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J Gliklich

Publications and source records attributed to J Gliklich.

8 recordsLinked to original sources
PubMed1985

Electrophysiologic testing in patients with recurrent syncope: are results predicted by prior ambulatory monitoring?

Syncope is a common medical problem which can result from many etiologies, including cardiac dysrhythmias. Because ambulatory monitoring usually fails to capture a syncopal episode, electrophysiologic testing has been used to elucidate dysrhythmic mechanisms in patients with recurrent syncope. To assess whether findings on ambulatory monitoring not obtained during syncope can be used to indicate the results which are found on electrophysiologic testing in patients with recurrent syncope, we reviewed the ambulatory monitoring records of 59 such patients referred for electrophysiologic testing. Although 29 patients had abnormalities on electrophysiologic testing, 13 of which were severe, in only six were the findings suggested by the abnormalities recorded during ambulatory monitoring. Twenty-one patients actually had concordance between electrophysiologic testing and ambulatory monitoring results, but in 15 of the 21 results of both tests were normal. Severe abnormalities were more frequently detected in our patient population by electrophysiologic testing than by ambulatory monitoring, especially if patients had organic heart disease.

Adolescent↗
PubMed1985

Sinus node echoes and concealed concealed conduction: additional sinus node phenomena confirmed in man by direct sinus node electrography.

Direct sinus node electrography has been previously used to assess several aspects of sinus node physiology: sinus node pauses, overdrive suppression, sinoatrial entrance block. This report presents data in which sinus node electrograms confirm two additional physiologic phenomena in man: concealed conduction in the sinoatrial junction and sinus node reentry. These findings verify the presence of previously suspected phenomena by careful deductive analysis of electrocardiographic and electrographic tracings.

Adult↗
PubMed1983

Indirectly estimated sinoatrial conduction time by the atrial premature stimulus technique: patterns of error and the degree of associated inaccuracy as assessed by direct sinus node electrography.

The atrial premature stimulus method for estimating sinoatrial conduction time (SACT) is commonly used. When the stimulated atrial premature depolarization (APD) does not appear to affect sinus node automaticity or conduction, the indirectly estimated SACT (SACT1) is quite accurate. That is, SACT1 correlates quite highly with SACT measured directly (SACTD) on sinus node electrograms (SNE). In this study we used direct SNE recordings in 17 patients to assess SACT1 when factors thought to produce inaccuracy in SACT1 were present. Three patients had sinoatrial entrance block, which might make some expect sinoatrial exit delay to be present. However, SACTD was normal in two (60 and 70 msec) and prolonged (130 msec) only in the one who had other evidence of sinus node dysfunction. Therefore, sinoatrial entrance block does not necessarily indicate sinoatrial exit delay. Thirteen patients had apparent depression of sinus node automaticity by the induced APD (A3A4 greater than A1A1). In all 13, SACT1 overestimated SACTD. One patient had apparent sinoatrial conduction delay induced by the APD and/or vagal transmitter release induced by the APD. In this patient, too, SACT1 exceeded SACTD. Thus when sinoatrial automaticity or conduction are depressed by the stimulated APD, SACT1 will overestimate SACTD. If SACT1 is normal, SACTD will be normal; however, if SACT1 is prolonged, SACTD may or may not be prolonged.

Aged↗
PubMed1981

Clinical and electrophysiologic characteristics of sinoatrial entrance block evaluated by direct sinus node electrography: prevalence, relation to antegrade sinoatrial conduction time, and relevance to sinus node disease.

When AV conduction is normal, the absence of VA conduction is not abnormal. Analogous information about retrograde sinoatrial conduction is not available. Although the premature atrial stimulas (PAS) technique can demonstrate the presence of sinoatrial entrance block (SAEB), both its prevalence and its relationship to antegrade SA conduction are unknown. Using PAS, we determined the incidence of SAEB in 59 patients with known or suspected dysrrhythmias or conduction defects to be 6.8%. Using catheter recorded sinus node electrograms (SNE), we then directly measured sinoatrial conduction time (SACT) in three patients with SAEB. Antegrade SACT was normal in two and prolonged in one. Only the latter had sinus node dysfunction recognized by ECG and/or conventional sinus node testing. We conclude that SAEB occurs infrequently, may occur when antegrade SACT is normal, is probably analogous to behavior at the AV node, and should not be used as an indicator of sick sinus syndrome.

Adolescent↗
PubMed1980

The human sinus node electrogram: a transvenous catheter technique and a comparison of directly measured and indirectly estimated sinoatrial conduction time in adults.

To improve methods for evaluating human sinus node function (SNF), we developed a transvenous electrode catheter technique for direct recording of sinus node electrograms in adults. Sinus node electrograms (SNE) characterized by low-frequency, anatomically localized pre-P-wave potentials were obtained in 19 of 23 patients. The SNE configuration was similar to that previously found for endocardial SNE recordings in in vitro atrial preparations, in open-chest dogs and during human open heart surgery. In 16 patients with normal SNF, directly recorded sinoatrial conduction times (SACTs) were 46-116 msec. In three patients with sick sinus syndrome, SACT was 110-126 msec. In 15 of the 19 patients, SACT was estimated by the atrial premature stimulus technique and was compared with the directly measured SACT. When atrial premature depolarizations produced no sinus node depression, the mean differences between the direct and estimated SACT was 1.8 +/- 5.6 msec.

Adult↗