ABSTRACT
The authors summarized the experience of the use of the stimulus and the activation mapping under fluoroscopic control to search for sources of ventricular ectopic followed by radio-frequency effects on the vulnerable zone arrhythmias. The authors presented an algorithm for finding a pathological focus on the basis of an evaluation of the surface electrocardiogram, followed by sequential endocardial mapping. The results of radiofrequency ablation of ventricular arrhythmia in different localization of the source are presented. The authors generalized and systematized the experience detection and cure of ventricular ectopy in 65 patients. The regularities of changes in the ventricular complex according to surface electrocardiogram in certain localizations of ectopic focus are revealed. Effectiveness of the operation of radiofrequency ablation with ventricular arrhythmias was about 90%, which is generally consistent with data from other clinics. Complications requiring additional interventions were not. Highlight the work areas of the endocardium, analysed the causes of inefficient operations and poor results. Alternative methods of destruction of the endocardium in complex localization of ectopic focus are suggested.
Subject(s)
Algorithms , Arrhythmias, Cardiac/physiopathology , Arrhythmias, Cardiac/therapy , Catheter Ablation/methods , Electrocardiography , Adult , Aged , Arrhythmias, Cardiac/diagnosis , Female , Humans , Male , Middle AgedABSTRACT
During the sleep person is in the state of antiorthostasis, this state provokes vascular cerebral abnormalities (night cerebral hypervolemia). The nature of encephalon blood supply is changing in this horizontal state, in the result there is lowering of hydrostatic blood pressure, rise of the encephalon blood supply and more difficult venous outflow. 60 patients with essential hypertension (1-2 phases) at the age of 64.2 +/- 1.8 years which were in the state of slightly raised upper segment of the head and body during night sleep were examined. By the method of the cerebral venous hemocirculation defined. Conclusion. Cerebral arterial blood flow of examined patients has increased by 25-30% during the sleep, the changes of arterial and cerebral venous hemocirculation have attended hypervolemia. Being in the state of upper (by 10-15 degrees) head of the bed decreases blood redistribution and decreases the extension of cerebral blood circulation's acute abnormalities.
Subject(s)
Brain/blood supply , Cerebral Arteries/physiopathology , Cerebrovascular Circulation , Hypertension/therapy , Hypokinesia/therapy , Sleep , Aged , Blood Flow Velocity , Brain/physiopathology , Female , Humans , Hypertension/physiopathology , Hypokinesia/physiopathology , Male , Middle AgedABSTRACT
Diagnosis of acute coronary syndrome (ACS) in elder patients encounters difficulty due to age-specific features of CHD resulting from a number of physiological and pathological changes associated with aging. This study was designed to analyse the structure of risk factors and clinical signs of ACS based on the examination of 176 patients of different age groups. It turned out that the number of risk factors and concomitant disorders grows with age. The occurrence and significance of certain risk factors (smoking, obesity) tends to change in the opposite direction. Old and very old patients show increased frequency of subtle and atypical forms of ACS. This together with variable ECG features on tribute to the difficulty of diagnosis.
Subject(s)
Acute Coronary Syndrome/diagnosis , Acute Coronary Syndrome/physiopathology , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Risk Factors , Sex FactorsABSTRACT
Neuroendocrine tumor consisting of pancreatic alpha-cells -- glucagonoma -- is a very rare finding (one case per two million people a year). This functionally active, usually malignant tumor has typical clinical manifestations. Glucagonoma syndrome is a disease that has an original clinical picture that includes necrolytic migrating erythema with secondary bullous dermatitis, glucose tolerance disorder or diabetes mellitus, weight loss, anemia, hypoaminoacidemia, venous thrombosis, and alimentary and mental disturbances. By the time diagnosis is made, 60 to 70% of glucagonomas already give metastases, and even small glucagonomas should be considered tumors with unknown malignant potential or malignant tumors. Glucagonomas grow slowly, and patients live long (the survival median is approximately 15 years). The authors describe their own observation.
