ABSTRACT
Data of analysis of the clinical course of a natural phenomenon of short PQ interval in 300 children are presented. During the period.
Subject(s)
Heart Rate , Tachycardia, Reciprocating , Adolescent , Child , Child, Preschool , Electrocardiography , Female , Heart Conduction System , Humans , MaleABSTRACT
Results of long term clinic-electrophysiological follow-up of a large group of children with Wolf-Parkinson-White (WPW) phenomenon are present. From 1993 to 2011 we examined 176 children - 117 boys (66,5%) and 59 girls (33,5%) - with manifesting type of WPW. Age at first examination was 12.5+/-3.2 ( 0.1 18 ). In 66.5% of children WPW phenomenon was present in the age from 10 to 18 . Hundred fifty nine children (104 [65.4%] boys and 55 [34.6%] girls) were followed up for 0.5-17 years (mean 7.4+/-4.5 years). During follow-up spontaneous attacs of atrioventricular reciprocal tachycardia appeared in 13 children (8.2%, 95% confidence interval [CI] 4.4-13.6%). Spontaneous disappearance of signs of ventricular pre-excitation on electrocardiogram and transition to intermittent form of WPW were registered in 14(8.8%, 95%CI 4.9-14.3%) and 12 children (7.5%, 95% CI 3.9-12.8%). Short lasting syncopal states were observed in 15 children (8.4%). In 3 of them atrial fibrillation with high rate of venricular rhytm was induced during transesophageal electrophysiological study. Two (1.3%) children had history of clinical death. In one of them WPW phenomenon was combined with hypertrophic cardiomyopathy and polymorphic ventricular tachycardia. This child died at the age of 11 years. One (0.6%) boy with WPW phenomenon died suddenly in 3 years after initial examination. Thus, children with WPW phenomenon are at risk of development of life threatening states and sudden cardiac death. Stratification of risk of sudden death is necessary at examination of such children.
Subject(s)
Death, Sudden, Cardiac/epidemiology , Wolff-Parkinson-White Syndrome/diagnosis , Wolff-Parkinson-White Syndrome/mortality , Adolescent , Adult , Causality , Cause of Death , Child , Comorbidity , Female , Follow-Up Studies , Humans , Male , Risk Assessment , Russia/epidemiology , Young AdultSubject(s)
Heart Block/therapy , Pacemaker, Artificial , Adult , Female , Heart Block/psychology , Humans , Quality of LifeABSTRACT
The paper gives recommendations for cardiologists and cardiac surgeons who are engaged in working out indications, choice of the type and mode of cardiac pacing. Based on the understanding of the great importance of nomenclature documents concerning the development of indications for pacemakers implantation, the Working Group of the Expert Committee, Ministry of Health of the Russian Federation and Russian Academy of Medical Sciences, for implantable antiarrhythmic devices and electrophysiology has developed recommendations on pacemaker implantation in acquired atrioventricular (AV) block, in AV-block after myocardial infarction, chronic bi- and tri-fascicular block, sinoatrial nodal dysfunction, hypersensitive carotid sinus syndrome, neurovascular syndromes, as well as in childhood bradyarrhythmias. In developing the recommendations, the authors have used their own 25-year experience in implanting pacemakers and the recommendations proposed by the Working Group of the American College of Cardiologists and the American Association of Cardiologists in 1984 and 1991 for implanting pacemakers in bradyarrhythmias. The proposed recommendations define indications and contraindications for implantation of up-to-date pacemaker models and determine the behaviour policy of a specialist in selecting patients with bradyarrhythmias for the optimal pacing mode, which suggests a compulsory certification of the centers engaged in implanting pacemakers in bradyarrhythmias.
