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Biomedical subjects

R Oter

Publications and source records attributed to R Oter.

13 recordsLinked to original sources
PubMed1991

Ventricular fibrillation in the Wolff-Parkinson-White syndrome.

Ventricular fibrillation (VF) is a well-known but rare complication of the Wolff-Parkinson-White syndrome (WPW). Clinical and electrophysiological data of 23 patients with spontaneous VF were compared with data from 100 consecutive patients with WPW without VF but with symptomatic supraventricular tachycardia. The 23 patients were collected in a multicentre retrospective study in seven European centres. VF occurred in only one patient who was receiving antiarrhythmic drugs, and was the first manifestation of the syndrome in six. No significant differences were found between those with VF and without VF in age, complaints of palpitations, syncope, and presence of structural heart disease. The retrograde effective refractory period of the accessory pathway, the atrial refractory period and the fastest atrial pacing rate with 1:1 anterograde conduction over the accessory pathway were similar in both groups. Significant differences were found for sex, permanent pre-excitation on the electrocardiogram, type of documented supraventricular tachyarrhythmias, shortest RR interval less than or equal to 220 ms during spontaneous atrial fibrillation (AF), inducibility of supraventricular tachycardias, ventricular effective refractory period less than or equal to 190 ms, mean shortest RR interval during induced AF less than or equal to 180 ms and presence of multiple accessory pathways.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1991

Recovery of sinus node function after pacemaker implant for sinus node disease following cardiac transplantation.

In a 4-year interval, 3/55 (7.8%) heart transplant recipients developed (greater than 4 weeks) severe sinus node dysfunction. An epicardial ventricular pacemaker was implanted at 90, 40, and 38 days after operation. Follow-up ranged from 7 to 20 months. In two of the three cases, failure of stimulation or sensing was detected at the 3rd and 4th month after pacemaker implantation. Sinus rhythm reappeared in two of the three patients at the 2nd and 4th months after transplantation. Severe sinus node disease requiring pacemaker implantation can improve following the first 3 months after transplantation. Failure of stimulation or sensing may not be uncommon.

Adult↗
PubMed1988

Interatrial conduction block and retrograde activation of the left atrium and paroxysmal supraventricular tachyarrhythmia.

We studied 16 patients with electrocardiographic evidence of advanced interatrial block and retrograde activation of the left atrium (P greater than or equal to 0.12 s, and diphasic (+/-) P waves in leads II, III, and VF). Eight patients had valvular heart disease, four had dilated cardiomyopathy and four had other forms of heart disease. Patients with valvular heart disease and cardiomyopathy were compared with a control group of 22 patients with similar clinical and echocardiographic characteristics, but without this type of interatrial block. Patients with advanced interatrial block and retrograde activation of the left atrium had a much higher incidence of paroxysmal supraventricular tachyarrhythmias (93.7%) during follow-up than did the control group, (27.7%) (P less than 0.001). Eleven of 16 patients (68.7%) with advanced interatrial block and retrograde activation of left atrium had atrial flutter (atypical in seven cases, typical in two cases, and with two or more morphologies in two cases). Six patients from the control group (27.7%) had sustained atrial tachyarrhythmias (five atrial fibrillation and one typical atrial flutter). The atrial tachyarrhythmias were due more to advanced interatrial block and retrograde activation of left atrium and frequent atrial extrasystoles than to left atrial enlargement, because the control group with a left atrium of the same size, but without advanced interatrial block and retrograde activation of left atrium and with less incidence of atrial extrasystoles, had a much lower incidence of paroxysmal tachycardia.

Aged↗
PubMed1988

Study of the evolution of masked bifascicular block.

Masked bifascicular block (MBB) (absent or minimal S in I and VL, high R in Vi and AQRS approximately -60 degrees) is a rare condition. We have found 16 such cases in the last 12 years, thirteen male and three female, mean age 70 +/- 9 years. The conventional electrocardiogram was tabulated and the clinical features and evolution of the patients were followed over 39.1 +/- 32 months. Ten patients required pacemakers, nine because of complete atrioventricular (AV) block or increase in the previous AV block. Seven patients died (follow-up 27.3 +/- 32 months), five from heart failure. This study shows: (1) MBB is a subgroup of patients with a high risk of advanced atrioventricular block; (2) a pacemaker implant does not significantly reduce the high mortality in this group because of the severity of the underlying disease; (3) these results should be evaluated in a larger series of patients in order to confirm our provisional results.

Aged↗
PubMed1978

Concealed atrial electrical activity.

In the following paragraphs we describe a case diagnosed clinically and haemodynamically as a cardiomyopathy. Atrial flutter which was not in evidence in the standard ECG was diagnosed by the use of a new technique of amplification and filtering of special surface leads (T.A.F.). The diagnosis was later confirmed by means of special internal techniques (intra-atrial ECG and His bundle recording). The existence of a subpraventricular rhythm, probably sinusal, and also unapparent in the standard ECG, was observed by using the same method after electrical defibrillation. We comment on the extreme rareness of discovering concealed atrial rhythms and their possible explanation, and we emphasize the usefulness of the T.A.F. technique in their diagnosis.

Adult↗
PubMedDate not supplied

[Use of temporary pacemaker programming in VVT mode for the treatment of recurrent ventricular tachycardia].

This is a report of a 59-year-old man with a Björk aortic prosthetic valve and mitral commissurotomy with left ventricular dysfunction and recurrent ventricular tachycardia (VT) in spite of antiarrhythmic therapy with amiodarone. Serial electrophysiologic studies were performed using standard ventricular extrastimulation technique. During these studies, sustained VT was induced and terminated by programmable extrastimulus pacing. The usual rhythm of the patient was atrial fibrillation with slow ventricular rate. The Medtronic Spectrax model 5985 pulse generator was implanted. A temporary program converts this device from inhibited (VVI) to triggered (VVT) mode, permitting programmed ventricular stimulation through synchronization with chest wall stimulation by a standard external programmable stimulator. During episodes of VT the pacemaker was temporary programmed to the VVT mode with a refractory period of 220 msec. With the chest wall stimulation by a electrophysiology stimulator it was possible to convert the VT with 2 or 3 synchronised extra stimulus. Thanks to the triggered mode the pacemaker will fire when the chest wall is stimulated, working as an external electrophysiology stimulator.

Aortic Valve↗
PubMedDate not supplied

[Electrophysiologic characteristics of the transplanted heart].

The electrophysiologic characteristics of the denervated human heart were assessed in 20 cardiac transplants recipient from the Cardiology Department, at the Hospital of San Pablo, Barcelona, Spain. We studied the donor and the recipient sinus node function at rest and exercise test. Holter recording of 24 hours was performed in a few cases. At rest, in 14 patients the intrinsic heart rate of the donor atrium was slower when we used the technique of José. When we analyzed all the results we did not find statistical differences in the heart rate of either: the donor or the recipient atria (r = 0.58, p less than 0.01). However we observed a marked increase in heart rate of the donor with exercise test and normal activity (Holter), probably reflecting an increase in circulating catecholamines (exercise test: base-line 116 +/- 16 vs maximum exercise 140 +/- 10, p less than 0.001; Holter: minimal rate 64 +/- 9.66 vs maximal rate 112 +/- 23, p less than 0.001). We also describe the cardiac arrhythmias including two sudden deaths associated with ventricular tachyarrhythmias and in five patients sinus node disfunction in relation with episodes of acute rejection. We concluded that is important to perform a standard 12 lead electrocardiogram, exercise testing, Holter recording and electrophysiologic study as part of the ongoing routine evaluation of surviving cardiac transplant patients.

Arrhythmias, Cardiac↗