New indications for dual chamber pacing: hypertrophic and dilated cardiomyopathy.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to L G Futterman.
Explore the source record for details and available documents.
HRV offers information about sympathetic and parasympathetic autonomic function and thus can serve as a measure of risk stratification for serious cardiac arrhythmias and sudden cardiac death. HRV appears to be altered in patients with acute myocardial infarction or diabetic neuropathy and is affected by other physiologic and pathophysiologic processes. Use of HRV measurements requires continued investigation to determine optimal methods and tools by which HRV indices and its variables are analyzed. Long-term studies are required to help correct for differences in values pertaining to age and disease process. Also, studies are needed to determine how patient management strategies will be affected by knowledge gained through HRV analysis and to determine which patient populations should be monitored for HRV analysis and to identify those at risk for sudden cardiac death.
Vasovagal syncope is a common syncope in patients who have no structural heart disease and occurs more often in young adults. It typically occurs in the erect posture, either standing or sitting. Upon recognition of the prodrome associated with NCS, subjects may avert syncope by lying down or putting the head between the knees. Use of head-up tilting is a recognized diagnostic tool and widely used for the evaluation of vasovagal syncope. However, cardiac diagnostic tests are not 100% accurate. This fact was recently underscored by what occurred in the recent tragic loss, due to ventricular fibrillation, of basketball star Reggie Lewis of the Boston Celtics. It is alleged that the tilt-table test was positive but that he also had structural heart disease. The most important diagnostic tool is the physician's clinical judgment.
Explore the source record for details and available documents.
Use of percutaneous catheter ablation with radiofrequency current for cardiac arrhythmias is expanding rapidly. Technical ease, high success and low complication rates have allowed RFCA to become standard treatment for accessory AV connections and is the therapeutic procedure of choice for patients with atrioventricular node reentry tachycardias. Techniques still being investigated and evaluated for the treatment of supraventricular tachycardias include laser catheter ablation, cryocatheter ablation and microwave catheter ablation. With further clinical experience, the efficacy and safety of these and other procedures can be determined.
Explore the source record for details and available documents.
Syndrome X continues to be a puzzle to the profession. A consensus as to the definition, etiology, pathology, prognosis and treatment has still to be developed.
Ablative therapy in the treatment of arrhythmias is an exciting development of the last decade. Although direct-current, high-energy shock can be effective treatment for many supraventricular tachycardias, clinicians are concerned about potential problems associated with its use. Drug therapy for arrhythmias has been inadequate, ineffective, poorly tolerated and fraught with toxic or proarrhythmic reactions. Because of its relative technical ease, high success rate and low complication rate, RFCA remains the therapeutic procedure of choice for patients with atrioventricular nodal reentrant supraventricular tachycardia. Other catheter ablation techniques such as laser, cryocatheter and microwave catheter are still being tested.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Orthotopic cardiac transplantation has become the treatment of choice for selected patients with end-stage heart disease. Proliferation of cardiac transplantation centers and relaxed selection criteria have resulted in increasing populations of transplant candidates and recipients. As these numbers continue to grow, so too do the numbers of nursing personnel who must respond to the intricacies and demands of cardiac transplantation. Nursing care begins with physiologic and psychologic support of a patient with terminal cardiac disease and continues throughout the transplantation evaluation, waiting, surgical, postoperative, and outpatient periods. In addition to routine postsurgical care, the nurse involved in cardiac transplantation needs to be familiar with the function of a denervated heart, as well as with the effects of unbalanced immunosuppression and immunocompetence. The surge of organ transplantation in the last several years has brought about administrative concerns regarding the financial impact of increasing numbers of transplantations, as well as an inadequate supply of necessary donor organs. This critical shortage of suitable donors demands that nurses and other health care professionals become active in enlarging the donor organ pool by identifying potential organ donors, maintaining optimal hemodynamics and oxygenation so as to ensure organ viability, and providing emotional support of the grieving family.
Many of the postoperative concerns of the cardiac transplant recipient are similar to those of any patient after cardiac surgery. Immunosuppression and immunocompetence, however, pose additional considerations for this patient population. Current immunosuppressive protocols include agents such as azathioprine, prednisone, cyclosporine, T cell antibodies, and monoclonal antibodies, most of which blunt the body's response to foreign antigens. Follow-up and long-term care of the cardiac transplant recipient must address potential problems associated with long-term immunosuppression, such as infection, malignant processes, accelerated graft atherosclerosis, and overall quality of life.
Explore the source record for details and available documents.