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Biomedical subjects

M Heinke

Publications and source records attributed to M Heinke.

17 recordsLinked to original sources
PubMed2006

[Implantation of a re-synchronization device in a patient with persistent left superior vena cava-a case report].

We report an implantation of a cardiac re-synchronization system in a patient with persistent left superior vena cava. This anomaly occurs in 0.3 to 0.5% of healthy individuals and remains usually asymptomatic. Variations of the superior vena cava should be considered in venous catheterization and other procedures such as implantation of pacemaker and ICD systems as well as port catheter insertion. In re-synchronization systems, persistent left superior vena cava can be an obstacle for cannulation of the coronary sinus and placement of a transvenous left ventricular lead.

Aged↗
PubMed1999

[Late fields in magnetcardiography and late potentials in electrocardiography after acute myocardial infarction].

UNLABELLED: A high specificity and a high positive prediction has been reached in risk stratification for a sudden cardiac death after acute myocardial infarction (AMI) by combining multiple methods. But sensitivity and negative prediction are still not satisfying. There are the same physiological processes underlying magnetocardiography (MCG) and electrocardiography (ECG). Nevertheless, the signals in each method contain different information. METHODS: We studied the cardiac magnetic fields in 50 patients after AMI and in 32 probands and calculated the magnetic late field (LF), according to Simsons late potential (LP) analysis. We defined normal values, according to the 95% confidence interval of the probands (QRS < =97 ms, RMS > = 0. 6, LAS < 25 ms). RESULTS: We compared the results of LF and LP analysis regarding pathologic-nonpathologic and found 76% of the patients with the same results in both methods. Four patients had magnetic signals with low amplitude in the ST segment in contrast to the ECG result, while 6 patients with a "LP positive" diagnosis based on RMS and LAS only, did not show LF. In addition, we have found the magnetic QRS complex to be shorter than the electrical one. DISCUSSION: In general, the results of LF measurement are similar to the ones of LP measurement. Presumably, there are intracardial currents, which are not detectable by ECG. Further studies are needed to evaluate the prognostic value in patients at high risk for cardiac arrhythmias.

Adult↗
PubMed1994

Esophageal balloon electrode catheter for transthoracic recording of His-bundle potential with transesophageal atrial pacing.

To evaluate the influence of transesophageal atrial pacing of the transthoracic His potential identification, we combined signal-averaged ECG with transesophageal atrial pacing with low threshold for pacing averaging ECG recording. A tripolar 10 French esophageal balloon electrode catheter, with one cylindrical electrode on the tip of the catheter and two balloon electrodes on the cardiac side of the catheter, used in 53 patients, allowed a painless transesophageal atrial pacing and a high signal to noise distance in the signal-averaged ECG. Transesophageal atrial pacing allowed in 37 of 53 patients an identification of His potential by increasing the distance between the end of the atrial potential and the onset of the His potential in the pacing averaging ECG. The esophageal balloon electrode catheter allowed a painless transesophageal atrial pacing with low threshold for atrial capture during a long pacing time and a high signal to noise distance in the pacing averaging ECG. The increasing of the heart rate with transesophageal atrial pacing allowed the transthoracic identification of the His potential in the pacing averaging ECG.

Atrial Function↗
PubMed1993

[Clinical-electrophysiologic studies on the actions of the anti-arrhythmic substance AWD-G256 in man].

The effects of the new antiarrhythmic drug AWD-G256 (1) were investigated by clinical electrophysiology (His bundle electrography, programmed electrical stimulation) in 19 patients with supraventricular tachycardias but without structural heart disease. In a maximal dosage of 0.45 mg/kg body mass 1 only minimally affects electrophysiological parameters of the impulse formation and conduction. At this time the therapeutic value of 1 is not clear.

Adult↗
PubMed1992

Balloon electrode catheter for transesophageal atrial pacing and transesophageal ECG recording.

