ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06683.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACTEndocardial transvenous pacemaker electrodes have been implanted in 246 patients owing to symptomatic bradycardia. The electrode was malplaced in the middle cardiac vein in 12 patients. All the patients were on stable ventricular pacing at the time of implantation. The electrodes were still in function in six patients after 5–96 months (average 55). The electrode was replaced in three patients owing to the occurrence of exit block. Three patients died during the period under study. Right‐sided bundle branch block (RBBB) configuration of paced QRS complexes was observed on the ECG when the electrode was malplaced in the middle cardiac vein. As RBBB only occurs with malplacement, the ECG can be employed to ensure correct positioning of the electr

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06684.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACTFifty patients with SA block have been treated with permanent pacing and followed up for 1–14 years. Survival after one, two, five and eight years was calculated to 94, 85, 64 and 48%, respectively. These figures indicate an excess yearly mortality in the first five years of 4–5% compared with a population of the same age and sex. Analysis of the survival curves shows that the excess mortality is caused by coexisting diseases, primarily coronary heart disease with previous myocardial infarction and valvular heart dise

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06685.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACTThe effects of lidoflazine on exercise tolerance have been tested during a double‐blind cross‐over trial in 14 male post‐infarction patients with a median age of 47 years (range 24–58). Each treatment phase lasted three months. Lidoflazine dosage was one 60 mg tablet t.i.d. At rest, significant decreases in diastolic blood pressure (DBP) and heart rate (HR) were noted during lidoflazine treatment. Bicycle ergometric tests revealed a significant increase in maximum work load and a significant decrease in the product HR × systolic BP at a 100 W work load during lidoflazine. No similar changes were recorded during placebo periods. Five patients were able to resume their professional activities whilst on lidoflazine, against only two on

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06686.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACTRenal function, measured as glomerular filtration rate (GFR), sodium excretion and osmolality after thirst, has been determined in untreated (n= 35) and treated (n= 22) hypertensives and in a reference group (n= 80), all derived from a random population sample of 50‐year‐old men. Renal function was related to casual and resting BP and to relative body weight. Hypertension was defined as SBP>175 or DBP>115 mmHg on two separate occasions or current antihypertensive treatment. Mean GFR was 100 ± 11.7 ml/min in the reference group and significantly lower, 94 ± 15.7 ml/min, in the hypertension group. In the hypertension group, 20% had a reduced GFR, although the standard diagnostic procedure, serum creatinine, demonstrated only 4%. Hypertensives with reduced GFR were characterized by higher BP, lower urinary sodium excretion, reversed diurnal rhythm of salt and water excretion and a higher relative body weight, which was, however, explained by the correlation of BP to relative body weight. GFR was negatively correlated to DBP at rest and positively correlated to urinary sodium excretion. Untreated hypertensives with persistent high BP after rest had lower GFR, lower urinary sodium excretion and reversed diurnal rhythm of salt and water excretion, indicating high renal resistance. The results suggest that subjects with relatively severe hypertension as judged by BP and renal function have an increased renal vascular resis

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06687.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACTSystolic time intervals (STI) have been measured in 50 individuals without heart disease. Electromechanical systole (QS2), left ventricular ejection time (LVET) and preejection period (PEP), but not PEP/LVET, were correlated to heart rate (HR). Regression equations were made and used when correcting STI for HR in two groups of patients: a) 51 patients with acute myocardial infarction (AMI) b) 22 patients with chest pains, but no AMI. STI was measured on the first 4 days, on the 7th day, on the day of discharge and at a control about 60 days later. In the AMI group there was a reduction in left ventricular performance from the 1st to the 4th day, and the difference in shortening of LVET was significant (p<0.001), while PEP and PEP/LVET increased from the 1st to the 3rd day (p<0.001). Between the AMI and the control groups there were significant differences (p<0.001) in LVET and PEP/LVET on the 3rd, 4th and 7th day, and in PEP on the 3rd and 4th day. STI was not found to separate clinical groups with heart failure of different severity. The survivors had a lover (p<0.05) PEP/LVET on the 1st day than those who died. The various localization of the infarction made no difference in STI. LVET was found to be strongly correlated (p<0.001) to the hydroxybutyric dehydrogenase values.

