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  • 1
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiac surgery 9 (1994), S. 0 
    ISSN: 1540-8191
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Elective replacement of the aortic root in patients with Marian syndrome is indicated to prevent aortic dissection and prevent left ventricular failure from aortic regurgitation. The two most important factors bearing on the patient's risk for aortic dissection are the maximal aortic root dimension and a family history of aortic dissection. Improvements In surgical technique, favorable long-term postoperative results, and the observation that a substantial proportion of Marian patients die of aortic dissection with an aortic root dimension in the 50-to 60-mm range have led to new recommendations. Asymptomatic Marian patients may be followed annually with echocardiography. When the aortic root dimension reaches 50 mm, the interval between examinations should be shortened to every 3 to 4 months. Asymptomatic individuals with aortic root dimension between 50 and 55 mm should be referred for elective composite graft repair if one or more of the following additional factors are present: moderately severe aortic regurgitation, severe mitral regurgitation, a family history of aortic dissection, and a future need for other major operative procedures such as abdominal aortic aneurysm repair or spinal fusion. In the absence of these factors, asymptomatic individuals may be followed until the aortic root dimension is 55 mm and should then be referred for surgery. Symptomatic individuals with or without aortic root dilatation should be operated upon urgently If evidence of an aortic dissection is present. Postoperatively, all patients should be maintained on beta blockade indefinitely and receive prophylactic parenteral antibiotics before dental, genitourinary, or gastrointestinal procedures. (J Card Surg 1994;9[Suppl]:174–176)
    Type of Medium: Electronic Resource
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  • 2
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of interventional cardiology 8 (1995), S. 0 
    ISSN: 1540-8183
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 3
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 5 (1994), S. 0 
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Neural Network for Detecting AF. Introduction: A neural network classifier has been designed, which is able to distinguish atrial fibrillation (AF) from other supraventricular arrhythmias in ambulatory (Holter) ECGs. Method and Results: The classification algorithm uses a rhythm analysts that considers the ECG to be a time series of RR interval durations. This is combined with an analysis of baseline morphology that considers the morphological characteristics of the non-QRS portions of the waveform. A back propagation-based neural network has been used as part of the classifier implementation. When applied to a library consisting exclusively of 42,970 examples of AF and other supraventricular rhythm disturbances validated by an experienced cardiologist, the algorithm demonstrated a sensitivity of 82.4% for 10-beat runs of paroxysmal atrial fibrillation (PAF) and a specificity of 96.6%. Since this system has been implemented as a postprocessor to a conventional automated Holter system, operating only on segments of ECG that are known to contain supraventricular arrhythmias rather than ventricular arrhythmias or sinus rhythm, it can be added to most existing Holter processing systems without significantly increasing the average time to process a tape. Conclusion: A neural network system has been designed, which can potentially provide, for the first time, an accurate, quantitative technique to determine the natural history of PAF and to evaluate potential treatments for PAF.
    Type of Medium: Electronic Resource
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  • 4
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 8 (1997), S. 0 
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Antiarrhythmic Drugs for AF. Antiarrhythmic drugs have been used for the acute conversion of atrial fibrillation to sinus rhythm, as well as for the long-term maintenance of sinus rhythm. In recent years, concerns regarding antiarrhythmic drug efficacy as well as safety have prompted a re-examination of the indications for antiarrhythmic therapy in patients with atrial fibrillation. This review will focus on the safety and efficacy of antiarrhythmic therapy in the acute and chronic management of patients with atrial fibrillation.
    Type of Medium: Electronic Resource
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  • 5
    Electronic Resource
    Electronic Resource
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 6 (1995), S. 0 
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Atrial Fibrillation and Flutter. Two major treatment strategies have emerged for managing atrial fibrillation: maintaining sinus rhythm by chronic administration of suppressive antiarrhythmic agents versus controlling the ventricular rate and chronic anticoagulation. Potential benefits of maintenance of sinus rhythm include improvement of the hemodynamic profile of the patient, a decreased risk of cerebrovascular accidents, reduced symptoms, and, if atrial fibrillation is successfully suppressed, possible elimination of the need for chronic anticoagulation. When selecting long-term antiarrhythmic drug therapy for suppression of atrial fibrillation, it should he recalled that at least 50% of patients have a recurrence of the arrhythmia within the first year and the majority of other patients have a recurrence within the next 3 to 5 years. In addition, the risk of proarrhythmia and sudden cardiac death must be considered: this has stimulated interest in nonpharmacologic approaches to maintaining sinus rhythm. Large multicenter randomized trials are now under way to compare the benefits and risks of maintaining sinus rhythm versus controlling the ventricular rate and chronically anti-coagulating patients in atrial fibrillation. Important endpoints of these trials include mortality, functional capacity, and quality of life.
    Type of Medium: Electronic Resource
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  • 6
    ISSN: 1619-7089
    Keywords: 99mTc-TBI ; Myocardial infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract Technetium-99m hexakis (t-butylisonitrile) technetium (I) (99mTc-TBI) is a new myocardial perfusion imaging agent. To determine its potential in the evaluation of myocardial infarction, 15 patients with suspected or confirmed acute infarction were studied by bedside imaging in the coronary care unit. Good-quality planar scintigrams in multiple projections were obtained in 13 patients. Gated perfusion studies were performed in 14 patients, and for comparison 13 of these were restudied 24–72 h later by standard gated equilibrium blood pool radionuclide ventriculography. Conventional and planar scintigraphic criteria for myocardial infarction (acute or old) agreed in 12 (92%) patients (k=0.81, p〈0.05). All the infarctions detected by scintigraphy were associated with electrocardiographic Q-waves. Localization of infarction by the electrocardiogram and scintigraphy exhibited moderate agreement (k=0.49, p〈0.1). Regional wall motion analysis by standard radionuclide ventriculography and gated 99mTc-TBI scintigraphy were in complete agreement for 25 (64%) of 39 left ventricular segments (k=0.35, p〈0.05). However, in 7 other segments, associated with areas of infarction, regional wall motion abnormalities were noted only on gated 99mTc-TBI scintigraphy. Therefore, 99mTc-TBI scintigraphy can readily provide data on regional myocardial perfusion and wall motion, permitting detection and localization of areas of myocardial infarction. The superior imaging properties, ready availability and low cost of 99mTc point to the considerable potential value of 99mTc-TBI in assessing patients with suspected or confirmed myocardial infarction.
    Type of Medium: Electronic Resource
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  • 7
    Electronic Resource
    Electronic Resource
    Springer
    Cardiac electrophysiology review 3 (1999), S. 96-99 
    ISSN: 1573-725X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 8
    Electronic Resource
    Electronic Resource
    Springer
    Journal of thrombosis and thrombolysis 5 (1998), S. S137 
    ISSN: 1573-742X
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 9
    Electronic Resource
    Electronic Resource
    Springer
    Journal of thrombosis and thrombolysis 6 (1998), S. 239-252 
    ISSN: 1573-742X
    Keywords: echocardiography ; chest pain ; myocardial infarction
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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  • 10
    Electronic Resource
    Electronic Resource
    Springer
    Journal of thrombosis and thrombolysis 6 (1998), S. 211-238 
    ISSN: 1573-742X
    Keywords: antiarrhythmics ; amiodarone ; heart failure ; beta-blockers ; quinidine ; lidocaine ; flecanide ; bretylium
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Type of Medium: Electronic Resource
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