ABSTRACT
For several decades, highly refined cardiac implantable electronic devices (CIED) are used to prevent and manage various types of cardiac pathology, which have saved the lives of many patients. Cardiac implantable electronic devices help maintain and improve the quality of life by regulating the heart rate, terminating life-threatening arrhythmias, and improving systolic function, including pacemakers, implantable cardioverter defibrillators, and cardiac resynchronization therapy devices. Regardless of the benefits received after its implantation, in some cases, serious complication has appeared, such as CIED infections, associated with severe morbidity, mortality, financial expenses and changes in the quality of life. Exactly, in this article will be addressed the issues of prevention, diagnosis, and treatment of this condition, which will help specialists to properly assess the problem and to find a way to effectively solve it.
Subject(s)
Defibrillators, Implantable , Pacemaker, Artificial , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/prevention & control , Cardiac Resynchronization Therapy Devices , Electronics , Humans , Quality of LifeABSTRACT
A 55-year-old man, with no previous history, presented with extreme fatigue and fever and was admitted to hospital. He had progressive renal dysfunction and his serum anti-neutrophil cytoplasmic antibodies (ANCA) were markedly elevated. Renal histology was consistent with ANCA-associated vasculitis. The patient was successfully treated with cyclophosphamide and prednisolone. The classification and management of the ANCA-associated vasculitides are described. The classification was guided by the clinical presentation, serology and results of tissue biopsies. The ANCA inflammation had affected the middle sized and small vessels of especially the upper and lower airways, and the kidneys. The antibodies were directed at proteinase-3 (PR3) or myeloperoxidase (MPO). PR3-ANCA is predominantly found in Wegener's granulomatosis, while MPO-ANCA is related to microscopic polyangiitis. Tissue studies showed granulomatous inflammation of the airways which is typical of Wegener's disease. This type of inflammation is absent in microscopic polyangiitis. The initial treatment schedule consists of prednisone 1 mg/kg daily and oral cyclophosphamide 2 mg/kg daily. In the remission phase, the cyclophosphamide is replaced by azathioprine. It is not yet known how long maintenance treatment should be continued and which parameters have prognostic value.
Subject(s)
Antibodies, Antineutrophil Cytoplasmic/blood , Immunologic Factors/therapeutic use , Kidney Diseases/diagnosis , Vasculitis/diagnosis , Azathioprine/therapeutic use , Cyclophosphamide/therapeutic use , Drug Therapy, Combination , Humans , Kidney Diseases/drug therapy , Male , Middle Aged , Prednisolone/therapeutic use , Remission Induction , Severity of Illness Index , Treatment Outcome , Vasculitis/drug therapyABSTRACT
The main functional characteristics of the left ventricle (LV) were defined using a method of multiphase radiopaque left ventriculography. Three groups of indices of LV function (energetic LV indices, indices of chamber diastolic function, and indices of local motion of the LV walls in the course of a complete cardiocycle) were standardized in healthy persons. An original algorithm of analysis of local LV myocardial contractility was used. A combined approach to interpretation of results of this method was worked out. A standard set of indices, reflecting LV function, was defined. Standardized values of these indices, necessary for an effective use of this method, were obtained.
Subject(s)
Diatrizoate Meglumine , Gated Blood-Pool Imaging , Ventricular Function, Left/physiology , Adult , Female , Humans , Male , Middle Aged , Reference ValuesSubject(s)
Coronary Circulation/drug effects , Coronary Vessels/drug effects , Myocardial Infarction/drug therapy , Streptokinase/therapeutic use , Thrombolytic Therapy , Ventricular Function, Left/drug effects , Age Factors , Aged , Coronary Circulation/physiology , Coronary Vessels/physiopathology , Female , Humans , Male , Middle Aged , Myocardial Infarction/physiopathology , Ventricular Function, Left/physiologyABSTRACT
The effect of Ritmilen and allapinin, a new Soviet antiarrhythmic drug, on hemodynamics and myocardial contractility were evaluated in 36 patients with various heart rhythm disorders during diagnostic coronary angiography. Ritmilen has been shown to have an essential cardiodepressive effect. An intravenous 150 mg dose of Ritmilen results in a depression of dp/dtmax, Veragut's index, ejection fraction, mean standard circular fibre shortening rate, and increase in left ventricular systolic and end diastolic pressure, total peripheral resistance and mean arterial blood pressure. Allapinin (30 mg) has no marked cardiodepressive effect, as compared to Ritmilen.
Subject(s)
Aconitine/analogs & derivatives , Anti-Arrhythmia Agents/therapeutic use , Arrhythmias, Cardiac/drug therapy , Disopyramide/therapeutic use , Hemodynamics/drug effects , Myocardial Contraction/drug effects , Adult , Arrhythmias, Cardiac/diagnosis , Arrhythmias, Cardiac/physiopathology , Depression, Chemical , Drug Evaluation , Female , Humans , Male , Middle AgedABSTRACT
A patient aged 42 with the aortic valve prosthesis was examined with the help of coronography and ultrasonic scanning of the heart in the period of ischemic injury of the anterior myocardium: occlusion of the unchanged anterior descending artery by an embolus formed on the artificial cardiac valve was revealed. Despite rapid recovery of arterial permeability (3 h 47 min, after the onset of disease) by intracoronary administration of streptase with subsequent anticoagulant and antiplatelet drug therapy the patient developed anterior myocardial infarction with left ventricular aneurysm and intracardiac thrombosis.
