SEARCH · PubMed Health

Results for “Telemetry”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 1,675 records · Page 93Linked to original sources

PubMed2005

Activity levels of bats and katydids in relation to the lunar cycle.

Animals are exposed to many conflicting ecological pressures, and the effect of one may often obscure that of another. A likely example of this is the so-called "lunar phobia" or reduced activity of bats during full moon. The main reason for lunar phobia was thought to be that bats adjust their activity to avoid predators. However, bats can be prey, but many are carnivorous and therefore predators themselves. Thus, they are likely to be influenced by prey availability as well as predation risk. We investigated the activity patterns of the perch-hunting Lophostoma silvicolum and one of its main types of prey, katydids, to assess the influence of the former during different phases of the lunar cycle on a gleaning insectivorous bat. To avoid sampling bias, we used sound recordings and two different capture methods for the katydids, as well as video monitoring and radio-telemetry for the bats. Both, bats and katydids were significantly more active during the dark periods associated with new moon compared to bright periods around the full moon. We conclude that foraging activity of L. silvicolum is probably influenced by prey availability to a large extent and argue that generally the causes of lunar phobia are species-specific.

Animals↗

PubMed2005

Incorporating patterns of disperser behaviour into models of seed dispersal and its effects on estimated dispersal curves.

The processes determining where seeds fall relative to their parent plant influence the spatial structure and dynamics of plant populations and communities. For animal dispersed species the factors influencing seed shadows are poorly understood. In this paper we test the hypothesis that the daily temporal distribution of disperser behaviours, for example, foraging and movement, influences dispersal outcomes, in particular the shape and scale of dispersal curves. To do this, we describe frugivory and the dispersal curves produced by the southern cassowary, Casuarius casuarius, the only large-bodied disperser in Australia's rainforests. We found C. casuarius consumed fruits of 238 species and of all fleshy-fruit types. In feeding trials, seeds of 11 species were retained on average for 309 min (+/-256 SD). Sampling radio-telemetry data randomly, that is, assuming foraging occurs at random times during the day, gives an estimated average dispersal distance of 239 m (+/-207 SD) for seeds consumed by C. casuarius. Approximately 4% of seeds were dispersed further than 1,000 m. However, observation of wild birds indicated that foraging and movement occur more frequently early and late in the day. Seeds consumed early in the day were estimated to receive dispersal distances 1.4 times the 'random' average estimate, while afternoon consumed seeds received estimated mean dispersal distances of 0.46 times the 'random' estimate. Sampling movement data according to the daily distribution of C. casuarius foraging gives an estimated mean dispersal distance of 337 m (+/-194 SD). Most animals' behaviour has a non-random temporal distribution. Consequently such effects should be common and need to be incorporated into seed shadow estimation. Our results point to dispersal curves being an emergent property of the plant-disperser interaction rather than being a property of a plant or species.

Animals↗

PubMed2005

Sex-specific foraging behaviour in a seabird with reversed sexual dimorphism: the red-footed booby.

Most hypotheses attempting to explain the evolution of reversed sexual dimorphism (RSD) assume that size-related differences in foraging ability are of prime importance, but the studies on sex-specific differences in foraging behaviour remain scarce. We compare the foraging behaviour of males and females in a seabird species with a RSD by using several miniaturised activity and telemetry loggers. In red-footed boobies males are 5% smaller and 15% lighter than females, but have a longer tail than females. Both sexes spend similar time on the nest while incubating or brooding. When foraging at sea, males and females spend similar time foraging in oceanic waters, forage in similar areas, spend similar proportion of their foraging trip in flight, and feed on similar prey-flying fishes and flying squids-of similar size. However, compared to males, females range farther during incubation (85 km vs. 50 km), and furthermore feed mostly at the extremity of their foraging trip, whereas males actively forage throughout the trip. Males are much more active than females, landing and diving more often. During the study period, males lost mass, whereas females showed no significant changes. These results indicate that males and females of the red-footed boobies differ in several aspects in their foraging behaviour. Although some differences found in the study may be the direct result of the larger size of females, that is, the slightly higher speeds and deeper depths attained by females, others indicate clearly different foraging strategies between the sexes. The smaller size and longer tail of males confer them a higher agility, and could allow them to occupy a foraging niche different from that of females. The higher foraging effort of males related to its different foraging strategy is probably at the origin of the rapid mass loss of males during the breeding period. These results suggest that foraging differences are probably the reason for the differential breeding investment observed in boobies, and are likely to be involved in the evolution and maintenance of RSD.

