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  • 1
    Electronic Resource
    Electronic Resource
    Retrograde Multiple and Multifiber Accessory Pathway Conduction in the Wolff-Parkinson-White Syndrome: (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 9 (1998), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Retrograde Multiple Accessory Pathway Precipitating AF. Introduction: The determinants of susceptibility to atrial fibrillation (AF) and the existence of accessory pathway conduction have remained unidentified in the Wolff-Parkinson-White (WPW) syndrome. We tested the hypothesis that excitation inputs into the atrium over a retrograde multiple or multifiber accessory pathway during AV reentrant tachycardia (AVRT) could precipitate initiation of AF. Methods and Results: Two hundred fifty consecutive patients with WPW syndrome underwent electrophysiologic study and radiofrequency catheter ablation. The patients were classified into two groups according to the study results: 29 with retrograde multiple or multifiber accessory pathway (MP) and 221 with retrograde single accessory pathway (SP). Compared with the SP patients, the MP patients showed a significantly higher incidence of clinical AF (MP vs SP: 19/29 vs 51/221, P 〈 0.01), induced AF (12/29 vs 32/221, P 〈 0.01), and initiated AF during ventricular pacing and AVRT (10/12 vs 17/32, P 〈 0.05). There were no differences between the two groups in incidence of clinical and induced AVRT (24/29 vs 200/221 and 25/29 vs 206/221, respectively), mean cycle length of induced AVRT, or electrophysiologic parameters of the accessory pathway. AF inducibility during AVRT or ventricular pacing was eliminated by partial ablation in 7 of 10 patients with MP. After total ablation, the incidence of induced AF was similar between the two groups (MP vs SP: 1/29 vs 11/221). Conclusion: The existence of a retrograde multiple or multifiber accessory pathway in patients with WPW syndrome is associated with a higher incidence of clinical and induced AF. Successful ablation of the retrograde multiple or multifiber accessory pathway can eliminate the induction of both AVRT and AF.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.1998.tb00895.x
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  • 2
    Electronic Resource
    Electronic Resource
    High Energy Radiofrequency Catheter Ablation for Common Atrial Flutter Targeting the Isthmus between the Inferior Vena Cava and Tricuspid Valve Annulus Using a Super Long Tip Electrode (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 21 (1998), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: There have been controversies concerning the optimal target sites and approaches in radiofre-quency catheter ablation of common atrial flutter. We attempted high energy radiofrequencv catheter ab-lation targeting the isthmus between the inferior vena cava and tricuspid valve annulus (IVC-TV isthmus) with a super long (8 mm) tip electrode, and compared the efficacy of this anatomical approach with the electrophysiological approach targeting the posteroseptal right atrium posterior to the coronary sinus us-ing a standard 4-mm tip electrode. Atrial flutter was successfully ablated in 12 of 12 patients (100%) with-out recurrence with the anatomical approach, while, in 7 of 9 patients (64%) with 2 recurrences with the electrophysiological approach. In comparison of ablation data between the anatomical and electrophysi-ological approaches, there were significant differences in the mean number of application pulses (anatomical vs electrophysiological: 2.3 ± 0.8 vs 9.9 ± 6.4, P 〈 0.01), applied wattage (39 ± 12Wvs24 ± 6W.P 〈 0.01), applied energy per application (1.986 ± 426 / vs 659 ± 323 J. P 〈 O.O1), fluoroscopic time (26 ± 11 min vs 74 ± 30 minutes, P 〈 0.01), and procedure time (59 ± 8 min vs 181 ± 53 min. P 〈 0.01). In conclusion, the anatomical approach is superior to the electrophysiological one with respect to proce-dure and radiation time, and linear ablation at the IVC-TV isthmus with an 8-wm tip electrode and high energy application is highly effective and safe.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1998.tb00064.x
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  • 3
    Electronic Resource
    Electronic Resource
    Longitudinal Dissociation in the His Bundle: A Possible Mechanism of Two Distinct Cycle Lengths in Atrioventricular Reentrant Tachycardia (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 20 (1997), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Two wide QRS tachycardias with identical morphology but different cycle lengths (CLs) developed in a 63-year-old man. Electrophysiological study demonstrated inducible atrioventricular reentrant tachycardia (AVRT) due to a concealed left posterior accessory pathway (AP), which was successfully ablated by radiofrequency application. Neither dual AV nodal pathways nor other APs were documented. Splitting of the His-bundle electrogram was shown, and programmed stimulation induced sudden prolongation of intra-hisian conduction time. These results suggest longitudinal dissociation in the His bundle may be responsible for two distinct CLs in AVRT without dualAV nodal physiology.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1997.tb03611.x
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  • 4
    Electronic Resource
    Electronic Resource