A new balloon electrode catheter (10 French) with five or six balloon electrodes placed on the cardiac side was developed for transesophageal atrial pacing and bipolar ECG recording. The diameter of the hemispheric electrodes is 6 mm and the length of the esophageal balloon is 10 cm. The transesophageal atrial pacing threshold was measured with the balloon electrode catheter by transesophageal programmed atrial stimulation (TPS) (n = 54). At the onset of TPS, the feeling, capture (n = 54), and pain voltage threshold (n = 6) were measured by increasing the amplitude of the pacing voltage during high rate bipolar atrial pacing and bipolar atrial ECG recording. In 38 TPS, the capture threshold was lower than the feeling threshold (n = 28). In 16 TPS, the capture threshold was higher than the feeling threshold. In conclusion, painless atrial pacing and excellent ECG recording can be achieved with a multipolar esophageal balloon electrode catheter with a low pacing voltage amplitude and a high P wave amplitude.

Cardiac Pacing, Artificial↗
PubMed1992

Termination of tachycardias by transesophageal electrical pacing.

To evaluate the therapeutic significance of noninvasive transesophageal pacing for termination of tachycardias the method of rapid atrial or ventricular transesophageal pacing was used in 233 patients with different tachycardiac arrhythmias. We were able to terminate atrial flutter in 136 of 162 patients by transesophageal rapid atrial stimulation (conversion to sinus rhythm in 75 cases, induction of atrial fibrillation in 61 cases). Atrial tachycardias were interrupted in 17 of 23 patients (sinus rhythm in 11 cases, atrial fibrillation in six cases). AV reciprocating/AV nodal supraventricular reentry tachycardias were terminated in 62 of 63 patients (sinus rhythm in 58 cases, atrial fibrillation in four cases). By transesophageal rapid ventricular pacing ventricular tachycardias could be terminated in ten of 15 patients. The success rate of transesophageal pacing was influenced by the pacing rate, by the type of tachycardiac arrhythmia inclusive by the type of atrial flutter and by the tachycardia's cycle length. Because the success rates are comparable with invasive technique and the procedure is simpler, the noninvasive transesophageal antitachycardiac pacing should be respected as the method of the first choice in patients with supraventricular tachycardias.

Atrial Flutter↗
PubMed1991

[Electrophysiological anti-arrhythmia effects of tiracizine in ventricular tachycardia].

The electrophysiologic effects and antiarrhythmic efficacy of tiracizine, a new class I antiarrhythmic drug, were studied in 16 patients with documented sustained ventricular tachycardia (VT) after intravenous drug application and in 6 patients after oral drug administration by means of programmed ventricular stimulation (PVS). After intravenous tiracizine (0.3 mg/kg) the VT was no longer inducible by PVS in 3 of 16 patients and became nonsustained in another patient. In 11 of 13 patients with further inducible VT the cycle duration of VT increased after tiracizine (mean 29 ms). After oral tiracizine (150-225 mg/day) the VT induction was suppressed in one patient. In a second patient the VT became nonsustained. Cycle length of VT in 4 patients with persistent induction of VT was longer after therapy (mean 88 ms). Antiarrhythmic efficacy of intravenous or oral tiracizine can be expected in at least one third of patients with VT.

Administration, Oral↗
PubMed1991

[Therapeutic value of trans-esophageal electrostimulation in tachycardic arrhythmias].

We were able to terminate atrial flutter in 136 of 162 patients by transesophageal rapid atrial stimulation (conversion to sinus rhythm in 75 cases, induction of atrial fibrillation in 61 cases). Atrial tachycardias were interrupted in 17 of 23 patients (sinus rhythm in 11, atrial fibrillation in 6 cases), AV reciprocating resp. AV nodal supraventricular tachycardias were terminated in 32 of 33 patients (sinus rhythm in 28 cases, atrial fibrillation in 4 cases). By transesophageal rapid ventricular and/or atrial pacing, ventricular tachycardias could be terminated in 10 of 15 patients. The success rate of transesophageal pacing is influenced by the type of tachyarrhythmia, by the type of atrial flutter and by the stimulation rate. It is not influenced by the tachycardia's cycle length. Because the success rates are comparable with invasive technique and the procedure is simpler, the non-invasive transesophageal antitachycardia pacing represents a useful method for termination of tachycardic arrhythmias.

Adult↗
PubMed1989

[Ventricular late potentials in patients with cardiomyopathies in relation to electrophysiologic and myocardial biopsy findings].