Animals↗

PubMed2006

Energetics of parental care in six syntopic centrarchid fishes.

We studied parental behavior in six syntopically breeding species of centrarchid fishes to determine whether energetic costs could contribute to our understanding of the diversity of parental care. We used a combination of underwater videography, radio telemetry and direct observation to examine how the cost of parental care varied with both its duration and intensity. Duration of parental care, activity patterns, and energetic costs varied widely among species. Overall, the duration of care increased with parental size between species. When energetic costs were adjusted for species-specific differences in the duration of parental care, the cost of parental care also increased with mean size of the species. Species with extended parental care exhibited stage-specific patterns of activity and energy expenditure consistent with parental investment theory, whereas fish with short duration parental care tended to maintain high levels of activity throughout the entire period of parental care. The only apparent exception (a species with brief parental care but stage-specific behavior) was a species with multiple breeding bouts, and thus effectively having protracted parental care. These data suggest that some species with short duration parental care can afford not to adjust parental investment over stages of offspring development. Using our empirical data on parental care duration and costs, we reevaluated the relationship between egg size and quality of parental care. Variation in egg size explained almost all of the observed variation in total energetic cost of parental care, and to a lesser degree, duration-the larger the eggs, the more costly the parental care. This research highlights the value of incorporating energetic information into the study of parental care behavior and testing of ecological theory.

Animals↗

PubMed1999

Nocturnal sleep structure and temperature slope in MPTP treated monkeys.

The nocturnal sleep of three 1-Methyl, 4-phenyl, 1,2,3,6-tetrahydropyridine (MPTP) treated monkeys (one non-motor disabled and two severely motor disabled), while held in a primate chair was registered using a reversible system for head fixation and chronic recordings. Two electroencephalogram (EEG) channels, one electrooculogram (EOG) and one electromyogram (EMG) channel were monitored constantly and tape recorded during eight nights for posterior analyses. Subcutaneous temperature was registered each minute using a radio telemetry system. An analysis of sleep patterns and temperature parameters revealed lighter sleep, decreased amounts of slow wave and rapid eye movement (REM) sleep and lower temperature values in the two motor disabled MPTP-treated monkeys than in the non-motor disabled monkey. The temperature linear slope was negative in the case of one disabled monkey for just one night. Although the motor disability of the two monkeys was similar, their sleep organization patterns and temperatures slopes differed. The present study confirmed the differential vulnerability of the nigrostriatal system of monkeys to MPTP, suggesting that if a high cumulative dose was needed to reach stable motor alterations, the cumulative dose-effect of the toxin independent of the nigrostriatal system might be responsible for non-motor symptoms that also appear in Parkinson's disease besides the classic tetrad.

1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine↗

PubMed2006

In vivo evaluation of the improved MCMS-0102 pacemaker with a rapid pacing mode for induction of experimental heart failure in animals.

The MCMS-0102 cardiac pacemaker for rapid ventricular pacing to induce heart failure in animals has been improved in terms of miniaturization and performance. To determine the performance of the new MCMS-0102, six devices were implanted in beagle dogs, and two of these devices were reimplanted for continued pacing in a total of eight beagle dogs. The hearts were paced at 260 beats per minute for 4 weeks (P group: n = 8). The hemodynamic status of the P group was examined and compared with nonpaced dogs (NP group: n = 8). The neurohumoral status of the P group was evaluated before and after rapid pacing. Stable operation of the six devices during rapid pacing was confirmed using the telemetry system. Postmortem examinations revealed features similar to clinical heart failure characterized by massive ascites, pleural effusion, cardiomegaly, and liver congestion in all the paced dogs. Cardiac output was 1.1 +/- 0.2 l/min in the NP group and 0.5 +/- 0.1 l/min in the P group (P < 0.0001). The left atrial pressure and the central venous pressure of the P group and the NP group were 23 +/- 6 versus 6 +/- 2 mmHg (P < 0.0001) and 10 +/- 3 versus 4 +/- 3 mmHg (P < 0.001), respectively. In the paced dogs, plasma renin activity increased from 0.5 +/- 0.4 to 8.5 +/- 7.4 ng/ml/h (P < 0.05) and atrial natriuretic peptide levels increased from 69 +/- 41 to 229 +/- 72 pg/ml (P < 0.001). The improved MCMS-0102 was successfully implanted in beagle dogs and it succeeded in inducing the congestive heart failure model.