    Adenosine-Sensitive Atrial Reentrant Tachycardia Originating from the Atrioventricular Nodal Transitional Area (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 8 (1997), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Adenosine-Sensitive AT from AVN Area. Introduction: Atrial tachycardia shows wide variations in its electrophysiologic properties and sites of origin. We report an atrial tachycardia with ECG manifestations and electrophysiologic characteristics similar to an atypical form of AV nodal reentrant tachycardia (AVNRT). Methods and Results: This supraventricular tachycardia was observed in 11 patients. It was initiated by atrial extrastimulation with an inverse relationship between the coupling interval of an extrastimulus and the postextrastimulus interval. Its induction was not related to a jump in the AH interval, and its perpetuation was independent of conduction block in the AV node. Ventricular pacing during tachycardia demonstrated AV dissociation without affecting the atrial cycle length. A very small dose of adenosine triphosphate (mean 3.9 ± 1.2 mg) could terminate the tachycardia. The earliest atrial activation during tachycardia was recorded at the low anteroseptal right atrium with a different intra-atrial activation sequence from that recorded during ventricular pacing, where the tachycardia was successfully ablated in 9 of 10 attempted patients. Bidirectional AV nodal conduction remained unatttched after successful ablation. Conclusion: There may he an entity of adenosine-sensitive atrial tachycardia probably due to focal reentry within the AV node or its transitional tissues without involvement of the AV nodal pathways. This tachycardia can he ablated without disturbing AV nodal conduction from the right atrial septum.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.1997.tb00846.x
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  • 5
    Electronic Resource
    Electronic Resource
    Catheter Ablation for Ventricular Tachycardia from a Diverticulum at the Right Ventricular Outflow Tract (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 21 (1998), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: A case is presented of a 73-year-old man with drug resistant ventricular tachycardia that originated from the right ventricular outflow tract. A right ventriculogram showed a diverticulum in the interventricular septum at the right ventricular outflow tract. Low energy radiofrequency catheter ablation within the diverticulum was performed successfully and safely.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1998.tb00289.x
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  • 6
    Electronic Resource
    Electronic Resource
    Clinical validation of fully-automated contour detection for gated radionuclide ventriculography with a slant-hole collimator (1986)
    Springer
    European journal of nuclear medicine 12 (1986), S. 53-59 
    Details
    ISSN: 1619-7089
    Keywords: Fully-automated contour detection ; Gated blood-pool image ; Left ventricle ; Ejection fraction ; Volume curve ; Slant hole collimator ; Butterworth filtering
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract A new fully-automated method for processing gated blood-pool images is presented and its clinical validity and performance for images with various noise levels are investigated using data obtained from a slant-hole collimator. The optimal preprocessing conditions are evaluated for the images with various noise levels to obtain the accurate ejection fraction, end-diastolic and end-systolic counts. This new method has successfully detected left ventricular contour in 92% of the 61 patients. The left ventricular ejection fraction obtained by the method related closely to that of contrast ventriculography (correlation coefficient r=0.90). The end-diastolic volume also had a good correlation with contrast ventriculography (r=0.90).
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF00364728
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  • 7
    Electronic Resource
    Electronic Resource
    Double nuclei in endomyocardial biopsy: A comparative study of the incidence in myocarditis and chronic right ventricular overloading (1985)
    Springer
    Heart and vessels 1 (1985), S. 58-59 
    Details
    ISSN: 1615-2573
    Keywords: Endomyocardial biopsy ; Double nuclei ; Myocarditis ; Chronic right ventricular overloading
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary The incidence of double nuclei in myocarditis and in cases with right ventricular overloading (CRVO) was histopathologically assessed in a minimum of 100 longitudinally cut myocytes in specimens obtained at right ventricular endomyocardial biopsy. In myocarditis, the incidence of double nuclei was shown to be 5.8 ± 1.8 and in CRVO and in normal heart tissue it was seen in 3.0 ± 0.8 and 3.2 ± 0.9% (m±S.D.), respectively, of the population of myocytes. It is concluded that double nuclei result from either the activity or the reparative process of myocarditis and that it is not the expression of chronic right ventricular overloading. It is suggested that quantitative assessment of the frequency of double nuclei is an useful method in the interpretation of myocardial biopsy.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02066490
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  • 8
    Electronic Resource
    Electronic Resource
    Recent trends in cardiac sarcoidosis research in Japan (1985)
    Springer
    Heart and vessels 1 (1985), S. 45-49 
    Details
    ISSN: 1615-2573
