Biomedical subjects

I Gajdosová

Publications and source records attributed to I Gajdosová.

11 recordsLinked to original sources

PubMed1997

[The role of the atrium and optimal values of AV intervals in sequentially paced patients].

In 1995, 2249 dual chamber pacemakers were implanted in the Czech Republic. These pacemakers make it possible to set an optimal AV delay between the atrial and ventricular impulse. Although the optimization of the AV interval has its well defined physiologic advantages, it does not seem to be necessary in otherwise healthy individuals with a good atrial and ventricular function. In these patients the default value, usually about 170 ms, is acceptable. However, AV interval optimization--i.e. finding the interval at which the atrial contribution to ventricular filling is maximal--should be done in all patients with left ventricular dysfunction, indicated for pacing because of bradyarrhthmia. In this subset of patients, even a small improvement in ventricular filling is believed to be clinically useful. Moreover, it has been documented, that in some types of ventricular dysfunction the so-called "primary optimization" (i.e. optimization of the AV interval in patients, in whom the pacemaker is not indicated for bradyarrhthmia but for ventricular dysfunction that might be improved by AV interval optimization) may be clinically useful. It is the case in patients with hypertrophic obstructive cardiomyopathy, dilated cardiomyopathy with presystolic regurgitation and AV interval prolongation, and perhaps even in some patients with impairment of ventricular systolic function and substantial prolongation of the AV interval. Despite all that, optimization of the AV interval is not routinely performed because even the best available optimization procedures (stroke volume measurements at different AV intervals by aortic Doppler echography) is observer dependent, time-consuming and costly.

Arrhythmias, Cardiac↗

PubMed1996

Atrial contribution to ventricular ejection in sequentially paced patients.

A new method for quantitative assessment of the atrial contribution to ventricular ejection in sequentially paced patients is described. The atrial contribution (AC) has been defined as the pulse pressure decrement (invasive arterial measurement by a canulla inserted into the brachial artery), expressed in percent of the control pulse pressure, induced by switching off the atrium activating impulse for one beat. In 17 patients, the AC was found to be atrioventricular (AV) interval dependent, the measurements were well reproducible (the mean difference between two measurements at different times was 93%, S.D. 8.4). For the AV interval of 170 ms, it was found to be 293% (+8.9) in patients with the sick sinus syndrome, 27.0% (+3.2) in patients with complete AV block and only 10.8% (+2.1) in a patient with complete AV block and heart dysfunction.

Aged↗

PubMed1995

[Arrhythmogenic right ventricle].

A 26-year-old patient with an irrelevant personal and family-history was treated on account of attacks of relapsing ventricular tachycardia and cardiac failure, mostly dextrolateral. After ruling out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, out other possible causes of the disease--such as embolism of the lungs, ischaemic heart disease, Ebstein's anomaly, the diagnosis of an arrhythmogenic right ventricle was established. This disease is suggested by negative T waves in the thoracic leads V1-V3 during sinus rhythm and by the shape of the QRS complex which was the type found in block of the Tawara branch with an axis of + 100 degrees during attacks of ventricular tachycardia. Moreover, ventricular tachycardia of the same type was produced during electrocardiographic examination. On angiographic examination ARVD is suggested by marked trabeculization and impaired kinetics of the outflow tract of the right ventricle. In the prevention of relapses of ventricular tachycardia beta-blockers and Cordarone were successful when used simultaneously with cardiac stimulation type AAI applied on account of a confirmed sinoatrial block.

Adult↗

PubMed1994

[Actilyse (a recombinant tissue-type plasminogen activator] in the treatment of acute myocardial infarct. Comparison of the effects of Actilyse and streptokinase].

The preparation Actilyse--a tissue plasminogen activator prepared by recombination--is an effective fibrinolytic drug. The authors recorded in a group of 33 patients reperfusion in 91%, evaluated on the basis of indirect criteria. In a group of 18 patients treated with streptokinase reperfusion was achieved in 74%. Based on changes of CK and CK-MB values--an earlier rise of values following Actilyse administration and conversely their more marked increase during subsequent sampling after streptokinase administration--it may be assumed that earlier dissolution of the thrombus in the coronary artery occurs after Actilyse administration, as compared with streptokinase. It may be thus assumed that there is also a smaller necrotic focus after Actilyse treatment, as compared with streptokinase. Early re-occlusion--according to indirect indicators--occurred in 8.6% in the Actilyse treated groups, as compared with 5.9% in the streptokinase treated group. The fibrinogen values decline in the Actilyse group to 40% and in the streptokinase group to 28%. Later enhanced new formation of fibrinogen occurs and the fibrinogen values rise to 160% in the Actilyse treated group and to 250% of the initial value in the streptokinase treated group. The elevated fibrinogen value, as compared with the baseline value, persists for the 12 days of the follow-up. No severe spontaneous haemorrhage was recorded, haemorrhagic manifestations were associated with blood sampling and i.v. administration of drugs only. The necessity to administer blood was due to a complication during puncture of the subclavian vein in one patient.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗

PubMed1992

[Late ventricular potentials in patients without ventricular tachycardia 3 years after myocardial infarct].

In 57 patients who in the course of 29-48 months (mean 36 months) after myocardial infarction did not develop sustained ventricular tachycardia, late ventricular potentials were investigated. Positive findings were revealed in 13 (22.8%) patients using a 25-250 Hz filter and in 14 patients resp. (24.6%) using a 40-250 Hz filter. Late ventricular potentials were significantly more frequent in patients after myocardial infarction of the lower rather than the anterior wall (p less than 0.05). No differences were revealed between groups with positive and negative late ventricular potentials as regards the occurrence of repeated infarction, left-side cardiac failure, ectopic ventricular contractions, diabetes mellitus, arterial hypertension and cardiothoracic index. The assembled data are comparable with data in the literature pertaining to the incidence of late ventricular potentials in patients after myocardial infarction without sustained ventricular tachycardia.

Action Potentials↗

PubMed1990

[Aortic stenoses and pulmonary hypertension].

Authors have been catheterized a total of 36 patients with isolated aortal stenosis. In 14 from them (38%), the mean pression value in pulmonar artery was ranged as over 25 torrs (3.33 kPa). It was proved on the statistical evaluation of hemodynamic data that the pulmonar hypertension is correlated with the pression on the end of diastola of the left ventricle (correlation coefficient r = 0.89), being irrelated of the extent of aortal gradient, bed surface, heart index, age, pulmonar vascular resistence and functional classification. The pression value in pulmonar artery is correlated negatively with the ejection fraction of left ventricle (r = -0.76). Pulmonar hypertension in isolated aortal stenoses is inflicted with functional disorder of left ventricle. The significance of pression value in pulmonar artery is discussed from the scope of indicatory strategy as to provide an urgent surgery, i.e. the exchange of the aortal valve.

Aortic Valve Stenosis↗

PubMed1988