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S Faerestrand

Publications and source records attributed to S Faerestrand.

27 records · Page 2Linked to original sources
PubMed1992

[Sudden cardiac death].

Sudden cardiac death is instant unexpected death that occurs within one hour of an abrupt change in a person's stable clinical state. The mechanism is generally a ventricular tachyarrhythmia. The underlying pathology is usually coronary heart disease. In 1990, 18 patients who survived sudden cardiac death, excluding those with acute myocardial infarction, were evaluated and treated in our institution. 15 patients had coronary heart disease, one had hypertrophic cardiomyopathy, one had dilated cardiomyopathy and one had a replaced aortic valve. Evaluation included heart catheterization and electrophysiological examination. Treatment was specifically tailored to each patient according to etiology, results of all tests and the patient's prognostic factors. Treatment included a permanent pacemaker-cardioverter-defibrillator, antiarrhythmic drug therapy, aortocoronary bypass and betablocker therapy.

Aged↗
PubMed1992

[Intermittent bradyarrhythmia in infants and small children treated with permanent pacemaker].

Four children aged two, two and four months and five years respectively, with intermittent cardiac bradyarrhythmias and otherwise normal hearts are described. The diagnoses were based upon findings by telemetry and 24-hour ECG-recordings. Two patients had sinus node disease, one patient had intermittent complete atrioventricular block, and the fourth had a permanent first degree atrioventricular block and intermittent high grade second degree atrioventricular block. All patients presented serious symptoms with apparent life-threatening events before admission. They were given a permanent cardiac pacemaker. One patient experienced recurrent excessive increase in the myocardial stimulation threshold, leading to further syncopal episodes. All patients are developing adequately with normally functioning pacemakers.

Bradycardia↗
PubMed1987

A time-related study by Doppler and M-mode echocardiography of hemodynamics, heart size, and AV valvular function during activity-sensing rate-responsive ventricular pacing.

Noninvasive Doppler and M-mode echocardiography were used to: measure stroke volume (SV), left atrial (LA) size, left ventricular end-diastolic (EDD), end-systolic dimensions (ESD), left ventricular fractional shortening (FS), and for determination of mitral and tricuspid insufficiency (MI and TI) before starting and after 1, 3, and 6 months of rate-responsive ventricular pacing (RRP). The study group consisted of 13 patients (mean age, 75 years) who could be expected to benefit from an increase in cardiac output mediated by an increment of heart rate during exercise. In VVI + activity mode (RRP), the pacemaker was programmed to a basic heart rate of 60 and a maximum heart rate of 125 bpm. The SV at rest was 71 +/- 5 before RRP, and fell to 57 +/- 4 after 3 months (p less than 0.05) and to 53 +/- 4 ml/beat after 6 months of RRP (p less than .01). The LA size and ESD were unchanged during follow-up. The EDD decreased from 6.2 +/- 0.3 to 5.4 +/- 0.2 (p less than 0.002) during the first 6 months of RRP. The FS was reduced from 33 +/- 4 to 27 +/- 3% (p less than 0.02) during the first 6 months of RRP. Four of 6 patients treated previously with a VVI pacemaker (mean duration, 9 years) had MI + TI, and 3 of the 7 patients not paced previously had MI before RRP. In the last group, 1 new patient developed MI, 1 new patient developed MI + TI, and 2 patients who had MI also developed TI within 6 months of pacing. Thus, of 13 patients, 9 (69%) had either MI or MI + TI.

Aged↗
PubMed1987

Assessment of the work capacity and relationship between rate response and exercise tolerance associated with activity-sensing rate-responsive ventricular pacing.

