ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb05995.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT.1329 patients were discharged alive after acute myocardial infarction initially treated in a CCU. In a five‐year follow‐up, 537 (40%) of the patients died. Routine data registered uniformly during the CCU period showed that, apart from age, the most important factors regarding long‐term prognosis in general were previous ischaemic heart disease and direct or indirect signs of heart failure registered in the CCU. The possibilities to predict sudden death (130 patients died within 2 hours of onset of final symptoms during the follow‐up period) were small, although a definite dominance of this mode of death was noted in patients below 60 years of age. The clinical profile of the majority of the 134 patients who died during the first half‐year was distinguished by a history of prior myocardial infarction and signs of left heart failure during the CCU stay. However, in a significant number of patients dying early after discharge, none of the ordinary unfavourable prognostic signs had been r

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb05996.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT.The occurrence of rupture of the external cardiac wall (CR) in a consecutive series of 2 244 admissions with confirmed acute myocardial infarction (AMI) has been analysed. The series comprises the unselected admissions to a single department, evaluated according to uniform criteria, with postmortem examination in 95% of fatal cases. The incidence of CR was 3.2% af all cases of AMI, and 12.6% of all deaths. CR was significantly more frequent in women than in men, and in both sexes significantly more frequent after the age of 60, though the age distribution did not differ significantly from that of the patients dying from other causes. Moreover, CR was significantly more frequent in anterior wall infarctions, and in patients with no previous AMI. The majority of CR (84%) occurred within the first week, and a considerable part (32%) within the first 24 hours after the onset of infarction. According to findings at autopsy, CR was accompanied particularly often (in 71%) by complete occlusion of a major coronary artery. Autopsy findings gave no evidence that attempts at resuscitation, including external cardiac massage (65 patients), as well as intracardial injections (55 patients) and transthoracic introduction of a pace catheter (3 patients), could have any connection with the development of CR. The usual strict immobilization of the patients was applied during the first part of the series, but in the latter half (1 337 admissions) the patients were allowed to be out of bed from the first day with no imposed immobilization at all. The incidence of CR did not change significantly throughout the period, and the indication for maintaining the traditional immobilization of patients with AMI is questioned.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb05997.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT.The performance of an automated arrhythmia monitoring system has been studied with reference to asystole, ventricular fibrillation (VF) and ventricular tachycardia (VT) during two periods of routine monitoring. The system distinguished normal, supraventricular and ventricular ectopic beats with the use of rhythm and QRST data. VF was recognized from the power spectrum of the ECG. A total of 17 arrhythmia diagnoses (alarms) could be made by the system. A write‐out, with a delayed ECG and a diagnostic message in parallel, was recorded at each alarm. In the first part of the study a continuous ECG, used as a reference, was recorded from all patients in the coronary care unit during a 4‐week period. The number of manually recorded episodes of asystole, VF and VT was 24, 4 and 44, respectively. Out of these, 92, 100 and 82%, respectively, were reproduced on the alarm write‐outs. A correct diagnosis was made by the automated system in 33, 75 and 70% of true asystole, VF and VT events, respectively. Three false asystole alarms, all due to loose electrodes, were reported during this part of the study. In the second part of the study all arrhythmia write‐outs were analysed for six months for the occurrence of VF and VT alarms. Out of 22 episodes of VF, 73% were reported as VF and the remaining as VT. Of 534 VT episodes, 82% were diagnosed correctly. The proportions of correct: false positive VF and VT detections were approximately 1: 5 and 4: 1. Compared with conventional monitoring, the automated system seems to specifically improve the detection rat

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb05998.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT.Using the aVF lead, the ST segment deviation and the amplitudes of Q and R waves were measured hourly for 48 hours after the onset of symptoms in 14 patients with inferior AMI. The average ST deviation reaches a maximum elevation at about 3 hours and then falls to a uniform level within 12 hours. The average depth of the Q waves began to increase within the first 2 hours, and the increase was linear until around the 12th hour, whereafter the depth was somewhat uneven. The average height of the R waves declined almost linearly from the 3rd to 15th hour, after which the height became fairly uniform. Within a 48‐hour period after the onset of symptoms, there was a significant positive correlation not only between the average amplitudes of the Q and R waves (r= 0.951,p>0.001), but also between the courses of the individual Q and R waves in 13 of the 14 patients. A significant positive correlation was found between ST elevation at 3 hours and the reduction in the R wave within 24 hours (r= 0.634,p>0.05), but no correlation existed between ST elevation and the Q wave at these times. It is concluded that within 48 hours of the onset of symptoms, the magnitude of electrically inert myocardial tissue can be determined by the course of the Q or R waves, but that during the first 24 hours the R wave is superior to the Q wave for evaluating the evolution of the infarction proces

