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H Kiss

Publications and source records attributed to H Kiss.

61 records · Page 4Linked to original sources
PubMed1986

[Value of long-term ECG in patients with syncope].

In a prospective study 24 hour long-term ECG (LT-ECG) recordings under ambulatory conditions were performed in 126 patients with syncopes (SY) of unknown origin. LT-ECG revealed arrhythmias (AR) in 57%, whereas 43% had inconspicuous findings. One patient developed a SY during LT-ECG without any evidence for arrhythmias. In 40% of these patients AR not detected previously by other methods were discovered. In 36% AR detected by LT-ECG had to be considered as precursors of syncopes (i.e. bradycardia less than 40 b.p.m., tachycardia greater than 160 b.p.m., AV-block II/II and III, or ventricular arrhythmias Lown IV). LT-ECG increased the information about the cause of syncope in 35%, whereas in 65% LT-ECG did not produce any further information. Consequently LT-ECG led in 56% to drug therapy, in 8% to PM-implantation. During a mean follow-up of 22 months 22% of patients developed again a syncopal attack and 4% died suddenly. Despite LT-ECG recording an ECG-registration during a typical syncopal attack for the confirmation or exclusion of an arrhythmogenic genesis of the SY is achieved only by chance. Nevertheless further informations with regard to precursing AR can be obtained, which may lead to therapeutic consequences in some patients. Therefore, LT-ECG has to be recommended as an essential, non-invasive procedure in patients with SY of unknown origin.

Adolescent↗
PubMed1984

[Value of ECG-telephone transmission in determining symptomatic heart-rhythm disorders].

The ECG-telephone-transmission (TTM) was used to record an ECG-strip during a typical symptomatic period in patients complaining of symptoms possibly caused by arrhythmias (palpitations, dizziness, paroxysm tachycardia, pulse irregularities; angina and dyspnea only if other reasons could be excluded). Patients complaining of syncope only were not admitted, because of the inability to make a telephone call successfully during such a symptomatic period. The ECG was transmitted to the CCU using a frequency modulation technique. In 60% of 196 patients an ECG-TTM could be achieved during a typical symptomatic period, whereas arrhythmias as cause for the symptoms could be excluded in 51 patients (26%). The remaining 66 patients (34%) demonstrated various arrhythmias ranging from simple SVPB and PVC to total AV-block and sustained VT. TTM, an easy-to-perform and cost-effective method allowed a successful ECG registration during a symptomatic period in almost two-thirds of symptomatic patients. In these patients arrhythmias could be verified or excluded as cause of the symptoms.

Adolescent↗
PubMed1984

[Diagnosis of syncopes in suspected arrhythmias].

Several mechanisms lead to attacks with unsuspected sudden and intermittent loss of consciousness. A major cause for such syncopes are arrhythmias. Only in rare cases it is possible to register an ECG during a typical attack despite many newer methods as long-term ECG (LT-ECG), exercise stress test and electrophysiologic investigations. LT-ECG does not record the ECG only during symptomatic periods (syncopes, dizziness, palpitations etc), but also registers asymptomatic AR, which can be precursors of SY. Carotid sinus massage is a valuable tool for the detection of a cardio-inhibitory Carotid-Sinus-Syndrome, which can be treated with PM-implantation. Exercise stress testing induces ventricular arrhythmias, which also indicates AR as underlying cause for SY. Using the invasive electrophysiologic investigation methods the importance measuring supraventricular parameters (SNRT, SA-, AH-interval) or parameters of the AV-nodal conduction (AH-, HV-interval) decreased in contrast to the ventricular stimulation techniques. With these invasive procedures ventricular tachycardias, ventricular flutter or fibrillation can be induced in selected patients, which indicates also a possible arrhythmogenic substrate for SY. In a suspected arrhythmogenic genesis of SY it has to be recommended to perform LT-ECG, carotid sinus massage, exercise stress testing and -- in selected patients -- electrophysiological investigations in addition to the routine-ECG to exclude or confirm arrhythmias as possible substrate for SY.

Arrhythmias, Cardiac↗
PubMedDate not supplied

[Surgical treatment of spinal metastases].

87 patients were treated for metastatic disease of the spine between 1970 and 1992. In the majority of the patients anterior decompression and stabilization was performed. The posterior approach was chosen only in case of predominant infiltration of the dorsal parts of the vertebra or in case of inaccessibility of the tumor via an anterior approach. The most common primary tumors were cancer of the breast, kidney and thyroid. Overall survival was 15.1 months. Only patients with metastases of thyroid cancer showed a statistically significant longer survival. Clinical results showed an improvement of pain in 83% and preoperative neurologic dysfunction could be improved in 53% of the patients. Our results suggest that surgical treatment improves life quality also in patients with short life expectancy. Patients who are expected to have longer survival times should be treated according to the general principles of stabilizing spine surgery.

Bone Plates↗
PubMedDate not supplied

[Effects of inflammation-induced spinal fusion of the lumbar area on movement of the lumbar spine].

Lateral x-rays of the lumbar spine in standing position and functional flexion-extension roentgenograms of 21 patients with spontaneous fusion within the lumbar area after spondylitis were checked related to kyphosis of the block, lordosis and mobility of the lumbar spine and the single discs, and the appearance of degenerative spondylolisthesis. 76% demonstrated degenerative spondylolisthesis of the neighbouring discs, the half of them more than 5 mm with a significant higher number of segmental loosening of the disc caudal to the fusion. The kind of instability is a pseudo-spondylolisthesis (Junghans 1930) above and a retrolisthesis below the fused area. No higher mobility (no significant difference of mobility between the two cranial and the two caudal discs) can be seen as cause of this behaviour. The increased lordosis of the caudal segments is discussed to be the cause of the retrolisthesis distal the fusion. Altogether, kyphosis of the fused area leeds compensatory to a higher grade of lordosis in the mobile part of the lumbar spine without reaching the physiological lordosis of total lumbar spine. Kyphosis of the block does not influence mobility of the discs or the total lumbar spine, but increases significantly the rate of degenerative spondylolisthesis in the vicinal segments. These results suggest the operative reduction of lumbar lordosis in cases of kyphotic spondylitic destruction within the lumbar or thoracolumbar region in younger patients.

Adult↗