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Biomedical subjects

J Vlasínová

Publications and source records attributed to J Vlasínová.

8 recordsLinked to original sources
PubMed2005

[The use of auto mode switching in patients with sick sinus syndrome].

BACKGROUND: At present the dual chamber pacing, originally developed for patients with AV blockades, is widely used also for patients with Sick sinus syndrome (tachycardic-bradycardic type). But these patients often cause therapeutical problems to their physicians. In these cases either antiarrhythmic therapy is necessary to prevent recurrent supraventricular tachycardias (which are cause of rapid ventricular pacing) or in the case of failure of AA therapy the pacing mode has to be changed to DDI/R, which excludes physiological VAT pacing. The Auto Mode Switching (AMS) function ensures adequate ventricular pacing rate in the time of SV arrhythmias. METHODS AND RESULTS: Effects of dual chamber pacemakers equipped with AMS were studied in a group of patients with paroxysmal atrial fibrilation and/or atrial flutter. CONCLUSIONS: Therapy brings effects in lower of expenses due to less frequent visits at the physician, lower rate of rehospitalizations and lower need for powerful AA therapy.

Adult↗
PubMed2005

[Long-lasting survival of patients with implantable cardioverter-defibrillators implanted for secondary preventive reasons].

BACKGROUND: The effectiveness of therapy with implantable cardioverter-defibrillators is usually evaluated according to the total mortality of ICD patients. The aim of this study is to analyse the total mortality of long-term followed ICD patients and to evaluate mortality according to the main diagnosis and analyse the influence of revascularization in patients with coronary artery disease. METHODS AND RESULTS: We have observed 138 consecutive patients in mean age of 62.0+/-12.2 year (108 M, 30 F) with mean LVEF 0.38+/-0.14, who had ICD implanted for malignant ventricular arrhythmias from X/95 to XII/02 from secondary preventive reasons. The mean follow-up was 47.35 months. 99 patients had coronary artery disease, 16 dilated cardiomyopathy, 5 right ventricle dysplazia, 4 LQT syndrome, 1 valvular disease and 13 pts were without structural heart disease. The total mortality of the group of patients was 22% (31 patients). The terminal heart failure was the main cause of death in our pts--in 84% of the cases. We had no sudden death in our group of pts. The highest mortality (27%) was in pts with coronary artery disease, nobody died in the group of pts without structural heart disease. The higher mortality was in patients in pts where the revascularization was not possible before ICD implantation (38% versus 20%) One-year survival of the whole group of pts covered 90% and two-year survival was 87%. CONCLUSIONS: The survival of ICD pts is shorter if coronary artery disease is present and there is no possibility to revascularize pts before ICD implantation.

Adult↗
PubMed2003

[Comparison of various methods of correction of QT intervals during exercise in familial long QT interval syndrome].

BACKGROUND: Pathologic prolongation of QT interval is related to increased risk of arrhythmias. Changes of this parameter are influenced by many conditions, the most important is heart rate. Several formulas have been proposed for mathematical description of QT interval/heart rate relationship. The aim of this study was comparison of different QT interval correction formulas in families with congenital long QT syndrome (LQTS). METHODS: In 28 members of 6 families with LQTS occurrence bicycle ergometry testings were performed. QT and RR intervals were measured before exercise, at peak exercise and in the 1st and the 6th minute of restitution. For QT interval correction single-parameter formulas by Bazett, Fridericia, Malik and Framingham study were used. In 3 families the results could be correlated with genetically proved diagnosis (KCNQ1 gene mutations in 2 families, HERG-KCNH2 gene mutation in the other). RESULTS: In the described group the genetically established diagnosis of LQTS correlated at best with values obtained with correction by Bazett. All the mutation carriers were correctly identified only by this method. The Fridericia, Malik and Framingham formulas failed to identify 2 patients--mutation carriers (both KCNQ1 and HERG-KCNH2 mutations). DISCUSSION: Because of simplicity the Bazett formula remains the most common method of QT interval correction. Moreover, in our study this formula appeared to be the most sensitive for clinical diagnosis of LQTS.