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb05999.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT.Six patients with Wolff‐Parkinson‐White (WPW) syndrome were given long‐term treatment with amiodarone. Symptomatic relief was obtained in all. Tolerance to the drug was good. Reversible corneal changes appeared after some weeks' treatment in five patients. No thyroid side‐effects were noticed. Prior to treatment, dual atrioventricular (AV) conduction was demonstrated on His bundle electrograms in all six patients. Recordings were made at varied heart rates, using atrial and ventricular pacing. Reciprocating tachycardia was readily provoked by properly timed extra stimuli in all patients. When amiodarone treatment had become clinically effective, a second comparative study was made in four patients after 26–85 days' treatment. Amiodarone reduced heart rate and second degree AV block appeared at a lower atrial pacing rate. It increased the refractory periods of right atrium, AV node, and the accessory pathway in proportion to the duration of treatment. Induction of tachycardia was effectively prevented by the drug. It appears that amiodarone in chronic treatment has a predictable and unique depressant action on cardiac conduction, supporting the opinion that this compound, despite side‐effects, has an important role to play in the treatment of refractory arrhythmias in patients with the W

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb06000.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT.In patients with chronic atrial fibrillation (AF), symptoms and cardiac function may be improved by regularizing the ventricular rhythm, even though the AF persists. This study concerned effects of i.v. and oral verapamil (V) on ventricular regularity. A regularizing effect was observed in 5 out of 10 patients after 0.15 mg of V/kg b.wt. i.v., but in only one patient after 80 mg of V by mouth. V in a dose of 240 mg by mouth resulted in ventricular regularity in 6 out of 10 other patients, 320 mg in a further 2 and 400 mg in the remaining 2 patients. Six patients were given chronic oral therapy in progressively increasing doses. Although ventricular regularity and symptom relief were obtained, intolerable side‐effects precluded the evaluation of subjective long‐term effects of this therapy in all but one patient. Further investigations, particularly concerning the pharmacokinetic mechanisms of V, are needed before the treatment can be recommended for patients with chronic

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb06001.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT.Increasing amounts of Digoxin, Lasix®, Teofyllamin and CI‐775 were added to human blood in vitro and the whole blood oxygen affinity was measured. We found no definite proof that any of the drugs was able to affect the oxygen affinity of the red cells even at unphysiologically high concentratio

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb06002.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT.A new sustained release preparation (Lipettes®) of quinidine has been evaluated with regard to dissolution, absorption, serum concentration and side‐effects. The serum levels of quinidine after single oral doses and after long‐term treatment have been compared with the serum levels after administration of some other quinidine preparations on the Swedish market. The side‐effects of the sustained release preparations have also been studied. Results indicated that this new sustained release quinidine preparation yields more even serum concentrations of quinidine and seemed to cause less troublesome side‐effects than the marketed prep

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb06003.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY

摘要:

ABSTRACT.During the last four years we have used a new cardioselective β‐adrenergic blocking substance, ICI 66.082 (atenolol or Tenormin®), alone or in combination with other drugs for treatment of hypertension in a total of 104 patients, including 15 with a chronic obstructive lung disease. Fifty‐one patients started treatment with atenolol because of side‐effects—especially from the central nervous system—during previous treatment with non‐selective β‐blockers, mostly propranolol (Inderal®). Mean duration of treatment was 16 months (range 8–36) and mean dosage 163 mg/day. In 18 patients treatment with Tenormin was withdrawn, but only in 10 of them could this be referred to side‐effects. Of the 51 patients who complained of or showed sideeffects from another β‐blocker, 80% were improved after changing to Tenormin. Of the patients with side‐effects from the central nervous system, 73% improved, especially those who complained of nightmares, hallucinations, i

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1979.tb06004.x

出版商:Blackwell Publishing Ltd    

年代:1979

数据来源: WILEY