Animals↗

PubMed2004

Syncope and seizures-differential diagnosis and evaluation.

Syncope and seizures are common conditions and pose diagnostic challenges for the clinician. The cumulative lifetime incidence of epilepsy is 3%, and the incidence of a first attack of syncope is 6.2 per 1000 person-years in the general population. Although the underlying pathophysiological processes are distinct, seizures and syncope share some clinical characteristics which may lead to diagnostic confusion. Confounding matters further is the fact that seizures and syncope may coexist in a given patient. For example, some conditions such as prolonged QT syndrome may result in both arrhythmia-associated syncope and seizures, and in some cases, seizures may result in cardiac arrhythmia and syncope. The clinical history, examination, electrocardiography, and combined EEG/ECG telemetry are all helpful in the diagnosis of seizures and syncope.

Adolescent↗

PubMed2006

Assessment of QT liabilities in drug development.

Since the publication, in 1997, of the CPMP (Committee for Proprietary Medicinal Products) Points to Consider document on "The assessment of potential for QT prolongation by non-cardiovascular medicinal products," both regulatory bodies and the pharmaceutical industry have paid increasing attention to the conduct of careful preclinical studies on the subject. Regulatory attention has focused on the drafting of Safety Pharmacology guidelines through the ICH (International Conference on Harmonization) process, which resulted in approval by the ICH and acceptance by the three main regions (USA, Europe, and Japan) of the ICH S7A guideline. The guideline does not deal only with cardiovascular studies and does not provide guidance on QT investigations. This part has been deferred to a second guideline (ICH S7B). Nevertheless, pharmaceutical companies have implemented screening strategies aimed at selecting compounds that do not present QT liabilities. These strategies can differ according to the pharmaceutical class, while experimental models differ according to the stage of development of the compound. Several in vitro models are employed in discovery (radioligand binding, high-throughput patch clamp, efflux, and fluorescence assays). These models, coupled with in silico methods, allow companies to screen a high number of compounds. Other in vitro models, applied later in the R&D process (action potential duration, APD, in Purkinje fibers or papillary muscle and the isolated heart) are useful in better describing the activity of compounds on cardiac ion channels. The most robust and accepted in vivo test is represented by telemetry studies in conscious non-rodents.

Animals↗

PubMed2006

Telemetric system for hydrology and water quality monitoring in watersheds of northern New Mexico, USA.

This study utilized telemetric systems to sample microbes and pathogens in forest, burned forest, rangeland, and urban watersheds to assess surface water quality in northern New Mexico. Four sites included remote mountainous watersheds, prairie rangelands, and a small urban area. The telemetric system was linked to dataloggers with automated event monitoring equipment to monitor discharge, turbidity, electrical conductivity, water temperature, and rainfall during base flow and storm events. Site data stored in dataloggers was uploaded to one of three types of telemetry: 1) radio in rangeland and urban settings; 2) a conventional phone/modem system with a modem positioned at the urban/forest interface; and 3) a satellite system used in a remote mountainous burned forest watershed. The major variables affecting selection of each system were site access, distance, technology, and cost. The systems were compared based on operation and cost. Utilization of telecommunications systems in this varied geographic area facilitated the gathering of hydrologic and water quality data on a timely basis.

Environmental Monitoring↗

PubMed2006

The use of joint time frequency analysis to quantify the effect of ventilation on the pulse oximeter waveform.

OBJECTIVE: In the process of determining oxygen saturation, the pulse oximeter functions as a photoelectric plethysmograph. By analyzing how the frequency spectrum of the pulse oximeter waveform changes over time, new clinically relevant features can be extracted. METHODS: Thirty patients undergoing general anesthesia for abdominal surgery had their pulse oximeter, airway pressure and CO(2) waveforms collected (50 Hz). The pulse oximeter waveform was analyzed with a short-time Fourier transform using a moving 4096 point Hann window of 82 seconds duration. The frequency signal created by positive pressure ventilation was extracted using a peak detection algorithm in the frequency range of ventilation (0.08-0.4 Hz = 5-24 breaths/minute). The respiratory rate derived in this manner was compared to the respiratory rate as determined by CO(2) detection. RESULTS: In total, 52 hours of telemetry data were analyzed. The respiratory rate measured from the pulse oximeter waveform was found to have a 0.89 linear correlation when compared to CO(2) detection and airway pressure change. the bias was 0.03 breath/min, SD was 0.557 breath/min and the upper and lower limits of agreement were 1.145 and -1.083 breath/min respectively. The presence of motion artifact proved to be the primary cause of failure of this technique. CONCLUSION: Joint time frequency analysis of the pulse oximeter waveform can be used to determine the respiratory rate of ventilated patients and to quantify the impact of ventilation on the waveform. In addition, when applied to the pulse oximeter waveform new clinically relevant features were observed.

