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H Pham-Huy

Publications and source records attributed to H Pham-Huy.

5 recordsLinked to original sources

Application of the single moving dipole inverse solution to the study of the Wolff-Parkinson-White syndrome in man.

The single moving dipole (SMD) inverse solution was performed in 28 patients with the Wolff-Parkinson-White preexcitation syndrome to see if the calculated position of the SMD during the initial delta wave could indicate the site of the underlying accessory pathway. This site was first estimated to be at one of eight locations around the atrioventricular ring, from the patient's QRS and ST segment body surface potential maps, as has been described by others. Next, SMD parameters were calculated during the delta wave so as to approximate, on a numerical torso model, the patient's body surface potential map. Visualization of the calculated position of the SMD around the atrioventricular ring was done by projecting it on a plane parallel to this ring. This plane corresponded to the most basal transverse section of a heart model present in the torso model. One limitation was the use of non-varying heart and torso models for all patients. As a result, the SMD technique lacked the precision to separate accessory pathway sites into eight atrioventricular locations. However it was capable of distinguishing between patients belonging to the larger classes of right-sided, posterior, and left-sided preexcitation, formed by combining adjacent atrioventricular accessory pathway locations. With more accurate heart and torso models, it may be possible to increase SMD resolution so as to locate accessory pathway sites deep within the heart. This would represent an advantage over the surface potential map approach which only identifies the site of earliest epicardial breakthrough associated with the accessory pathway.

Adolescent↗

A comparative evaluation of three different approaches for detecting body surface isopotential map abnormalities in patients with myocardial infarction.

Three approaches for detecting abnormalities in body surface potential maps recorded from patients with myocardial infarction were evaluated. The maps are generated from 26 simultaneously recorded unipolar electrocardiograms. All three approaches detect the deviations in certain parameters from control values determined from 50 normal subjects. The first approach emphasizes qualitative deviations in the trajectories of the surface potential map extrema during QRS and correctly classified all but one infarct in a test group comprising 30 normals and 30 cases of myocardial infarction. The second approach classifies a test subject as abnormal if any one of his 26 lead waveforms deviates appreciably at any instant during QRS from the mean waveform for the particular lead plus or minus two standard deviations, these being determined from the control group. This method, while correctly identifying all infarcts, resulted in a large number of false positives, misclassifying 22 of 30 normals. A final method was to obtain an instant by instant plot of the correlation coefficient between the mean surface potential map during QRS for the 50 normals and that of the subject being tested. Test cases were classified as abnormal if any correlation coefficient value fell below an envelope determined from the correlation coefficient plots obtained by correlating the maps of all 50 normals with their own mean. Twenty-nine normals and 26 infarcts were correctly classified. On the basis of these results, the first approach is superior to the other two for detecting surface potential map abnormalities in patients with myocardial infarction.

Electrocardiography↗

Electro- and echocardiographic study of the left ventricle in man after training.

Fourteen sedentary middle-aged men underwent a chest X-ray, a 12 lead ECG, a VCG, and an echocardiographic examination prior to and following 5 months of training a moderately severe intensity, on a cycle ergometer. No modification in the X-ray cardiac profile was observed following training. Some electrocardiographic (R wave amplitude in V5 and V6 and Sokolow index: SV1 + RV5 or V6) and vectorcardiographic (maximal QRS vector amplitude, maximal spatial QRS vector, and R wave amplitude) indices of left ventricular hypertrophy were slightly but significantly increased following training. The echocardiographic measurements in diastole (septal and posterior wall thickness, left ventricular internal diameter, and left ventricular mass) were unchanged after training. Results suggest that electrical changes may not provide adequate indications of left ventricular morphological modifications. The lack of echocardiographic evidences of left ventricular hypertrophy suggest that: (1) training does not necessarily induce left ventricular hypertrophy; (2) the large heart sometimes observed in athletes may be the result of a genetic factor or of a prolonged and very intensive training pursued since a very young age, over a number of years; and (3) left ventricular enlargement probably plays a minor role in the increase in aerobic capacity following training.

Echocardiography↗