ABSTRACT
RESUMEN Se presenta el caso de una paciente de 84 años de edad, con antecedentes de hipertensión arterial, dislipemia, insuficiencia venosa crónica y osteoartrosis, que -debido a una neuralgia del trigémino- había recibido tratamiento con varios fármacos, sin lograr control del dolor neuropático, por lo que se inició tratamiento con lacosamida en monoterapia, con incremento de dosis hasta lograr el objetivo terapéutico; pero la paciente presentó manifestaciones clínicas y alteraciones electrocardiográficas compatibles con disfunción sinusal, que se resolvieron tras la reducción de la dosis del fármaco.
ABSTRACT The case of an 84-year-old female patient is presented, with a history of high blood pressure, dyslipidemia, chronic venous failure and osteoarthritis, which -due to trigeminal neuralgia- had received treatment with several drugs, without achieving neuropathic pain control; that was why the treatment with lacosamide was started in monotherapy, with an increase in dose until the therapeutic objective was achieved; but the patient presented clinical manifestations and electrocardiographic alterations compatible with sinus dysfunction, which were solved after reducing the dose of the drug.
Subject(s)
Heart Rate Determination , Long Term Adverse Effects , Lacosamide , AnticonvulsantsABSTRACT
Approximately 30 indices have been proposed for assessing heart rate variability (HRV). Some are mathematically identical or very closely related to each other, and results can be interpreted from completely different viewpoints. Comparing various indices from a tachogram, and combining statistical significance with physiological plausibility could improve the result's interpretation. Using the KubiosHRV package, we studied the chi-meditation R-R database available at Physionet.org, addressing the following questions: i) Which HRV indices are the most suitable for describing meditation effects? ii) Are the effects of meditation beneficial, harmful or insubstantial? iii) Which are the most likely physiological events associated to meditation? It was concluded that power spectrum low frequency component (LF), LF/HF ratio, and nonlinear indices α 1 and α 2, recurrence rate and Shannon entropy performed the best (p<0.05). Observed changes suggest that they harmonize with changes observed in other health-pursuing circumstances as physical training, stress combating; whereas they are in the opposite tendency of changes associated to aging, heavy smoking, high blood glucose levels, autonomic heart denervation and congestive heart failure. Changes induced by chi meditation seem to be associated to increases in respiratory component around0.04 Hz, lower entropy and reduced long-term correlation with higher cardio vascular complexity(AU)
Alrededor de 30 índices han sido propuestos para evaluar la Variabilidad de la Frecuencia Cardiaca. Algunos de esos índices son matemáticamente idénticos o muy semejantes a otros y los resultados pueden ser interpretados desde puntos de vista completamente distintos. Al comparar varios índices estimados a partir de un tacograma y combinando la significación estadística con la plausibilidad biológica pudiera mejorarse la interpretación de los resultados. Utilizando el paquete de análisis KubiosHRV estudiamos la base de datos de señales R-R Chi meditation, disponible en el portal Physionet.org, centrándonos en las interrogantes siguientes: i) ¿cuáles índices son los más adecuados para describir los efectos de la meditación? ii) ¿son los efectos de la meditación beneficiosos, nocivos o insustanciales? iii) ¿cuáles son los eventos fisiológicos asociados a la meditación? Se concluye que el componente de baja frecuencia del espectro de potencia (LF), la relación LF/HF y los índices no lineales α 1 yα 2, la razón de recurrencia y la entropía de Shannon, fueron los indicadores más apropiados (p < 0.05). Los cambios observados parecen armonizar con cambios observados en otras acciones promotoras de salud como entrenamiento físico, combatir el estrés, mientras que exhiben una tendencia opuesta a los cambios asociados al envejecimiento, hábito de fumar, elevados niveles de glucosa, denervación cardiaca, e insuficiencia cardiaca congestiva. Los cambios inducidos por la meditación chi parecen estar asociados a incrementos en el componente respiratorio próximo a los 0.04 hertzios, a una menor entropía y una menor correlación a largo término combinadas a una mayor complejidad cardiovascular(AU)
Subject(s)
Humans , Male , Female , Meditation/methods , Heart Rate Determination/methodsABSTRACT
Objective To evaluate the curative effect of coenzyme complex and potassium magnesium aspartate on the restoration of rhythm and anti-arrhythmia in postoperative valve replacement patients for rheumatic heart disease.Methods Eight two patients with rheumatic heart disease were randomized into 2 groups,with no statistical significance in the patients' parameters.Treatment group A (n =41 )received i.v.coenzyme complex and potassium magnesium aspartate 30 ml during operation.Group B ( n =41 ) were only given potassium magnesium aspartate 30 ml.Other conventional therapies were the same for the two groups.At the same time,rate of spontaneous restoration of rhythm and severe arrhythmia incidences and low cardiac output syndrome were also recorded.Results The rate of spontaneous restoration of rhythm in the treatment group were higher than that in the control group ( 97.56％ vs 80.49％,x2 =6.12,P =0.01 ).There were significant differences in the severe ventricular tachycardia,ventricle fibrillation and auricular flutter events between the 2 groups ( 19.51％ vs 41.46％,x2 =4.67,P =0.03 ).The rate of low cardiac output in the treatment group were lower than that in the control group( 14.63％ vs 36.58％.x2 =5.18,P =0.02).To evaluate the effect of combination therapy on the spontaneous restoration of rhythm,Logistic regression analysis showed that OR( odds ratio) value was 9.69 and 95％ CI( confidence interval) was 1.15 - 81.55 ( P =0.03 ).Other variables affecting the spontaneous restoration of rhythm included the time of aortic obstruction( OR =9.28,95％ CI 1.21 - 78.18,P =0.02) and cardiac function before operation ( OR =4.95,95％ CI 1.27 - 17.88,P =0.02),operating time (OR=3.99,95％CI 1.18- 11.62,P =0.04),age(OR=2.77,95％CI1.11 -9.74,P=0.04).Conclusion Combined administration of coenzyme complex and potassium and magnesium aspartate in the operation of valve replacement in patients with rheumatic heart disease is able to promote the spontaneous heart rhythm restoration and reduce the chance of severe ventricular tachycardia and low cardiac output events.
ABSTRACT
A study was performed on 82 cases, among which, 50% with fast heart rhythm disorders at Quang An Hospital. Results: The most common risk factors included: exhausted or moved activities. Fast heart rhythm disorders were more common in patients with hypertension and heart valvular disease. Common symptoms included: headache, dyspnea. More severe symptoms: unconsciousness, convulsion, enuresis, systolic blood pressures < 90 mmHg. There were 13.41% of cases could not cut off fast heart rhythm disorder, left the hospital within 24 hours with death prognosis.
Subject(s)
Arrhythmias, Cardiac , Diagnosis , TherapeuticsABSTRACT
The temporary making of heart rhythm emergency in 19 patients at Hai Phong Viet Tiep Hospital from 4/1997 to 11/2002, 10 males and 9 females, average age was 57.10 ± 21.16. Cause: bloc A-V degree III was 63.16%, in which cardiac infarct was 31.58%, sinus node deficiency syndrome was 31.58%. Clinical symptoms: senseless 57.89%, dizzy 37.84%, Adams-Stokes crisis 21.05%, hypotensive and pressure equal zero was 42.10%, mean ventricle frequency was 40.46 ± 11.97 CK/minute, left heart failure 26.31%. 100% machine use have good result. Immediately after machine use: stable pressure, faint sign and Adams-Stokes crisis disappeard. Mortality rate was 0%