Algorithms↗

PubMed1982

Therapeutic trials of pindolol in hypertension: comparison and combination with other drugs.

The antihypertensive effect of pindolol has been demonstrated in several hundred clinical trials performed in many countries. The results of several representative trials will be reviewed in this article. In a cooperative study of pindolol by Swiss internists, blood pressure (BP) normalization was achieved in 76% of the patients and a fair response in 9%. In a French trial, BP reduction was found to correlate with the initial pressure level. Pindolol was also found effective in treating renal hypertension (Germany) and was considered particularly useful in hypertensive patients with coexistent angina pectoris (South Africa). A favorable effect on the BP profile registered during the whole day was demonstrated by means of BP telemetry (Germany). A Swedish long-term study showed pindolol to have a sustained antihypertensive effect over 16 months associated with a progressive decrease in systemic vascular resistance. In a study conducted in New Zealand, pindolol compared favorably with drugs previously used for hypertension, (methyldopa, diuretics, rauwolfia, guanethidine, etc.). It proved slightly less effective than methyldopa in a Canadian trial but significantly more effective than this drug in a South African study. Danish investigators found pindolol equivalent to chlorthalidone in lowering the resting BP but more effective than the diuretic in reducing the pressure and pulse response to exercise. Of particular interest are comparisons of pindolol with other beta-blockers performed in Germany, Sweden, Australia, and New Zealand. BP reductions obtained with pindolol did not differ significantly from those obtained with the other beta-blockers, whether they were cardioselective (metoprolol, atenolol) or not (propranolol, timolol, nadolol); however, pindolol produced less slowing of resting heart rate than these five other drugs, which are devoid of intrinsic sympathomimetic activity (ISA). Pindolol proved somewhat more effective than other nonselective beta-blockers with ISA (i.e., oxprenolol), although both produced less bradycardia than propranolol (New Zealand). In resistant cases, the combination of pindolol with diuretics, methyldopa, or hydralazine was found to significantly increase the responder rate.

Adrenergic beta-Antagonists↗

PubMed1986

Intravenous lorcainide versus lidocaine in the treatment of frequent and complex ventricular arrhythmias.

Thirty patients with frequent (greater than or equal to 30/hr) and repetitive ventricular premature beats (VPBs) unassociated with acute infarction were randomized to intravenous lorcainide (LOR) or lidocaine (LID). Following at least 2 hours of baseline Holter monitoring, patients received LOR, 2 mg/kg then 200 mg/24hr, or LID, 1 mg/kg then 2 mg/min, with rebolus if needed. Nonresponders detected by bedside telemetry were crossed over. Clinical response was 6 of 25 (24%) including two of nine crossovers with LOR and 8 of 26 (31%) including 3 of 12 crossovers with LID (p = NS). By computer analysis of 24-hour Holter monitors and asymptotic regression of success rates at hourly intervals, it was projected that greater than or equal to 80% reduction in VPBs occurred in 28% of LOR and in 25% of LID (p = NS), and complete suppression of repetitive VPBs occurred in 102% of LOR and in 92% of LID (p = NS). The mean drug levels were 405 ng/ml (range 371 to 463) with LOR and 3.4 micrograms/ml (range 2.1 to 3.6) with LID. Side effects were similar, occurring in 8 of 25 LOR trials and in 11 of 26 LID trials (p = NS). Thus, LOR and LID effectively suppress repetitive VPBs and to a lesser extent VPB frequency. However, neither drug is superior and each may be an effective alternative when resistance to the other is encountered.

Aged↗

PubMed1986

Phase II intensive monitored cardiac rehabilitation for coronary artery disease and coronary risk factors--a six-session protocol.

