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L Bouwels

Publications and source records attributed to L Bouwels.

3 recordsLinked to original sources

How long should high-risk patients with acute anterior wall myocardial infarction be monitored?

In 143 patients with an acute anterior wall myocardial infarction, left ventricular ejection fraction was determined within 72 h of admission. Left ventricular ejection fraction was below 40% in 114 patients. In this group late ventricular tachycardia or ventricular fibrillation occurred in 30 patients (26%). A left ventricular ejection fraction below 40% identified all patients who developed any late ventricular tachycardia and a left ventricular ejection fraction below 30% identified all who developed late ventricular fibrillation. After discharge another 2 patients with late ventricular tachycardia were detected. Death between 48 h and 3 weeks only occurred in patients with a left ventricular ejection fraction below 30%. Thus in patients with an acute anterior wall myocardial infarction a left ventricular ejection fraction below 30% within the first 72 h after the acute event identifies a high risk for late ventricular tachycardia or ventricular fibrillation. The occurrence of late ventricular tachycardia showed a gradual increase during 3 weeks of monitoring and no cut-off point could be detected within this time-window.

Adult

The Activitrax rate responsive pacemaker system.

Bipolar Medtronic Activitrax rate responsive pacemakers were implanted in 31 patients for ventricular (28) or atrial (3) pacing. Mean follow-up was 16 months (range 10 to 26). Twenty pacemakers were implanted after catheter ablation of the His bundle, 7 for sick sinus syndrome. 1 for atrioventricular block and 3 for sick sinus syndrome with atrioventricular block. A rate response value was selected that gave a pacing rate of about 100 pulses/min during walking. Of the 31 patients, all had 24-hour ambulatory electrocardiographic monitoring with diary, 11 walked a 20-minute circuit, including a flight of stairs, and 20 had a treadmill exercise test. In 9 patients the pacing rate could be compared with the underlying sinus rate during exercise and was seen to match it very closely. In 12 patients the pacing rate during car driving was found to be similar to the sinus rate of 5 volunteers under similar conditions (mean minimum and maximum rate was 80 and 99 pulses/min, respectively). No pacing-induced arrhythmias were seen during ambulatory electrocardiographic monitoring. At high pacing rates slightly irregular pacing intervals were sometimes observed, which was due to polarization sensing. Sporadically, 1 pacing interval shortened to the upper rate value, because of a known and now resolved timing anomaly. Neither anomaly was of clinical consequence and the first could be resolved by reprogramming.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult

Successful long-term catheter drainage in an immunocompromised patient with purulent pericarditis.

A case of extensive staphylococcal pericarditis following renal transplantation is described. Purulent pericarditis resolved after 18 days of continuous catheter drainage from the pericardium combined with antibiotic therapy. This case illustrates that life-threatening purulent staphylococcal pericarditis after renal transplantation in an immunocompromised patient may respond to medical therapy.

Anti-Bacterial Agents