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06688.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACTAntiarrhythmic and hemodynamic effects of i.v. disopyramide phosphate (1.7 mg/kg b.wt. over 2 min) have been studied in nine patients, several in various degrees of cardiac decompensation, with sinus rhythm and persistent ventricular ectopic beats (VEBs). In one case with primary cardiomyopathy, with>30 VEBs/min, disopyramide (DE) abolished the arrhythmia for 30 min, but precipitated brief dyspnoea. Other side‐effects were tolerable and mainly attributable to anticholinergic effects of the drug. DE either abolished or significantly reduced the arrhythmia in all cases. For 30 min, only one patient showed VEBs, and in three patients no VEBs were seen for three hours. Changes in cardiac output and pulmonary artery (PAP) and central aortic pressures were measured in eight patients. Negative inotropic effects were indicated in seven by an increased diastolic PAP/stroke volume ratio and in seven by a decreased central aortic (dp/dt)max. Patients with high control values for diastolic PAP showed marked reductions in cardiac output, stroke volume and stroke work. In predicting myocardial depressant effects of DE, the control values for diastolic PAP seemed to be superior to central venous pressure, cardiac index and systolic time intervals. Mean arterial pressure measured 5 and 10 min after drug administration showed no significant change, indicating that vasoconstrictor reflexes were well preserved, and a pressure level significantly above the control value was reached from the 20th min. It is concluded that DE is potent in suppressing VEBs but exerts negative inotropic effects that may be of clinical importance. The optimal antiarrhythmic dose is probably lower than that used in the present stud

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06689.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACTA digital system for real‐time arrhythmia monitoring in the coronary care unit has been designed. The system is based on an algorithm for discrimination between normal complexes and ventricular ectopic beats (VBs). A beat is classified as normal if the absolute difference from a running average of the patient's normal QRS is below an adaptive threshold. To prevent artifacts and beats of non‐ventricular origin from being falsely interpreted as VBs, each abnormal beat is correlated with a typical VB waveform, incorporated into the program. A VB is recognized only when the correlation coefficient exceeds 0.8. In a performance study, ECGs from 15 patients were recorded on magnetic tape and replayed to the computer. Independent evaluation by two physicians showed a total of 1306 VBs, 94 % correctly classified by the computer. In the group labelled “suspected VBs” the detection rate was lower (average 69%). Out of the whole number of complexes (53 260), 0.45 % were falsely interpreted as VBs by the computer. Artifacts giving rise to false VBs are included in this figure. The causes of false positive and false negative VBs were thoroughly investigated and on the basis of these results, possible improvements in the system are di

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06690.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACTVentilatory and circulatory data from 20 patients suffering from chronic obstructive lung disease have been obtained before, during and after exercise at 600 kpm/min for 5 min on a bicycle ergometer. The patients had been given intravenously practolol, 15 mg, or saline alternatively, using a double‐blind cross‐over technique. A slight postexercise reduction of FEV1(8%) was noted after practolol medication as compared to placebo, with an accompanying decrease in PaCO2; PaO2did not differ substantially. No wheezing or inappropriate dyspnea attributable to the medication was noted in any of the patients. The well known β1‐blocking effects on the circulation were confirmed, with maintainedQand reduced HR, together with a lowered systemic BP during and after exercise. There was a significant positive relationship between the postexercise reduction of FEV, and the concomitant fall in HR. It is concluded that practolol in doses with near maximal circulatory effects had a slight, but clinically insignificant effect on the ventilatory para

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06691.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY

摘要:

ABSTRACTMetoprolol, a new selective adrenergic β1‐receptor blocking drug, has been compared to placebo in a series of 24 women who previously had taken alprenolol and propranolol during a cross‐over study. Blood pressure (BP) and heart rate (HR) were significantly reduced during metoprolol treatment compared to placebo. The occurrence of side‐effects was similar during treatment with metoprolol and placebo. After the cross‐over study the patients continued on metoprolol for more than two years, except for short periods on placebo or propranolol. During this follow‐up period BP remained at a similar level when the metoprolol dose was unchanged. Dose reduction (from SO or 100 mg t.i.d. to 50 or 100 mg b.i.d.) caused no, or only a very slight, increase in BP. No side‐effects were reported during long‐

ISSN:0001-6101    

DOI:10.1111/j.0954-6820.1976.tb06692.x

出版商:Blackwell Publishing Ltd    

年代:1976

数据来源: WILEY