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Biomedical subjects

L Filippi

Publications and source records attributed to L Filippi.

26 records · Page 2Linked to original sources
PubMed1981

Double atrial tachycardia with functional atrial dissociation.

A 57-year-old man with hypertensive and coronary heart disease and bradycardia-tachycardia syndrome suffered from paroxysmal palpitations, during which ECG showed a low atrial tachycardia at a rate of 150-200 beats/min with Wenckebach A-V block. During electrophysiological study an episode of atrial tachycardia appeared, characterized by: - atrial potentials in the high atrial electrocardiogram with regular cycle length (500-530 msec); - atrial potentials in the His bundle electrocardiogram with cycle length (570-580 msec), interrupted by premature atrial beats with coupling interval of 420-480 msec and with an atriogram of identical morphology. A-V conduction showed Wenckebach A-V block. After the cycles of 570-580 msec the low atrial potentials were simultaneous or preceded or followed the high atrial potentials by 10-20 msec. After the cycles of 420-480 msec the low atrial potentials preceded the high ones by 40-70 msec. Then, high atrial tachycardia abruptly stopped and the low atrial tachycardia only persisted with the same cycle length (570-580 msec); the high atrium was captured by the low atrial impulses with a low atrium - high atrium interval of 70 msec. These findings suggest that during the first part of tachycardia a conduction neither from high to low atrium, nor from low to high atrium can be possible. It is therefore a particular case of double atrial tachycardia - to our knowledge never before described in literature - sustained a few seconds because of functional atrial dissociation, induced by refractoriness related to the impulses delivered by the two tachycardia foci. The double atrial tachycardia was not diagnosed in the surface ECG leads. The two foci both appear to be localized at atrial level. The electrophysiological mechanism and the differential diagnosis with tachycardias at different sites are discussed.

Bradycardia↗
PubMed1981

[Paroxysmal supraventricular tachycardias due to re-entry via concealed retrograde atrio-His bypass (author's transl)].

Recently there have been proposed electrophysiologic criteria for the diagnosis of a concealed atrio-His bypass tract in patients with paroxysmal supraventricular tachycardia (PST). In order to verify the reliability of the proposed criteria--among the patients we studied for PST without ventricular preexcitation and in whom retrograde His bundle activation was recorded--we have chosen those with normal anterograde A-V conduction, with constant (or minimal increases) V-A interval during ventricular pacing and with short (less than 50 msec) and constant H2-A2 interval during ventricular premature stimulation. We encountered 15 patients with these electrophysiologic characteristics (37-73 years). H2-A2 interval (measured from the end of the His bundle deflection to the earliest atrial activity) ranged 20-45 msec (mean: 33 msec). The prolongation of S2-A2 interval observed in all patients was always within the S2-H2 tract. The retrograde effective refractory period of the A-V nodal region was always short, but not evaluable in any of the patients since it was shorter than that of ventricular myocardium (14 cases) or of His-Purkinje system (1 case). The S1-H2 interval was measured to evaluate whether during ventricular premature stimulation the retrograde His bundle activation was in fact anticipated. In 14 out of 15 patients this interval varied within a very narrow range: 0-20 msec. For this reason we believe that the differential diagnosis between a concealed atrio-His bypass and an accelerated retrograde A-V conduction can only be made if during electrophysiologic study a tachycardia is induced; in such case the detection of an H-Ae interval identical to H2A2, together with a normal retrograde atrial activation, is indicative of a bypass of the A-V node. A concealed atrio-His bypass tract must be differentiated also by a concealed septal Kent bundle; also in this case we believe that the detection of an H-Ae interval identical to H2-A2 indicates the former type of bypass. We conclude that a concealed atrio-His bypass can be diagnosed only if, besides the electrophysiologic criteria proposed by other authors, there is an H-Ae interval the same as H2A2.

Adult↗
PubMedDate not supplied

Reproducibility of electrophysiological parameters of sinus node following autonomic blockade.

We investigated the reproducibility of sinus node cycle length (SCL), corrected sinus node recovery time (CSRT) and sino-atrial conduction time (SACT) during the control state and following autonomic blockade in 25 patients (mean age: 56.9 +/- 13.8 years). Autonomic blockade was induced by i.v. administration of propranolol (0.2 mg/kg) and atropine (0.04 mg/kg). The electrophysiological study was repeated after 24 hr and the results were compared. The patients were divided into two groups: Group 1 (15) with normal and Group 2 (10) with abnormal intrinsic sinus node function. Following autonomic blockade in Group 1 the daily variations in SCL, CSRT and SACT were very slight whereas in Group 2 there was far greater variability in these parameters. However, in the latter group there were no patients who changed their status from prolonged to normal intrinsic CSRT on the second study, whereas SACT changed its status in 2 patients. In Group 1 the daily variations in sinus node parameters were much slighter following autonomic blockade than during the control state. In Group 2 the variations were very similar during control and following autonomic blockade. These data suggest that: (1) following autonomic blockade the reproducibility of sinus node parameters is very good in Group 1, whereas in Group 2 several patients show marked daily variations in sinus node parameters; (2) following autonomic blockade the sinus node electrophysiological parameters are meaningful in diagnosing an involvement of intrinsic sinus node function; and (3) in patients with abnormal sinus node parameters during control state, but with normal intrinsic sinus node function, the daily variations are mainly due to change in autonomic tone, whereas when the intrinsic sinus node function is abnormal, the day to day variations during control state appear due predominantly to intrinsic sinus node abnormalities.

Adolescent↗
PubMedDate not supplied

[Pilot studies on the effect of desmopressin on the personality of enuretic children].

The aim of this paper was to establish if there is a correlation between desmopressin administration and modification of psychological experience in enuretic children. 22 enuretic children (18 treated with desmopressin, 4 not treated) were enrolled in the study. They underwent a complete psychological examination, differentiated on the basis of chronological age, before the beginning and at the end of the treatment (duration 4 months). The psychologist was not informed if they were treated or not. In the 17 of 18 treated children with basal psychological problems, 14 became normal, 2 demonstrated a significative amelioration and 1 remained pathologic at the end of the treatment. No modification was observed in not treated patients, all presenting psychological problems. 6 emblematic cases with psychological findings and paintings are presented. The results seem interesting, despite the low number of children enrolled.

Adolescent↗