To evaluate phase II intensive monitored cardiac rehabilitation using a 6-level, 6-session protocol, 31 patients were placed in a progressive 6-level exercise protocol with careful supervision and assessment of heart rate, rhythm, blood pressure and perceived exertion. Duration after the cardiac event ranged from 12 days to 8 years (median 10 months). Each exercise prescription was based on exercise testing with oxygen consumption determinations. Exercise activities were individually prescribed according to percentages of maximal MET level achieved on the exercise test. Each exercise session incorporated calisthenics, treadmill exercise, and bicycle and arm ergometry with progressively greater workloads on the various stations. All patients completed the 6 levels within 6 sessions of approximately 1 hour each, and achieved their designated 50 to 75% target heart rate with perceived exertion level 13 or less. There were no critical cardiac events, i.e., high-grade ventricular arrhythmias or myocardial infarction. All completed the 6-level protocol and progressed to a nonmonitored exercise program with no difficulty. The results of this short-term method of telemetry-monitored rehabilitation suggest benefits of proper exercise instruction, successful achievement of the 50 to 75% exercise target heart rate, detection of minor new arrhythmias and alterations of blood pressure response, adequate use of the perceived exertion scale, and a safe and effective transition to subsequent exercise programs.

Adult↗

PubMed1988

Efficacy and safety of class IC antiarrhythmic agents for the treatment of coexisting supraventricular and ventricular tachycardia.

Thirty-three patients with concurrent supraventricular (SVT) and ventricular tachycardia (VT) were treated with class IC antiarrhythmic agents. Twenty-two patients had atrial fibrillation (17 with paroxysmal and 5 with chronic fibrillation), 1 patient had ectopic atrial tachycardia and 11 patients had reentrant paroxysmal SVT (8 with atrioventricular node reentrant tachycardia, 3 with atrioventricular reentrant tachycardia). Of 5 patients with Wolff-Parkinson-White syndrome, 2 had only atrial fibrillation. Six patients had sustained VT and 27 had nonsustained VT. Twenty-nine patients had organic heart disease (16 with coronary artery disease, 8 with cardiomyopathy and 5 with valvular heart disease) and 4 had primary electrical disease. The mean ejection fraction was 40 +/- 14% (range 15 to 66%). The study population's arrhythmias were not controlled despite having received 2 to 5 (mean 3.1) previous drug trials. Eighteen patients were referred for treatment of SVT and 15 were referred for treatment of VT (mean symptom duration 107 months). Efficacy was determined in 13 of 33 patients with sustained SVT or VT by programmed electrical stimulation and in 20 of 33 by telemetry and 24-hour Holter response. Twenty-two flecainide and 15 encainide trials were conducted in the 33 patients. Four patients underwent trials with both drugs. Of 33 patients with coexisting SVT and VT, 15 (45%) were controlled with an IC agent alone and 3 continued therapy with an IC agent plus additional therapy (2 drugs, 1 antitachycardia pacing). During the follow-up period (mean 10.4 months), flecainide produced a complete response in 9 patients and encainide in 9 patients. SVT was not controlled in 7 patients and VT was not controlled in 7 patients. One patient had neither arrhythmia controlled. Atrial or ventricular proarrhythmia was seen in 9 of 33 patients (27%) (5 with ventricular and 4 with atrial arrhythmia). Noncardiac side effects were uncommon. Oral class IC agents may be effective therapy for some patients with coexisting VT and SVT of different mechanisms. Patients with such complex arrhythmias should be evaluated carefully because there is a potential for both atrial and ventricular proarrhythmia.

Anilides↗

PubMed1991

Outcome of patients who were admitted to a new short-stay unit to "rule-out" myocardial infarction.

For emergency room patients with a low probability of acute myocardial infarction, we established a new short-stay coronary observation unit, a 2-bed nonintensive care unit with telemetry monitoring adjacent to the emergency room. Of 512 consecutive admissions to the coronary observation unit, 425 (83%) were discharged home without evidence of acute myocardial infarction or serious complications (mean length of stay, 1.2 days; median length of stay, 1 day); 87 (17%) were transferred to other hospital beds. The rate of acute myocardial infarction was 3%. No deaths and only 1 serious complication occurred in the coronary observation unit. At 6 month follow-up, the cardiac survival rate was 99% for patients sent home directly from this unit. It is concluded that the coronary observation unit is safe and adequate for ruling out acute myocardial infarction in a defined subset of patients. Short-stay units, however, encourage early discharges which, when premature, may miss patients who are at risk of having complications shortly thereafter. Strategies such as mandatory but expeditious predischarge stress testing to encourage early but not premature discharge may augment the efficiency of coronary observation units.

