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Sebastian Stec

Publications and source records attributed to Sebastian Stec.

12 recordsLinked to original sources
PubMed2006

A simple point score system for predicting the efficacy of external rectilinear biphasic cardioversion for persistent atrial fibrillation.

AIMS: To develop a simple point score system that can accurately predict the optimal energy of initial rectilinear biphasic (RLB) waveform shock for cardioversion (DC) of persistent atrial fibrillation (AF). METHODS AND RESULTS: Data from 302 consecutive patients with AF who underwent a step-up protocol of sequential shocks of 50 J-from 1 up to 2 J/kg-200 J of RLB waveform DC were prospectively examined. Using a logistic regression model, three variables independently predicted the need for 2 J/kg shocks: AF duration > 7 months, previous DC, and increased left atrial (LA) diameter > 4.5 cm. A simplified point score system (REBICAF score) that spans from 0 to 4 was developed. The score gives two points for AF duration > 7 months and one point for previous DC or LA diameter > 4.5 cm. The area under the receiver operator curve (ROC) of the proposed score for predicting the need for 2 J/kg shock was 0.84. There was a progressive increase in the need for 1 J/kg, 2 J/kg, and 200 J as the point score increased (P < 0.001, chi2 test for trend). More than 90% cumulative success rate was achieved in the low- (0-1), intermediate- (2), and high-REBICAF (3-4) score subgroups with 1 J/kg, 2 J/kg, and 200 J RLB shocks, respectively. CONCLUSION: A simple point score system is useful in prediction of successful initial RLB energy for DC of AF.

Adult↗
PubMed2006

[Echocardiography and tissue Doppler imaging in assessment of haemodynamics in patients with idiopathic, premature ventricular complexes].

UNLABELLED: Premature ventricular complexes (PVC) in patients without organic heart disease may be associated with severe symptoms and haemodynamic disturbances. The aim of this study was to evaluate haemodynamics during PVC by echocardiography (ECHO) and tissue Doppler imaging (TDI). MATERIAL AND METHODS: 40 consecutive patients (mean age 55 +/- 15) with frequent, idiopathic PVC were included into analysis. Patients were included if they had at least 2500 PVC on 24 - hour Holter monitoring (mean: 12124 +/- 6851, range: 2560 - 28677). Parameters of blood flow at the inflow and outflow tracts of the right and left ventricle (LV) as well as TDI of mitral annulus were recorded during sinus rhythm (S), PVC and sinus rhythm following PVC (post-PVC). RESULTS: LV stroke volume (SV) in PVC correlated with PVC coupling interval (r = 0.65, p < 0.01). The absence of SV was observed in PVC with coupling interval below 400 ms. Significant differences in SV and duration of cardiac cycle periods between PVC, S and post-PVC were found. Peak systolic velocity (Sm) derived from TDI in PVC was significantly decreased (4.08 +/- 2.04 cm/s) compared to Sm in S (9.35 +/- 1.26 cm/s) and in post-PVC (9.58 +/- 1.26 cm/s) in all studied patients (p < 0.0001). CONCLUSIONS: In patients with frequent, symptomatic, idiopathic PVC severe haemodynamic disturbances may be recorded by ECHO. Dysfunction of LV systolic movement is revealed by TDI.

Adult↗
PubMed2005

[Clinical usefulness of implantable loop recorder in diagnosis of unexplained syncope--case report].

Clinical usefulness of implantable loop recorder in diagnosis of unexplained syncope - case report. A case of a 67-year-old female with recurrent syncope is presented. In spite of extensive investigation, the cause of syncope remained unknown. The patient received insertable loop recorder (ILR). One month after implantation the patient suffered two syncopal episodes. ECG recorded by ILR showed asystolic pause of 8 seconds at the time of conversion of atrial fibrillation to sinus rhythm. This was the first ILR implantation in Poland which was covered by public health insurance and not by private funds.

Aged↗
PubMed2004

The incremental value of troponin-I testing in patients with intermediate risk unstable angina.

BACKGROUND: Classification of patients with unstable angina (UA) by Agency for Health Care Policy and Research (AHCPR) guidelines in the emergency department reliably stratifies risk of death or myocardial infarction (MI) for triage to outpatient evaluation (low-risk), hospitalization (high-risk), or additional testing (intermediate-risk). Cardiac troponin-I elevation may identify patients at higher risk, but the incremental value may vary with AHCPR clinical risk. HYPOTHESIS: The objective of this study was to determine whether cardiac troponin-I had any additional value beyond triage based upon history, physical examination, and electrocardiogram, in the evaluation of patients with UA. METHODS: In all, 212 consecutive patients with UA and normal serum creatine kinase (CK)-MB levels and elevated troponin-I were risk stratified by AHCPR guidelines to evaluate the incremental value of adding routine troponin-I measurements to our current model for risk stratification. RESULTS: Primary events (death/nonfatal MI) occurred in 35% of high-risk, 15% of intermediate-risk, and 0% of low-risk patients (p < 0.001 by chi-square for trend). High troponin-I (> or =2.0 ng/dl) occurred in 48% of high-risk, 21% of intermediate-risk, and 19% of low-risk patients. The remaining patients in each risk group had indeterminate troponin-I levels (> or =0.4 < 2 ng/dl). Of those with high troponin-I, a primary event occurred in 36, 42, and 0% in the respective high-, intermediate-, and low-risk groups (p < 0.001). High troponin-I levels corresponded with a statistically significant increased rate of primary events only in patients at AHCPR intermediate risk: 42.4 vs. 7.3%, p < 0.001. CONCLUSION: The AHCPR guidelines risk stratify patients with UA. High troponin-I adds significant (p < 0.001) prognostic value in the patients at AHCPR intermediate risk and should be evaluated further in larger trials of such patients.

Acute Disease↗
PubMed2002

Long-term prognostic value of an index of myocardial performance in patients with myocardial infarction.

BACKGROUND: The Tei index of myocardial performance (IMP), which combines parameters of both systolic and diastolic ventricular function, is a useful prognostic factor in many clinical settings. HYPOTHESIS: This study assessed the long-term prognostic value of IMP in patients discharged from hospital after acute myocardial infarction (AMI). METHODS: Doppler/echocardiographic studies were recorded in 90 consecutive patients on Day 14 +/- 2 following an AMI. The IMP was calculated from the Doppler recordings, as a sum of isovolumetric contraction time and isovolumetric relaxation time, divided by the ejection time. RESULTS: The patients were followed for an average (SD) of 57.8 (16.1) months. During this period there were 22 (24%) cardiac events, defined as cardiac deaths (10) or nonfatal recurrent myocardial infarctions (12). After multivariate Cox analysis, Tei index > 0.55 (relative risk [RR] 4.45; 95% confidence interval [CI] 1.28-15.45; p = 0.019), LV end-systolic volume > 65 ml (RR 3.23; 95% CI 1.34-7.79; p = 0.009), and mitral E wave deceleration time < or = 0.145 s (RR 2.94; 95% CI 1.24-6.92; p = 0.014) were the only independent predictors of cardiac events during the follow-up period. In a subgroup of patients with preserved LV systolic function (ejection fraction > 0.40), IMP was the only predictor of cardiac events (RR 6.37; 95% CI 1.32-30.77, p = 0.02). CONCLUSIONS: The Tei index of myocardial performance, which is simple and easy to calculate, is a useful tool for risk assessment in patients following myocardial infarction, and in a subgroup of patients with normal or only mildly impaired systolic function.

Aged↗