with two media in between, agree rather well with measured values. It is suggested that the measurement of the capacitance of a pacemaker lead is an additional tool for the evaluation of chronically implanted pacemaker leads. This method can also be of interest for the quality control of pacemaker leads.

Electric Conductivity↗
PubMed1976

Results of follow-up study in cardiac pacing at St. Raphael University Hosital in Leuven.

After this follow-up period some data seem important for the future: 1. Sudden failure never occurred for ventricular asynchronous units. Moreover battery survival time of fixed rate units is longer than that of ventricular-inhibited units. On the other hand, the use of fixed rate pacers avoids a number of demand function-related electrode difficulties. We must be aware of false signals generated by malfunctioning electrodes. 2. The reliability of a pacemaker clinic improves by replacing ventricular-inhibited units after 34 months. 3. Despite the additional work and cost we feel that photoanalysis is indispensable in today's pacemaker clinic.

Electrodes, Implanted↗
PubMedDate not supplied

Assessment of the optimal atrioventricular delay in dual chamber-paced patients by a portable scintillation probe (VEST).

BACKGROUND: The optimal atrioventricular delay in dual-chamber pacing differs from patient to patient. The availability of a portable scintillation probe (VEST) enables noninvasive monitoring of left ventricular function. METHODS AND RESULTS: Hemodynamic variations were measured in 10 patients with programmable DDD pacemakers. The ejection fraction, stroke volume, and diastolic and systolic volume were evaluated, programming six different atrioventricular delays ranging from 75 to 200 msec, to determine the most favorable atrioventricular delay. Comparing left ventricular ejection fraction (LVEF), stroke volume, and end-diastolic and end-systolic volume at each DVI mode with a preceding DVI setting of 75 msec, all parameters at 200 msec were statistically different from those at 100 msec. An increase of LVEF and stroke volume and a decrease of end-systolic volume was found. In only five patients a switch of VVI mode to the optimal DVI mode results in an increase of LVEF of more than 5%. CONCLUSIONS: Our study stresses the importance of optimizing atrioventricular delay. The VEST system permits these measurements, increasing the accuracy of the determination of optimal atrioventricular delay, and appears to be valuable in the management of patients with cardiac dual-chamber pacemakers.

Aged↗