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  • 1
    Electronic Resource
    Electronic Resource
    Ventricular Arrhythmias in Apparently Healthy Subjects (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: While it is assumed that the normal heart does not predispose to serious arrhyilimias, several conditions are now being recognized as being associated with short-lasting ventricular arrhythmias. It also becomes clear that idiopathic VT (or repetitive monomorphic VT) sometimes exists on the background of a compromised heart. Whether this dysfunction is due to the arrhythmia or vice versa is not evident. Finally, VF occurs in patients who, at a first glance, have no apparent heart disease, and it is then called idiopathic VF. These complex electrical abnormalities probably reflect disorders, which often are genetically determined. Recognition of these syndromes, often characterized by abnormal repolarization or a disturbed autonomic function is possible if appropriate techniques are used.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1997.tb06118.x
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  • 2
    Electronic Resource
    Electronic Resource
    Fracture of a Circular Mapping Catheter After Entrapment in the Mitral Valve Apparatus During Segmental Pulmonary Vein Isolation (2003)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Futura Publishing, Inc.
    Pacing and clinical electrophysiology 26 (2003), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: We report on the entrapment of a circular mapping catheter in the mitral valve apparatus during segmental pulmonary vein isolation. In an attempt to remove the catheter by using mild traction in combination with clockwise and counter-clockwise rotation, the circular part and the shaft of the catheter separated. The circular part could be removed without sequelae using a transseptally positioned vascular extraction nipper in combination with a basket catheter. (PACE 2003; 26:1774–1775)
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1460-9592.2003.t01-1-00268.x
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  • 3
    Electronic Resource
    Electronic Resource
    Use of an Implantable Cardioverter Defibrillator in a Patient with Two Implanted Neurostimulators for Severe Parkinson's Disease (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: We report a patient with Parkinson's disease treated with two pectorally implanted neurostimulators (NSs) who presented with a life-threatening ventricular tachyarrhythmia in whom an abdominal ICD was implanted. Testing during implantation showed that the NS did not affect the bipolar sensing of the ICD. even when the NSs were set at a frequency of 130 pulses/s with an output of 5 V and pulse width of 0.21 ms in a bipolar and a unipolar configuration. The ICD shock, however, did affect both NSs: there was a reset to the output Off state and there was a reset of the electrode polarities.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2000.tb00899.x
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  • 4
    Electronic Resource
    Electronic Resource
    Factors Influencing Long Term Persistence of Sinus Rhythm After a First Electrical Cardioversion for Atrial Fibrillation (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: It is conventionally thought that electrical cardioversion in patients with atrial fibrillation (AF) of longstanding duration or with a large lefi atrial diameter, only seldom results in long term success. Recurrence is common, although antiarrhythmic drugs often effectively decrease the number and duration of recurrent AF episodes. We analysed clinical, functional and pharmacological variables which could possibly infiuence the long term outcome after a first electrical cardioversion for AF in a retrospective study on 85 patients. Univariate and multivariate analysis was used to identify factors predicting maintenance of sinus rhythm at 100 days, and absence of recurrence during the entire follow-up. In univariate analysis, the only significant predictor for maintenance of sinus rhythm at 100 days was the duration of the preceding AF episode. Multivariate analysis with persistence of sinus rhythm at 100 days as endpoint confirmed this as a prognostic factor (p 〈0.03), but sotalol treatment also contributed to maintenance of sinus rhythm (p 〈0.05). When considering ihe entire observation period, class III antiarrhythmic drugs, i.e. sotalol ami amiodarone, were useful in preventing recurrence (p 〈0.01 and 〈 0.02). High age (above 75 years) was a predictor of recurrence. In conclusion, class III antiarrhythmic drugs, the duration of atrial fibrillation and high age were the most important determirumts of long term outcome, while echocardiographic parameters and the presence of heart disease played no role.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.1998.tb01105.x
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  • 5
    Electronic Resource
    Electronic Resource
    Cardiac Effects of Chronic Oral Beta-Blockade: (2002)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of noninvasive electrocardiology 7 (2002), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Although well established on the sinus node, the effects of beta-blockade on ventricular repolarization are still conflicting. The aim of the study was to investigate the effects of a chronic beta-blockade on sinus node and repolarization parameters and their relationship.Methods: Sixteen healthy volunteers (10 males, mean age: 40 ± 6.7 years) were randomized to placebo or atenolol (100 mg). After 7 days, subjects were crossed over. Heart rate (HR) and HRV indices were calculated from long-term ECG recordings separately during the day and at night, together with ventricular repolarization parameters (QT interval duration and QT rate-dependence).Results: Mean R-R intervals were significantly and consistently increased after atenolol (Day: 916 ± 103 ms vs. 712 ± 89 ms, and Night: 1149 ± 93 vs. 996 ± 125 ms). HRV changes under atenolol were also consistent, with a significant decrease in sympathovagal ratio. In contrast, atenolol only lowered diurnal QT rate-dependence (0.123 ± 0.032 vs. 0.190 ± 0.065 on placebo, P 〈 0.001), but not the nocturnal pattern. After multivariate analysis QT rate-dependence changes induced by atenolol were correlated with pretreatment QT/RR relation (r = 0.65, P 〈 0.01) but not with any HR or HRV parameters.Conclusions: In healthy subjects, repolarization changes following chronic beta-blockade cannot be predicted by HR or HRV changes, but are dependent on pretreatment rate-dependence. A.N.E. 2002;7(4):379–388