Algorithms↗
PubMed2000

[Pacemaker dysfunction during use of a mobile telephone].

Ubiquitious electronic equipment increases the number of potential sources of electromagnetic interference with sufficient energy to influence a pacemaker function. Besides others the mobile phone play important role. A 76 year-old female patient with pacemaker was hospitalized because of bilateral congestive heart failure. During ECG telemetry a short episode of pacemaker dysfunction was recorded. In a period of 15 seconds at first a pulse output inhibition occurred, then an undersensing was present. In all the 24-hour recording no other similar episode was observed. Such an utterly atypical picture lead to a direct question on mobile telephone calling. The patient confirmed that during a visit of her relatives she was really using a mobile phone. The GSM (Global System for Mobile Communication) phones operate on a carrier frequency of 900 MHz which is modulated generally in pulses about 8 Hz and 2 Hz. These signals can be falsely detected as an intrinsic heart activity by a pacemaker or they are analysed to be an electromagnetic interference. As a result a pacemaker inhibition, an asynchronous pacing and in dual chamber systems also a ventricular triggering can be present. These reactions usually do not occur if the distance between phone and pacemaker is higher than 10 cm. With some measures patients with pacemakers can safely use mobile phones. In pacemaker dependent patients a careful approach is necessary.

Aged↗
PubMed1998

[Optimalization of rate adaptation using Holter functions in DDD/R pacemakers].

Introduction of the pacing rate adaptation according to the momentary metabolic needs added other programmable parametres which demand physician's attention during the initial postimplantation programmation and also in follow-up of pacemaker patients. The parametres setting is strictly individual with a need of feedback control. In some devices it is enabled by Holter functions as a part of pacemaker software. These methods were used to set the rate adaptive parametres in the group of 23 patients with implanted DDD/R pacemaker. The walking stress test was used. Model follow-up situations are presented in 3 case reports. Using Holter functions enables the physician to put patient's subjective complains in relation with actual heart rate--this is used to optimize the parametres of rate adaptation. The authors consider the Holter functions a necessary part of rate adaptive pacemaker software.

Aged↗
PubMed1994

[The effect of diuretics on the magnitude of the effect of isosorbide dinitrate given as a single dose and after long-term administration. Ergometric study in patients with stable angina pectoris].

The authors assessed in 24 men with stable angina pectoris, using means of ergometry, the antiischaemic and antianginose effects of a combination of the nitrate Iso-Mack retard and the diuretic Moduretic. The effects were compared with the effects of Iso-Mack retard administered alone and with the effects of placebo. The examination was made after a single dose of the drugs and after three-week administration. The authors revealed that a single dose of the diuretic significantly enhanced the effects of nitrate. During long-term administration the diuretic did not prevent a significant diminution of the nitrate effects. Finally the authors discuss possible mechanisms of development of tolerance for nitrates and possibilities how to influence this tolerance by a diuretic.

Adult↗
PubMed1993

[Comparison of the effects of molsidomine retard and isosorbide dinitrate retard in patients with stable angina pectoris using an ergometry test].

In 24 men with angina after exertion the authors assessed, using ergometry, the action of molsidomine retard and isosorbide dinitrate retard after a single dose and after tree-week administration of the drug. The authors found that 8 mg of molsidomine retard in a single dose had a somewhat more potent effect than 40 mg isosorbide dinitrate retard. After prolonged administration the effect of both drugs on haemodynamics diminished and in molsidomine a significant decline of action was observed before development of a reduced S-T segment on the ECG. After three weeks' administration the effects of both drugs were comparable. After neither drug clinically significant tolerance developed when the drug was administered every 8 hours. In the conclusion the authors discuss possible mechanisms involved in development of tolerance.

Adult↗