ABSTRACT
The Twiddler's syndrome is characterized by the migration of pacemaker's leads due to rotation of the pulse generator. In our case, ventricular leads coiled in the upper side of the right atrium with stimulation of pectoralis major muscle during left decubitus lateralis position.
Subject(s)
Foreign-Body Migration/diagnosis , Pacemaker, Artificial/adverse effects , Aged , Arrhythmias, Cardiac/surgery , Equipment Failure , Humans , MaleSubject(s)
Cardiomyopathy, Dilated/surgery , Heart Transplantation , Heart-Assist Devices , Ventricular Dysfunction, Right/therapy , Cardiomyopathy, Dilated/physiopathology , Humans , Male , Middle Aged , Ventricular Dysfunction, Right/physiopathology , Ventricular Function, Left , Ventricular Function, RightABSTRACT
Percutaneous coronary angioplasty (PTCA) nowadays appears as an attractive alternative to coronary artery by-pass grafting not only in young adults, but also in elderly patients. The aim of this study was to investigate the primary success, complications and long-term efficacy of PTCA in a consecutive series of 63 patients aged 70 years or over. Results are analysed in comparison to a younger group of 423 subjects who were submitted to PTCA during the same period of time. In the older group, PTCA was applied to 108 lesions. The angiographic success rate was 88%. Primary success was 87%, with a majority (91%) of complete revascularization. Failure of the procedure was recorded in eight patients (13%). Complications of PTCA were observed in three patients, (among these: one death). The outcome was excellent: out of 55 patients with successful angioplasty, 52 (94.6%) were asymptomatic at the time of hospital discharge. At follow-up (close to one year), 84.6% of the patients remained asymptomatic. The comparison with the younger group of patients showed no difference in terms of primary success, failure rate or incidence of complications. We therefore conclude that PTCA can be performed with safety and efficiency in patients aged 70 years or over.
Subject(s)
Angioplasty, Balloon, Coronary , Age Factors , Aged , Aged, 80 and over , Female , Follow-Up Studies , Humans , Male , Postoperative Complications/epidemiology , Retrospective Studies , Time Factors , Treatment OutcomeSubject(s)
Coronary Disease/therapy , Coronary Vessels , Stents , Aged , Aged, 80 and over , Humans , Prosthesis DesignSubject(s)
Atrial Flutter/therapy , Cardiac Pacing, Artificial/methods , Aged , Female , Humans , Male , Middle Aged , Time FactorsABSTRACT
Two preparations of dipyridamole have been studied by oral administration to 11 normal volunteers. The plasma levels of dipyridamole and its glucuronide were determined simultaneously by high performance liquid chromatography. The instant form (I.F., 100 mg) was administered four times daily and the slow release preparation (SRP, 200 mg) twice daily, for 3 days. Multiple blood samples were collected on Days 1-4 to provide plasma for assay, and simultaneously, platelet rich plasma was prepared for ex vivo study of the effect of dipyridamole on platelet uptake of adenosine. The pharmacokinetics of absorption and distribution of dipyridamole were described using a two compartment model with lag time and prolonged absorption. Strong inhibition of the platelet adenosine uptake was observed at therapeutic plasma levels. The inhibition of platelet adenosine uptake may be related to some of the pharmacological properties of dipyridamole.
