PubMed Health⌕ Search

Biomedical subjects

L Eckel

Publications and source records attributed to L Eckel.

48 records · Page 3Linked to original sources
PubMed1986

[Right bundle-branch block configuration in the pacemaker ECG--3 different observations].

We report on 3 cases of right bundle branch block configuration in the ECG after pacemaker implantation. In case 1 it was not noticed that the catheter had been directed through an unknown sinus venosus defect into the left atrium and the left ventricle. In case 2 the catheter reached the left ventricle via an iatrogenic perforation of the lower part of the atrial septum. In case 3 the catheter was situated correctly in the right ventricle, but the tip was penetrating the septum. Different possibilities of interpretation of this phenomenon are discussed, and a description of further pacemaker catheter misplacements which may be responsible for a right bundle branch block configuration is given. The authors take the view that a pacemaker catheter should not remain in the arterial area, in the pericardial space and in the coronary sinus. A lateral radiograph, a 12-lead ECG and an echocardiographic study are helpful for detecting and interpreting an unusual catheter position or a right bundle branch block configuration in the pacemaker ECG.

Aged↗
PubMed1982

Inotropic and electrophysiological effects of histamine on human ventricular heart muscle.

1. The effects of histamine were investigated on mechanical and electrophysiological parameters in isolated electrically driven human ventricular papillary muscles. The effects of cimetidine and propranolol on histamine responses were also investigated. 2. The effects of histamine were compared with those of noradrenaline, isoprenaline, dimaprit, a selective H2-receptor agonist, and a cyclic AMP derivative, 8-(4-chlorphenylthio) cyclic AMP. 3. The effects of histamine and dimaprit and the effects of cimetidine on histamine responses were also investigated in guinea-pig right ventricular papillary muscles in order to allow a comparison with human papillary muscles. 4. In human papillary muscles, histamine caused concentration-dependent increases in the force of contraction and reductions in both time-to-peak tension and time-to-half-maximal relaxation. Histamine simultaneously caused distinct changes in the action potential configuration with increases in the height and duration of the plateau phase and an increase in the over-all action potential duration. 5. Noradrenaline and isoprenaline produced similar responses to histamine, as did 8-(4-chlorphenylthio) cyclic AMP, consistent with the view that the effects of histamine as well as the beta-adrenoceptor agonists on human ventricle, were associated with cyclic AMP mediated increases in calcium-dependent slow inward current.

Action Potentials↗
PubMed1982

[Hemodynamic effects of computer-guided blood pressure-lowering with nitroprusside sodium during the postoperative phase after aortocoronary bypass operations].

The hypertension immediately after open heart surgery for coronary heart disease was chosen to evaluate the suitability of computer-controlled infusion sodium nitroprusside, to improve the circulatory state in heart failure by reducing the impedance to the left ventricular ejection. Sodium nitroprusside produced a prompt reduction of MAP to a preset level and a rise in cardiac index from an average of 2.1 +/- 0.3 to 2.4 +/- 0.4 when infused alone and to 3.1 +/- 0.5 1/min m2 (p less than 0.05, + 48%) after volume was infused to maintain LAP at a constant level to eliminate the effects of preload. The rise in cardiac index was associated with marked decrease in systemic vascular resistance from 2260 +/- 530 to 1415 +/- 280 and 1130 +/- 1130 +/- 270 dyns (p less than 0.005, 63%) respectively. The initial values of SVR correlated well with the fall of SVR (r = 0.78). Our results suggest that systemic vascular resistance is a strong indicator of the vascular responsiveness to vasodilation, the computer-controlled infusion of sodium-nitroprusside being suitable for the "titration" of the high systemic vascular resistance.

Adult↗
PubMedDate not supplied

Severe heart valve calcification in a young patient with Werner syndrome.

Werner syndrome is a rare autosomal recessive disorder characterized by the appearance of premature aging. We report on severe aortic and mitral valve calcification in an 18-year-old girl, necessitating double valve replacement. These special cardiovascular findings are discussed with regard to diagnosis and treatment.

Adolescent↗
PubMedDate not supplied

Electrophysiological study of human ventricular heart muscle treated with quinidine: interaction with isoprenaline.

We have investigated the effects of quinidine on the force of contraction and the intracellularly recorded action potential in papillary muscles isolated from human hearts. All preparations were obtained from patients undergoing corrective open heart surgery. The following results were obtained: (1) quinidine had a depressant effect on myocardial contractile force; (2) quinidine reduced the maximal upstroke velocity of the action potential; (3) quinidine shortened the plateau phase and prolonged the terminal repolarization of the action potential; (4) at higher concentrations quinidine reduced the resting potential; and (5) the depression by quinidine of both the plateau and the force of contraction was antagonized by isoprenaline. It is concluded that quinidine reduces the membrane conductances for sodium, calcium, and potassium ions. All of these actions of quinidine may contribute to the antiarrhythmic effects of the drug. The negative inotropic effect of quinidine can be explained by a depression of the calcium conductance at the myocardial cell membrane. The results show that earlier findings in laboratory animals regarding the effects of quinidine on the upstroke velocity and repolarization phase of the action potential are applicable to the human heart.

Action Potentials↗
PubMedDate not supplied

New surgical treatment for severe limb ischemia.

Revascularization after prolonged complete limb ischemia may result in severe damage to skeletal muscle and systemic alterations (postischemic syndrome). Our previous experimental studies have shown that this injury can be reduced substantially by treating the jeopardized extremity by controlling the conditions of reperfusion and composition of the initial reperfusate. In the present study this concept of controlled limb reperfusion was applied in patients with prolonged severe limb ischemia. Controlled limb reperfusion was used in 14 patients after prolonged complete uni- or bilateral ischemia. The ischemic interval ranged from 5 to 21 h. Two patients were in cardiogenic shock, 11 had associated cardiac disease, and seven coexistent peripheral vascular disease. After systemic heparinization, standard thromboembolectomy was done using a Fogarty catheter. Cannulas were placed into the iliac, profunda, and superficial femoral arteries and were connected to a reperfusion set. Oxygenated blood was drawn from the iliac artery and mixed with an asanguineous solution (ratio 6:1). This controlled reperfusate was delivered into the profunda and superficial femoral arteries using a single rollerpump. The system allows control of the composition of the reperfusate (calcium, pH, osmolarity, glucose, substrate, pO2, free radical scavengers) and the conditions of reperfusion (pressure, flow, temperature). After 30 min of controlled limb reperfusion, the cannulas were removed and normal blood reperfusion started. All 12 patients who were stable hemodynamically before the operation survived the revascularization. Eleven patients, including one with acute aortic occlusion for several hours, were discharged with functional recovery of their extremities. Despite the severe ischemic insult, controlled limb reperfusion avoided amputation and profound systemic complications. Two patients who were in cardiogenic shock preoperatively died from progressive cardiac failure. We conclude that controlled arterioarterial limb reperfusion may reduce the local manifestations of the postischemic syndrome after prolonged periods of ischemia, may salvage limbs thought previously to be damaged irreversibly by prolonged ischemia, and can be done easily in the operating room.

Adult↗