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.2002.tb00189.x
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  • 6
    Electronic Resource
    Electronic Resource
    Limited Benefit of Septal Pre-Excitation in Pace Prevention of Atrial Fibrillation (2005)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 16 (2005), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: Pre-excitation of the intra-atrial septum (IAS) by pacing at the ostium of the coronary sinus (CSO) can prevent atrial fibrillation (AF) in case of single atrial premature beats (APBs). We investigated whether pre-excitation of IAS, either by pacing at CSO or at the right ventricle in the presence of retrograde conduction (RV), can prevent atrial tachyarrhythmia triggered by single and multiple APBs. AF vulnerability was compared to pacing at the right atrium (RA) and sinus rhythm (SR). Methods: Seventeen patients, age 52 ± 21 years, who exhibited retrograde VA conduction and reproducible induction of atrial tachyarrhythmia during an electrophysiological procedure, were studied. Both during SR and pacing (S1-S1:600 ms) at RA, CSO, and right ventricle (RV), single (A1-S2:200 ms) and multiple premature stimuli (A1-S2-S3-S4:200–180–180 ms) were delivered at RA (4 × diastolic threshold). Results: During pacing at RA, single and multiple APBs invariably induced runs of atrial tachyarrhythmia (mean duration 34 ± 67 sec and 37 ± 69 sec, range 1 sec to 20 min). During preventive pacing at CSO and RV, single APBs (A1-S2:200 ms) did not induce atrial arrhythmia (0 ± 0 sec, 0 ± 0 sec, P 〈 0.05 vs pacing at RA). In contrast, when multiple APBs were applied, pacing at CSO or RV failed to prevent initiation of AF (mean duration 36 ± 63 sec, 38 ± 65 sec, NS). Also during SR, single APBs did not induce AF (0 ± 0 sec, P 〈 0.05 vs pacing at RA) whereas multiple APBs invariably induced AF (39 ± 74 sec, NS). Conclusions: Compared to pacing at RA, pre-excitation of IAS either by pacing at CSO or at RV with retrograde conduction can prevent initiation of paroxysms of atrial tachyarrhythmia triggered by single but not by multiple right APBs. These findings imply that the potential benefit of choosing an optimal pacing site in patients requiring atrial-based pacing is limited. Moreover, in the absence of bradycardia, no specific pacing site offers incremental benefit over the natural “protective” effect of sinus rhythm.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2005.40435.x
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  • 7
    Electronic Resource
    Electronic Resource
    Variable Atrioventricular Block During Atrial Flutter: What is the Mechanism? (2002)
    Oxford, UK : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 13 (2002), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2002.00950.x
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  • 8
    Electronic Resource
    Electronic Resource
    Infarct size and recurrence of ventricular arrhythmias after defibrillator implantation (2000)
    Springer
    European journal of nuclear medicine 27 (2000), S. 807-815 
    Details
    ISSN: 1619-7089
    Keywords: Key words: Arrhythmias ; Imaging ; Tomography ; Infarct size ; Defibrillator
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Notes: Abstract. Infarct size as determined by perfusion imaging is an independent predictor of mortality after implantable cardioverter defibrillator (ICD) implantation in patients with coronary artery disease (CAD) and life-threatening ventricular arrhythmias (VA). However, its value as a predictor of VA recurrence and hospitalisation after ICD implantation is unknown. Therefore, the objective of this study was to evaluate whether infarct size as determined by perfusion imaging can help to identify patients who are at high risk for recurrence of VA and hospitalisation after ICD implantation.We studied 56 patients with CAD and life-threatening VA. Before ICD implantation, all patients underwent a uniform study protocol including a thallium-201 stress-redistribution perfusion study. A defect score as a measurement of infarct size was calculated using a 17-segment 5-point scoring system. Study endpoints during follow-up were documented episodes of appropriate anti-tachycardia pacing and/or shocks for VA and cardiac hospitalisation for electrical storm (defined as three or more appropriate ICD interventions within 24 h), heart failure or angina. After a mean follow-up of 470±308 days, 22 patients (39%) had recurrences of VA. In univariate analysis, predictors for recurrence were: (a) ventricular tachycardia (VT) as the initial presenting arrhythmia (86% vs 59% for patients without ICD therapy, P=0.04), (b) treatment with β-blockers (36% vs 68%, P=0.03) and (c) a defect score (DS) ≥20 (64% vs 32%, P=0.03). In multivariate analysis, VT as the presenting arrhythmia (χ2=5.51, P=0.02) and a DS ≥20 (χ2=4.22, P=0.04) remained independent predictors. Cardiac hospitalisation was more frequent in patients with a DS ≥20 (44% vs 13% for patients with DS 〈20, P=0.015) and this was particularly due to more frequent hospitalisations for electrical storm (24% vs 3% for patients with DS〈20, P=0.037). The extent of scarring determined by perfusion imaging can separate patients with CAD into high- and low-risk groups for recurrence of VA and cardiac hospitalisation after ICD implantation.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s002590000261
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