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  • 1
    Electronic Resource
    Electronic Resource
    Circadian Variation of Vasovagal Syncope (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 11 (2000), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Circadian Variation of Vasovagal Syncope. Introduction. Circadian patterns have been demonstrated for several cardiovascular catastrophes. Chronobiologic factors play a role in the emergence of vasovagal syncope (VVS); however, diurnal variation of syncopal episodes in VVS has not been reported previously.Methods and Results. We assessed daily distribution of the time of syncopal episodes in VVS. Time of syncope could be determined in 80 episodes in 54 patients (32 men and 22 women; mean age 37 years, range 12 to 67). Patients who were prescribed beta blockers or vasodilators, and who had syncopes related to alcohol intake, were excluded from the study. Head-up tilt testing was performed in 53 patients. The distribution of the episodes of VVS in 3-hour intervals differed significantly from uniform occurrence (P 〈 0.0001). with a peak frequency between 6 A.M. and noon (67.5% of total episodes). In patients who had experienced the initial syncope in the morning, most (78%) of the next syncopal episodes also occurred in the morning. There was no significant correlation between the time of last syncopes and tilt testing results.Conclusion. We demonstrated a prominent circadian variation in the frequency of VVS, with a peak in the morning. Recognition of the daily distribution of VVS is useful for patient education and therapeutic strategy. (J Cardiovasc Eleciroptiysiol. Vol. 11. pp. 1078-1080, October 2000)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.2000.tb01751.x
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  • 2
    Electronic Resource
    Electronic Resource
    Normal Values for Time-Domain, Frequency-Domain, and Spectral Turbulence Analyses of Signal-Averaged Electrocardiograms in Healthy Subjects (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of noninvasive electrocardiology 5 (2000), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Signal-averaged electrocardiograms (SAE) have mainly been studied in high risk patients with ischemic heart disease. A systemic study of the normal values and the comparative results using analytical methods has not been reported.Methods: We recorded SAE results in 200 apparently healthy subjects (100 males and 100 females, average age 28.9 years). The obtained signals were analyzed by for the time-domain (TD), frequencydomain (fast Fourier transform [FFT]), and spectral turbulence (ST) analyses. The normal values for these parameters, including differences according to gender, were evaluated. The correlation between body characteristics and individual measurements was also evaluated for each analytical method. Results were compared using previously reported criteria and gender-specific criteria.Results: The normal values for TD and FFT analyses, but not ST analysis, showed differences related to gender. A significant correlation was observed between the body characteristics noted in the TD and the FFT analyses, but this correlation was not seen for all parameters in the ST analysis. According to the conventional criteria, the rate of positive diagnosis was 9% for TD analysis, 4.5% for FFT analysis, and 2% for ST analysis. When gender-specific criteria were applied, it was 1% for TD analysis, 3.5% for FFT analysis, and 0.5% for ST analysis. However, the positive results for subjects that were found using TD analysis were discordant with the results found using FFT and ST analyses in those subjects.Conclusions: The normal values for TD and FFT analyses showed gender-related differences that were not seen using ST analysis. Gender-specific criteria are recommended when using TD analysis because it decreased positive results for healthy subjects. However, as discordant results were obtained among the various analyses, the selection of the method for analyzing the SAE and interpretation of the results should be performed with caution.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.2000.tb00379.x
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  • 3
    Electronic Resource
    Electronic Resource
    Dislodgment of an Atrial Screw-In Pacing Lead 10 Years After Implantation (2004)
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 27 (2004), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Dislodgment of an atrial screw-in pacing lead is quite rare. This report describes a rare case of an atrial screw-in lead dislodgment 10 years after implantation. Although it is an uncommon complication, very late dislodgment can occur postoperatively, and careful follow-up is necessary. (PACE 2004; 27:264–265)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2004.00425.x
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  • 4
    Electronic Resource
    Electronic Resource
    Runaway Pacemaker Caused by a Stuck Accelerometer (1999)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 22 (1999), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report a case of runaway pacemaker with a ventricular pacing rate of 190 beats/min. The runaway occurred when the accelerometer became stuck due to the magnet application during VVIR pacing. Runaways in modern pacemakers are particularly rare, but they do still occur. The best solution for this phenomenon is generator replacement.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1999.tb00487.x
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  • 5
    Electronic Resource
    Electronic Resource
    Does an Early Increase in Heart Rate During Tilting Predict the Results of Passive Tilt Testing? (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Pacing and clinical electrophysiology 23 (2000), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Head-up tilt testing is a useful but time-consuming procedure. If we could accurately predict the tilt testing results; we would be able to substantially shorten the duration of tilt protocol. To clarify the hypothesis that an early increase in heart rate (HR) during tilting can predict the passive tilt results in our protocol (80-degree angle for 30 minutes), we studied 115 consecutive patients (72 men, 43 women, mean age 46 ± 19 years) who were clinically diagnosed with neurally mediated syncope. Twentynine (25%) patients had a positive tilt test (P group), whereas 86 (75%) patients had a negative test (N group). The early HR increase was defined as the maximum HR during the first 5 minutes of tilting minus the resting HR before tilting. The early HR increase was significantly higher in the P group (23.8 ± 9.5 beats/min) than in the N group (17.5 ± 8.2 beats/min, P = 0.0008), but it was negatively correlated with the tilt duration to positive response (r =−0.52, P = 0.0032) and the patient age in the entire study population (r = 0.62, P 〈 0.0001). Results of multiple regression analysis indicated that age, tilt result, and tilt duration were independently associated with the early HR increase. As a result, an early HR increase ± 18 beats/min, the best apparent cut-off point obtained in our study, was a sensitive (100%) marker for prediction of a positive response at ± 15 minutes of tilting, but it showed a low specificity (61 %). In conclusion, an early HR increase during 80-degree tilting may be only predictive for a positive result ± 15 minutes because it depends on the tilt duration to a positive response and patient age.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2000.tb00774.x
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  • 6
    Electronic Resource
    Electronic Resource
    Paroxysmal Atrioventricular Block Induced During Head-Up Tilt Testing in an Apparently Healthy Man (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: Paroxysmal AV Block During HUT Testing. Introduction: Prolonged asystole during head-up tilt testing has been reported, but the occurrence of paroxysmal AV block appears to he rare. Methods and Results: A 25-year-old man with no history of syncope underwent head-up tilt testing. After 11 minutes of 80° tilting, he developed syncope with paroxysmal AV block and asystole lasting 10.5 seconds. However, this response was not reproduced during a subsequent tilt test 4 weeks later. Treadmill exercise testing and Holter monitoring showed no abnormalities. Power spectral analysis of heart rate variability revealed a marked increase in sympathetic activity several minutes before the induction of paroxysmal AV block. Conclusion: We report a case of paroxysmal AV block that occurred during head-up tilt testing but did not recur on a subsequent test in an apparently healthy young man.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.1997.tb00824.x
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