The relationship between rate response and exercise tolerance was studied by measuring the symptom-limited maximum treadmill time (MTT)both during fixed rate VVI pacing and during VVI + activity mode pacing (RRP) in 15 patients (mean age, 73 years) who had received rate-responsive ventricular pacemakers. Their indications were atrioventricular block, sino-atrial block, and atrial fibrillation with slow ventricular response. Basic rate was programmed to 60 ppm in both pacing modes; rate response and activity threshold were programmed to 5 and medium, respectively. The order in which the two pacing modes were tested was randomly determined. The MTT was, on average, 29% longer in RRP than in VVI mode with a mean of 12 minutes in VVI and 14.8 minutes in RRP (p less than 0.001). For the subgroup of eight patients with paced-only rhythm the average increase in MTT was 38% with a mean of 9.5 minutes in VVI and 12.8 minutes in RRP (p less than 0.01). Seven patients who showed episodes of spontaneous rhythm, increased their average MTT by 17% (mean in VVI, 14.9 minutes; in RRP, 17.1 minutes; p less than 0.02). During RRP, a significant positive correlation existed between MTT and the increase in heart rate (N = 15; r = 0.83; p less than 0.001). In 12 patients with paced-only rhythm, the pacing rate remained at the programmed basic rate when the patients were lying, sitting, and standing and increased to 86 +/- 4 ppm during casual walking, and to 101 +/- 4 ppm during jumping up and down with the pacemaker programmed to the above-mentioned parameters. The maximum pacing rate during jumping corresponded with the maximum pacing rates measured from Holter recordings during normal daily activities.

Aged↗
PubMed1987

Noninvasive assessment by Doppler and M-mode echocardiography of hemodynamic responses to temporary pacing and to ventriculoatrial conduction.

A new, dual-chamber temporary pacing lead was introduced via the subclavian vein in 20 patients who needed a temporary pacemaker. Stroke volume (SV) was measured continuously by combining M-mode and noninvasive Doppler echocardiography during spontaneous rhythm (SR), AV sequential pacing at a positive AV interval (DP), ventricular pacing (VP) and AV sequential pacing at a negative AV interval (VA pacing). The valvular functions were determined by Doppler echocardiography. Left ventricular dimensions and function, and left atrial size were measured by M-mode echocardiography. In the nine patients with no valvular heart disease and with no ventriculoatrial (VA) conduction (group I) the CO increased 83 +/- 11% during DP and 42 +/- 9% during VP as compared to during SR when the heart rate (HR) was increased from 34 +/- 3 to 72 +/- 1 beats/min. The CO was 29 +/- 3% higher during DP than that during VP. In the seven patients with valvular heart disease and with no VA conduction (group II), the increment in CO compared to that during SR was 53 +/- 12% during DP and 31 +/- 11% during VP; the CO was 17 +/- 4% higher during DP than that during VP. In the four patients with spontaneous VA conduction (group III), the CO during DP was 35 +/- 10% greater than that during VP, which did not result in an increase in the CO compared to that during SR in spite of an increase in HR from 52 +/- 8 to 74 +/- 2 beats/min. The study demonstrated that DP is the preferred temporary pacing mode and also that VA conduction during VP resulted in a mean decrease of 20% in CO compared to that during VP without VA conduction. The hemodynamic benefit from DP compared to SR seems to decrease when the left ventricular end-diastolic dimension increases. Furthermore, patients with large left ventricular end-systolic dimensions seem to have a lower increase in stroke index during DP as compared to that during VP than patients with smaller end-systolic dimensions.

Aged↗
PubMed1985

A time-related study of the hemodynamic benefit of atrioventricular synchronous pacing evaluated by Doppler echocardiography.

We have used Doppler echocardiography to estimate the stroke volume (SV) in a study of 13 patients equipped with DDD pacemakers. SV was measured both during DDD and VVI pacing after observation times of 1,3,6, and 12 months of DDD pacing. SV was also measured at seven atrioventricular (AV) intervals (75-250 ms) in the search for optimal AV intervals. Mitral flow velocity was investigated to see if DDD pacing resulted in synchronous atrial contraction, and if mitral insufficiency existed at any of the pacing modes. Compared with the VVI mode, DDD pacing resulted in a mean increase in SV of 21 +/- 2% for the four observation periods. Two patients with severe left ventricular failure had no significant increase in SV during DDD vs VVI pacing. In each patient, an optimal AV interval ranging between 100-250 ms for the SV was found. Velocity profiles of mitral flow showed synchronous atrial contraction during DDD pacing, but not during VVI pacing. Mitral insufficiency was not seen in any pacing mode. DDD pacing resulted in a reduction in SV during the first 6 months, and was constant thereafter. Doppler echocardiography can be used repeatedly to evaluate the hemodynamic response of DDD pacing vs VVI pacing, and to find which AV interval gives the highest SV in the individual patient. Our study further shows that the hemodynamic benefit of DDD pacing is present after short-term as well as after long-term DDD pacing.

Adult↗