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Biomedical subjects

I Préda

Publications and source records attributed to I Préda.

At least 37 records · Page 2Linked to original sources
PubMed1999

Body surface potential field representation fidelity: analysis of map estimation procedures.

The first part of this study analyzed the spatial-temporal error distribution of the Lux-type limited lead system. Quantitative new evidence is reported that the 32-lead anterior subset estimates the further 160 leads with an average amplitude error less than 38.5 microV. The spatial error distribution revealed 8 sites where the error is the highest, primarily on the anterior side, independent of the clinical classification. The second part of the study examined inter-lead-system conversion strategies for interpolating the Lux-192 lead maps from the Montreal-63 data. The methodology based on the Laplacian interpolation yielded an average amplitude error of 143.7 microV and an average correlation of 0.87 for pattern fidelity. In this specific case a modified linear interpolation surpassed the Laplacian method. A presented example illustrates that even in cases when the fidelity of the signal information is heavily compromised the diagnostic information may remain less influenced.

Body Surface Potential Mapping↗
PubMed1999

Peripheral pulmonary migration of a retained pacemaker lead.

We report a case of lead migration into the right middle pulmonary lobe. The migrated electrode reached the pleura and produced severe pleural symptoms, therefore, surgical removal of the retained lead was required. This case report demonstrates the importance of a chest X ray in the follow-up of patients with an implanted pacemaker to detect complications like lead fracture or migration.

Adult↗
PubMed1998

Cerebral embolism due to a retained pacemaker lead: a case report.

There are only a few reported cases of a pacemaker lead migrating inadvertently into the left atrium or ventricle. An unusual complication of unremoved, unwanted pacemaker lead is presented. The free tip of the lead caused cerebral embolism after perforating the interatrial septum.

Cardiopulmonary Bypass↗
PubMed1998

QT dependent T wave sensing.

A case of QT duration dependent T wave oversensing mimicking QRS undersensing and pacemaker malfunction is presented. This example indicates that interpretation of pacemaker ECG may be difficult, even in case of VVI pacemaker.

Aged↗
PubMed1998

Clinical observations with long-term atrial pacing.

Atrial pacing (AP), despite its beneficial hemodynamic and antiarrhythmic effect, is still an underused mode of stimulation. The main purpose of this study was to evaluate the long-term results of AP. Sixty four patients (pts) with sinus node disease (28 male and 36 female: mean age 54.2; range: 44-88 years), 3.2% of the total implantation at our clinic were treated with AP between 1982-96. Criteria for atrial pacing were: no AV block in the history, no AV-block during carotid sinus massage, Wenckebach point > 130/min, left atrium < 50 mm, left ventricular EF > 40%. The indication for pacing was predominant sinus bradycardia (SB) in 34 pts and tachycardia-bradycardia syndrome (TBS) in 30 pts. Pts with TBS were on antiarrhythmic treatment, while most pts with SB received no antiarrhythmic drugs. All the pts were checked up at every 3-6 month. Sixty-two pts were followed for 3-154 (mean: 67) months, two pts were lost for follow-up. Repeated lead dislodgment occurred in two pts, which made a pacing mode change necessary. Four pts died during the follow-up period for non-cardiac reasons. At the end of the follow-up period the data of 60 pts were available for evaluation (33 pts with SB, 27 pts with TBS). All the pts with SB were in sinus rhythm, and no patient developed AV block by the end of the follow-up period. Seven out of 27 pts with TBS developed chronic atrial fibrillation, 3 out of them suffered a cerebral embolism; the remaining 20 pts were in sinus rhythm, and the number of paroxysmal attacks decreased significantly, which improved their quality of life significantly. Three pts in this group developed a temporary complete AV block, which regressed with decreasing the dosage of antiarrhythmic drugs. Atrial pacing is proved to be a safe and reliable treatment for sick sinus syndrome. Proper patient selection is crucial in preventing the development of AV conduction disturbance. Atrial stimulation had a satisfactory long-term antiarrhythmic effect in pts with sick sinus syndrome (SSS).

Anti-Arrhythmia Agents↗
PubMed1997

[Cerebral embolism caused by a right ventricular pacemaker electrode perforated into the left atrium].

The authors present a new, unusual side effect due to retained pacemaker lead. The free tip of the lead caused cerebral embolism by perforating the interatrial septum. Transoesophageal echocardiographic study showed the lead crossing the interatrial septum. The total abnormal course of the lead was demonstrated by lateral X-ray picture. Diagnostic and therapeutic approaches regarding retained leads in malposition are also discussed.