With the noninvasive registration of late ventricular potentials there is the possibility to obtain statements about a regionally delayed excitation of ventricular parts which may refer to an increased inclination to ventricular tachyarrhythmias. Late ventricular potentials in patients with suspicion of primary diseases of the myocardium more frequently appeared both in the case of inducible non-sustained or sustained ventricular tachycardias and in the presence of simultaneous fibrous hypertrophy of the myocardium and interstitial fibrosis in the bioptate of the myocardium than in noninducibility of ventricular tachycardias and in the absence of histological changes of the myocardium. Thus in patients with cardiomyopathies a certain predicting significance seems to be ascribed to the evidence of late potentials in the highly increased signal-averaged ECG both for the ability to evoke ventricular tachycardias by programmed ventricular stimulation and for the presence of more distinct histological changes of the myocardium.

Adult↗
PubMed1989

Bundle branch reentrant tachycardia treated by transvenous catheter ablation of the right bundle branch.

Recurrent episodes of ventricular tachycardia not responding to medical treatment occurred in a 56-year-old man. Electrophysiological investigation showed ventricular tachycardia due to bundle branch reentry. Using a method similar to catheter ablation of the atrioventricular junction, ablation of the right bundle branch was performed by an electrical shock of 250 joules. While before the ablation ventricular tachycardia occurred several times a day and its induction by programmed ventricular stimulation was facilitated by the administration of antiarrhythmic drugs, no initiation of ventricular tachycardia was possible after ablation of the right bundle branch. Over a follow-up of 30 months the patient has not suffered from tachycardia and the right bundle branch block persists.

Bundle of His↗
PubMed1988

[Transluminal electric catheter ablation in the treatment of drug-refractory focal ventricular tachycardias].

In a 46-year-old patient with dilatative cardiomyopathy and medicamentously therapy-resistant focal ventricular tachycardias after endocardial right- and left-ventricular catheter mapping a transvasal electric ablation of the focus of tachycardia was carried out. For this purpose at the left-ventricular-septally localized origin of tachycardia two electroshocks of 100 and 200 J via the electrode catheter positioned there was given. Immediately after ablation a stable sinus rhythm was to be registered; longer persisting recidivations of tachycardia did not appear again subsequently. In the further course the patient suddenly died after transitory haemodynamic improvement, in which case a new, acutely beginning arrhythmia is to be assumed as a prefinal event.

Cardiac Catheterization↗
PubMed1987

[Electrical therapeutic procedures in recurrent, drug refractory tachycardias. II. Electrical transvenous catheter ablation].

In 6 patients with medicamentously therapy-refractory tachycardias (3 times auricular flutter/auricular fibrillation with very rapid atrioventricular conduction, once focal atrial tachycardia, once paroxysmal atrioventricular reentry tachycardia, once recurrent ventricular tachycardia on the basis of an interventricular reentry) percutaneous transvenous catheter ablations of the atrioventricular conduction region (bundle of His ablation, 5 cases) and the right Tawara branch (1 case), respectively, were performed. During a follow-up period of 2-26 months (on an average 10.5 +/- 8.0 months) a permanent total block in 4 cases could be obtained (3 times AV-block III. once complete right bundle branch block). In two other patients the total AV block receded to the AV block I. and II. respectively, within 2 and 8 days, respectively; in the first case the AV node reentry tachycardias were no more to be evoked, in the second case a tolerable ventricular frequency was the result during the auricular flutter recidivations. In all patients treated by means of catheter ablation after the intervention an impressive improvement of the clinical symptomatology developed. Due to possible complication and the dependence upon the pacemaker of the patients concerned which is to be expected the indication to the ablation should be made only after the exhaustion of all medicamentous possibilities and taking into consideration other electric therapy methods.

Adult↗
PubMed1986

[Successful treatment of ventricular tachycardia by transvenous electrical ablation of the right Tawara branch].

Recurrent episodes of ventricular tachycardia not responding to medical treatment occurred in a 56 year old man. Electrophysiological investigation showed ventricular tachycardia due to bundle branch reentry. Using a method similar to catheter ablation of the atrioventricular junction an ablation of the right bundle branch was performed by an electrical shock of 250 J. While before the ablation ventricular tachycardia occurred several times a day, and its induction by programmed ventricular stimulation was facilitated by the administration of antiarrhythmic drugs, no initiation of ventricular tachycardia was possible after ablation of the right bundle branch. Over a follow-up of 4 weeks the patient has not suffered from tachycardia and the artificial right bundle branch block persists.

Bundle of His↗