Coronary Care Units↗

PubMed1991

Blood pressure during sleep: antihypertensive medication.

To investigate whether excessive reduction of blood pressure (BP) by antihypertensive medications correlates with myocardial infarction, especially during sleep in elderly patients, we used telemetry and cuvette dye-dilution methods to assess the direct BP and the hemodynamics of 68 inpatients with essential hypertension during wakefulness and sleep. There were 25 patients greater than or equal to 60 years old (OH-group) and 43 were less than or equal to 59 years old (YH-group). Of the OH-group, 36% showed high BP during the day, with marked decreases (minimum BP less than 110/70 mm Hg) during sleep. Average cardiac index (CI) of the OH-group was low during wakefulness and extremely low during slow-wave sleep. Changes of mean BP in the OH-group correlated with changes in total peripheral vascular resistance index (TPRI) during sleep, but this correlation was not observed in the YH-group. The antihypertensive effects on nocturnal BP of the various medications was: central adrenergic inhibitors less than or equal to beta blockers with intrinsic sympathomimetic activity less than or equal to alpha (alpha beta) blockers less than or equal to angiotensin-converting enzyme inhibitors less than or equal to calcium antagonists. Because BP and CI were found to be very low and TPRI seems to play an important role in BP regulation in sleeping elderly patients, excessive antihypertensive medication may be harmful to this subgroup. However, because the effects on nocturnal BP differ among various antihypertensive treatments, further research is required on the relation between antihypertensive medication and the hemodynamics of sleeping elderly hypertensive patients.

Adult↗

PubMed1992

Differences in circadian blood pressure between upper and lower extremity in aortic coarctation patients with and without postoperative pressure gradients.

The purpose of this study was to investigate possible circulatory differences between pre- and poststenotic vascular beds in postoperative coarctation patients with and without a residual pressure gradient during a physiologic decrease in circulatory activity. Simultaneous diurnal variations in blood pressure in the brachial and femoral arteries were recorded in 5 long-term postoperative coarctation patients with and in 5 without a pressure gradient. The patients were studied 6.5 to 8.5 years postoperatively with intraarterial blood pressure telemetry. Both groups of patients had a normal pressure decrease during the hours of sleep. A significant (p less than 0.05) increase, however, in brachial to femoral pressure gradients developed during the hours of sleep in patients with a positive gradient in contrast to patients without a gradient who had identical pressure profiles in both vascular beds. A significant positive correlation was found between changes in mean pressure gradient and upper extremity systolic pressure (r = 0.79, p less than 0.01). There was no difference between the 2 groups regarding pre- and postoperative pressures, preoperative gradients or age at surgery. Results suggest that normalization of prestenotic circadian vascular reactivity depends on complete relief of the gradient, and that upper extremity vascular abnormality may not be fully irreversible, even in older patients with coarctation.

Adolescent↗

PubMed1993

Effectiveness and costs of digoxin treatment for atrial fibrillation and flutter.

Clinical outcomes and costs associated with the use of digoxin in atrial fibrillation and flutter were evaluated in a prospective, observational study at 18 academic medical centers in the United States. Data were collected on 115 patients (aged > 18 years) with atrial fibrillation or flutter who were treated with digoxin for rapid ventricular rate (> or = 120 beats/min). The median time to ventricular rate control (i.e., resting ventricular rate < 100 beats/min, decrease in ventricular rate of > 20%, or sinus rhythm) was 11.6 hours from the first dose of digoxin for all evaluable patients (n = 105) and 9.5 hours for those only receiving digoxin (n = 64). Before ventricular rate control, the mean +/- SD dose of digoxin administered was 0.80 +/- 0.74 mg, and a mean of 1.4 +/- 1.8 serum digoxin concentrations were ordered per patient. Concomitant beta-blocker or calcium antagonist therapy was instituted in 47 patients (41%); in 19 of these, combination therapy was initiated within 2 hours. Adenosine was administered to 13 patients (11%). Patients spent a median of 4 days (range 1 to 25) in the hospital; 28% spent time in a coronary/intensive care unit and 79% in a telemetry bed. Loss of control (i.e., resting ventricular rate returned to > 120 beats/min) occurred at least once in 50% of patients and was associated with a longer hospital stay (p < 0.05). Based on 1991 data, the estimated mean hospital bed cost for patients with atrial fibrillation or flutter was $3,169 +/- $3,174.(ABSTRACT TRUNCATED AT 250 WORDS)

Aged↗