PubMed Health⌕ Search

Biomedical subjects

R Fiorilli

Publications and source records attributed to R Fiorilli.

30 records · Page 2Linked to original sources
PubMed1983

[Mexiletine: electrophysiologic effects].

A complete electrophysiological evaluation has been performed before and after the intravenous administration of Mexiletine (M.) (3 mg/Kg/B.W. in 5 minutes) in 28 patients (pts) (6 pts with normal conduction system, 4 pts with sick sinus syndrome, 5 pts with intranodal AV block, 13 pts with bundle branch block, of which 4 with pathological HV and 1 with intrahisian conduction defect). With the exception of a shortening of QTc interval in all the pts, the drug did not significantly affect any other electrophysiological parameters. In the patient with intrahisian conduction defect, M. prolonged the H1 - H2 interval. A statistically significant increase of heart rate has been also observed in a second group of 8 pts with normal sinus function, in whom M. administration was preceded by Atropine (I.V. bolus 0,04 mg/Kg/B.W.). This finding seems to exclude a vagolytic effect of M. The conclusions derived from our experience and pertinent literature are the following: M. is not useful in the treatment of supraventricular arrhythmias because it has negligible effects on atrial and AV nodal conduction; the drug may be safely employed in the treatment of ventricular arrhythmias in pts with atrial and/or AV nodal conduction defects; special caution must be employed when the drug is utilized in pts with sick sinus syndrome and/or with marked intraventricular conduction defects.

Aged↗
PubMed1982

Familial hypertrophic cardiomyopathy: vectorcardiographic findings in echocardiographically unaffected relative.

The electrocardiographic and vectorcardiographic (Frank system) features of the first degree relatives of subjects with documented familial hypertrophic cardiomyopathy were analysed. A total of nine affected members and 29 relatives were examined in four families. THe subjects were considered to be affected when the septal to free posterior wall thickness ratio exceeded 1.3 at M-mode echocardiography. Four relatives had asymmetric septal hypertrophy. Among 25 relatives without evidence of asymmetric septal hypertrophy, two over 20 years and 10 under 20 years of age showed increased voltage of QRS anterior forces (Qz amplitude greater than 0.80 mV) on the orthogonal electrocardiogram. The vectorcardiographic data of the relatives under 20 years of age without evidence of asymmetric septal hypertrophy (18 subjects) were compared with those of 38 normal control subjects of comparable age range. The young relatives without disproportionate septal hypertrophy had significantly greater Qz amplitude and Q/Rz ratio than the normal control subjects. In contrast, the echocardiographic data were not significantly different. We suggest that the electrocardiographic finding of abnormal anterior forces in one or more first degree relatives of subjects with documented hypertrophic cardiomyopathy may constitute a valuable aid in ascertaining the genetic transmission of the disease and in recognising affected members without echocardiographic evidence of hypertrophic cardiomyopathy.

Adolescent↗
PubMed1982

Severe involvement of the conduction system in a patient with sclerodermal heart disease. An electrophysiological study.

A case of progressive systemic sclerosis with syncopal symptoms is reported. The presenting ECG pattern was that of an anterior myocardial infarction. The clinical history and the coronary angiography excluded significant coronary atherosclerotic heart disease. The ECG pattern evolved from the infarctual pattern associated with right bundle branch block to probably major degree of right bundle branch block associated with left posterior fascicular block. M-mode echocardiography, heart catheterization and angiographic studies did not reveal significant mechanical impairment of the left or right ventricle function. His bundle electrogram documented a markedly prolonged H-V interval, confirming an advanced impairment of distal conducting system. This case supports the suggestion that intraventricular conduction disorders in sclerodermal heart disease are not always related to diffuse myocardial involvement. The risk of sudden death justifies accurate electrophysiological evaluation in selected patients with sclerodermal cardiopathy.

Bundle-Branch Block↗
PubMed1981

An unusual ECG pattern: left posterior fascicular block obscuring a right ventricular conduction defect?

A 23-year-old man with a history of palpitations and a single syncopal attack is described. Results of the physical examination were negative. The ECG showed a marked right axis deviation, a QRS duration of 0.13 sec. and an rS pattern from V1 to V6. In the high right precordial leads an rsR' pattern was recorded. The VCG (Frank system) showed a rightward dislocation of QRS vectors, a clockwise inscription of the QRS loop in the frontal and transverse planes and a slowing of the rightward and posterior terminal vectors. The X-ray film and the echocardiogram were negative. Neither intra-cardiac shunts nor pressure abnormalities were detected at the heart catheterization. The basal His bundle electrogram showed an H-V prolongation. Atrial pacing caused a progressive increase of the QRS duration and the appearance of an R configuration in the V1 lead, without axis shifting. We propose that the electrocardiographic pattern was suggestive of a left posterior fascicular block masking in the standard right precordial leads an associated right ventricular conduction defect.

Adult↗
PubMed1980

A computerized system for the analysis of the carotid pulse and apexcardiogram.

A computer program for the on-line analysis of the carotid pulse (CP) and of the apexcardiogram (ACG) is described. The program measures the absolute and the heart rate-corrected time intervals, the time intervals ratios, the amplitude absolute values, the quantitative ACG (DA/Dt), the ejection fraction and the circumferential fiber shortening velocity, according to Antani. Normalized amplitude and angular ACG items are also calculated. 80 normal subjects were examined to evaluate the reliability of the computer measurements in comparison with the manual measurements and to establish normal computerized values. No significant differences resulted in the comparison of the manual and computerized measurements. The normal computerized values are quite similar to those reported in the literature. The systolic time intervals (STI) were derived from the CP/phonocardiogram recording and directly from the ACG, utilizing the second peak of the first ACG derivative as marker of the onset of the ejection period. The left ventricular ejection time was 286.36 +/- 14 and 282.35 +/- 21.80 (no significant difference) and the pre-ejection period 87 +/- 14 and 93.16 +/- 23.16 (no significant) utilizing the CP/phonocardiogram and the ACG respectively. The results demonstrate a good reliability of the computer system and the usefulness of the system in the direct estimate of the STI from the ACG.

Adult↗
PubMed1980

[The sclerodermic cardiopathy. Infarction-like electrocardiographic picture and clinico-echocardiographic correlation in three observed cases (author's transl)].

We present three cases of primary sclerodermic cardiopathy with an electrocardiographic picture of anterior myocardial infarction not preceded by chest pain. On one of the cases a coronary angiography was performed with negative results. The echocardiogram of case no 1 showed a pattern of congestive cardiomyopathy, while case no 2 showed a picture of an infiltrative cardiomyopathy. In case no 2 the electrocardiographic picture changed to that of a right bundle branch block with left posterior fascicular block and with the disappearance of the anterior infarction. The His bundle electrogram showed a prolongation of the HV interval, while hemodynamically no signs were shown of impaired mechanical heart function. The clinical and echocardiographic aspects of the sclerodermic cardiopathy are here discussed with particular reference to the possibility of the prevalent compromise of the conduction system that could explain the not uncommon incidence of sudden death.

Adult↗