Echocardiography, Transesophageal↗
PubMed1996

[Peripartum cardiomyopathy with fatal outcome].

The authors reported the case of a 26 year-old primipara who had unexplained congestive cardiac failure on the 9th week after delivery. There was no previous disease in her history however her pregnancy endangered because of imminent abortion was preceded by 1 artificial and 2 spontaneous abortions. In the acute phase she had to be resuscitated because of ventricular fibrillation and then she had a pulmonary embolism followed by pneumonia and therefore she was in septic state for 4 weeks. After a 4 month clinical remission she died unexpectedly at home. At autopsy the histological appearance of myocarditis, thymic hyperplasia and hypoplastic vascular system were observed.

Abortion, Induced↗
PubMed1996

The treatment of septicemia in pacemaker patients.

The authors analyzed the data of seven patients who had undergone open heart surgery because of pacemaker endocarditis in the past 4 years. Repeated surgical interventions on the pacemaker system were found to be the most common predisposing factors. Staphylococcus aureus and Staphylococcus epidermidis were the most common causative organisms. Two-dimensional echocardiography was important in the diagnosis of cases with atypical clinical picture and negative blood cultures. We concluded that: (1) any pacemaker patient with fever should be considered to have a pacemaker endocarditis; (2) all of these patients should be examined by two-dimensional echocardiography; and (3) the total removal of the infected hardware seems to be the only way to achieve complete recovery.

Adult↗
PubMed1995

[Prognostic value of exercise parameters and simple non-invasive variables of left ventricular function in dilated cardiomyopathy].

Authors assessed the prognostic value of some simple, routinely used non-invasive parameters in dilated cardiomyopathy. Fifty patients, 43 male and 7 female, mean NYHA class 2.3, treated with digitalis, diuretics and vasodilators, were tested. Mean follow up time was 24 months. The evaluated parameters were as follows: maximal exercise capacity, heart rate, systolic blood pressure, as well as rate-pressure product at peak exercise, their increase during the test, fractional shortening measured by M-mode echocardiography, mean pulmonary capillary wedge pressure estimated by apexcardiography and clinical grade of heart failure (NYHA class). Exercise test was multistage, symptom limited, maximal upright bicycle ergometer test. Both one-way and multivariate analysis showed that except of fractional shortening all of the evaluated parameters related significantly to the survival. According to the one-way analysis maximal exercise capacity, rate-pressure product and systolic blood pressure at peak exercise as well as the estimated value of mean pulmonary capillary wedge pressure proved to be the strongest prognosticators. Multivariate analysis showed that the prognostic value of the rate-pressure product at peak exercise and that of the estimated mean pulmonary capillary wedge pressure proved to be additive, their combined consideration resulted in the highest accuracy of prediction.

Adolescent↗
PubMed1994

[Experience with long-term atrial pacing].

The aim of this study was to evaluate the long term results of atrial pacing. There were 27 atrial pacemaker implantations and 26 out of them were followed for an average of 47, 04 months. Lead dislodgement occurred in two cases, which made necessary a ventricular pacing. Three other patients developed chronic atrial fibrillation. The late results of the remaining 21 patients were very good. No AV-block occurred during the follow-up period. The atrial pacing in selected patients is safe and reliable, and financial restraints makes it advantageous for economic reason.

Aged↗
PubMed1994

[Amiodarone-induced hyperthyroidism causing progression of arrhythmia].

A case of a 38-year-old male with supraventricular paroxysmal tachycardia existing for more than a decade is reported. He has received amiodarone in a daily dose of 800 mg for three years and the tachycardia returned in 1992. New antiarrhythmic drugs were added but no beneficial effect has been achieved and moreover, a case of ventricular fibrillation occurred. The 12-lead ECG performed during tachycardia and the electrophysiological study showed orthodromic AV reentry tachycardia. Laboratory tests performed proved hyperthyreotic state. Attacks of paroxysmal tachycardia were returned and aggravated by the hyperthyreosis induced by amiodarone. Finally, antiarrhythmic drugs were discontinued and methimazol was introduced. Gradually, the patient become asymptomatic within two months. The most important conclusion of the case reported, that the amiodarone induced hyperthyreosis can be subclinical or obscure. Consequently, a regular control of serum thyreoid hormone levels at least twice a year on patients with long term amiodarone administration should be advised.

Adult↗