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary Our recent survey of the Japanese literature, actual case experience, and previous studies revealed the following results. Fifty-three cases were reported in which the main cause of death in sarcoidosis was congestive heart failure (11 of 17 cases, 64.7%) and not sudden death as was previously believed. ECG analysis revealed that third degree AV block, bundle branch block, and ventricular arrhythmias were the most frequent findings indicating the presence of cardiac sarcoidosis. It was recognized that in the Japanese population fatal myocardial sarcoidosis or clinical diagnosed cardiac sarcoidosis occurred most frequently in females over the age of 40 years. It is suggested that myocardial changes progress independently of granulomatous changes. This is due to the detection of a high incidence of basal lamina layering of myocardial capillaries (14 of 18 cases, 77.8%) and is considered to play a significant role in the progression of this disease. Radionuclide studies showed that thallium scintigraphy or technetium ventriculography were positive in those cases where ECG abnormalities are prominent, indicating the presence of myocardial disease. Previous therapeutic studies of cardiac sacoidosis have shown a decrease in the incidence of sudden death; death due to congestive heart failure occurred more frequently despite pacemaker implantation. Control of congestive heart failure is thus regarded as the most important aspect of improved treatment and prognosis.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02072359
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  • 9
    Electronic Resource
    Electronic Resource
    A clinicopathologic study on a cause of idiopathic cardiomyopathy and arrhythmia and conduction disturbance employing endomyocardial biopsy (1985)
    Springer
    Heart and vessels 1 (1985), S. 159-164 
    Details
    ISSN: 1615-2573
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary A comparative study of right ventricular histopathologic findings and clinical profiles in 174 cases with hypertrophic cardiomyopathy (HCM), 145 cases with dilated cardiomyopathy (DCM), and 241 cases with idiopathic arrhythmia and/or conduction disturbance with significant myocardial pathology [Electric disturbance type of cardiomyopathy (ECM)], totaling 560 cases, was made in order to clarify the role of viral myocarditis in these conditions. Postmyocarditic change (PMC) was defined by assessing serial biopsy findings in nine cases with acute myocarditis. The PMC was observed in three cases with HCM (1.7%), 22 with DCM (15%), and 21 with ECM (8.7%). The incidence of PMC was significantly higher in DCM and ECM than in HCM (P〈0.001). The typical pattern of onset of acute myocarditis, i.e., high fever, upper respiratory infection, and gastrointestinal symptoms preceding cardiac symptoms within 10 days, was recognized in one case with HCM, eight with DCM, and 6 of 123 cases with ECM. The incidence was higher in DCM and ECM than in HCM (P 〈 0.05). Of 46 cases with PMC, 12 (26%) showed this pattern, on the other hand only 3 of 377 cases (0.8%) without PMC did so (P〈0.0001). Familial occurrence was not found in any of the 46 cases with PMC but was found in 38 of the 377 cases without PMC (P〈0.01). This study indicates that viral myocarditis may often be the causative agent of idiopathic cardiomyopathy, especially DCM and ECM. It is also noticed that familial occurrence of the cases with PMC was never seen.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02072384
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  • 10
    Electronic Resource
    Electronic Resource
    Ultrastructural features of the myocardium of children with dilated cardiomyopathy (1999)
    Springer
    Heart and vessels 14 (1999), S. 52-56 
    Details
    ISSN: 1615-2573
    Keywords: Endomyocardial biopsy ; Dilated cardiomyopathy ; Children ; Ultrastructure ; Basal lamina layering of capillary
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Summary We analyzed the electron-microscopic features of endomyocardial biopsy from pediatric patients with dilated cardiomyopathy (DCM). The specimens examined were taken from the right ventricle of ten patients aged from 2 to 15 years (mean 9.7 years). Biopsy specimens from eight patients with congenital heart disease (tetralogy of Fallot), aged from 3 to 12 (mean 7.3 years), and ten adult patients with DCM, aged from 32 to 60 (mean 45 years), were also examined. Patients considered to have endocardial fibroelastosis, arrhythmogenic right ventricular cardiomyopathy, specific cardiomyopathy, or coronary heart disease were excluded from this study. Specimens from pediatric patients with DCM showed various degrees of ultrastructural abnormalities of myocytes, including myofibrillar fragmentation, mitochondrial abnormalities, and intracellular edema. The ultrastructurally determined contractility failure index based on the severity of myocardial degeneration at the electronmicroscopic level was 4.9 ± 1.1. This value was significantly higher than that in patients with tetralogy of Fallot (0.9 ± 0.6,P 〈 0.001) but was not significantly different from that in adult patients with DCM (6.1 ± 2.6). The index of pediatric patients with DCM who died within 3 years was high (6.0 ± 0.8). Basal lamina layering of a capillary (BLL) in the myocardium was revealed in 1 of the 10 (10%) pediatric patients with DCM and in 6 of the 10 (60%) adult patients with DCM (P 〈 0.05). No BLL was noted in the patients with tetralogy of Fallot. These findings may be related to the pathogenesis of DCM in children and adults.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02481742
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