Subject(s)
Bradycardia/therapy , Pacemaker, Artificial , Contraindications , HumansABSTRACT
A total of 105 patients with implantable pacemakers were examined. Whether the pacemaker disconnection test can be used to predict syncopes in failure of permanent cardiac pacing was studied. The spontaneous ventricular activity was evaluated in 62 patients with acquired complete atrioventricular block (CAVB) and in 43 patients with artificial CAVB. The patients with varying pacemaker dependence were grouped. It was ascertained that 7% of patients with artificial CAVB and 19% of those with acquired CAVB were dependent on pacemakers. In possible failure of stimulation or in reimplantation of a pacemaker on its disconnection, 93% of patients with artificial CAVB and 81% with acquired CAVB could develop their own cardiac rhythm. Lowering the frequency of pacing enabled the duration of asystole to be decreased. The usage of isadrin was demonstrated to enhance spontaneous ventricular activity.
Subject(s)
Death, Sudden, Cardiac/prevention & control , Heart Block/complications , Pacemaker, Artificial/adverse effects , Syncope/prevention & control , Aged , Aged, 80 and over , Cardiac Pacing, Artificial/methods , Death, Sudden, Cardiac/etiology , Electrocardiography , Equipment Failure , Female , Heart Block/diagnosis , Heart Block/therapy , Humans , Isoproterenol/administration & dosage , Male , Middle Aged , Prognosis , Syncope/etiologyABSTRACT
The natural disease course is analyzed in 311 patients with atrioventricular blockade admitted for surgical treatment to the Leningrad Center of Arrhythmia Surgery and Cardiac Pacing. It has been discovered that, as a rule, Morgagni-Adams-Stokes (MAS) attacks do not occur for over 2-3 years after their onset, which determines to a considerable measure the patients: life expectancy. The authors hold that the very first Mas attack which may occur in a patient with atrioventricular blockade is an absolute indication for implantation of a permanent cardiac pacemaker. If the permanent cardiac pacemaker was established, 1-, 3-, 5-, 7- and 8-year survival rates were, respectively, 91.1, 85.8, 77.3, 63.2, and 60.8%.
Subject(s)
Heart Block/diagnosis , Adams-Stokes Syndrome/diagnosis , Adams-Stokes Syndrome/etiology , Adams-Stokes Syndrome/mortality , Adams-Stokes Syndrome/therapy , Adult , Aged , Aged, 80 and over , Chronic Disease , Electrocardiography , Female , Heart Block/etiology , Heart Block/mortality , Heart Block/therapy , Humans , Male , Middle Aged , Pacemaker, ArtificialABSTRACT
Examined were 54 patients with different disorders of the cardiac rhythm with an implanted programmed electrocardiostimulator (ECS-200). The authors worked out methods and criteria of choosing individual regimes of electrostimulation, evaluated their effect on the severity of stenocardia and grade of circulatory insufficiency. The threshold frequency of stenocardia is of major significance in determining the optimal frequency of electrostimulation for patients with stable atrioventricular block. For patients with sinus node weakness and transitory atrioventricular blocks the criteria of choice of electrostimulation parameters is maximum maintenance of the sinus node rhythm with a frequency of not less 50/min.
Subject(s)
Bradycardia/therapy , Coronary Disease/therapy , Pacemaker, Artificial , Tachycardia/therapy , Aged , Bradycardia/etiology , Bradycardia/physiopathology , Coronary Disease/complications , Coronary Disease/physiopathology , Female , Heart Block/etiology , Heart Block/physiopathology , Heart Block/therapy , Hemodynamics/physiology , Humans , Male , Middle Aged , Sick Sinus Syndrome/etiology , Sick Sinus Syndrome/physiopathology , Sick Sinus Syndrome/therapy , Tachycardia/etiology , Tachycardia/physiopathologyABSTRACT
The APKA cardiocomplex was developed, which diagnoses short intermittent arrhythmias in patients with and without cardiocomplexes. The cardiocomplex may operate in inpatient conditions of the cardiosurgical and cardiological units which are engaged in cardiac rhythms and in outpatient conditions of the outpatient monitoring and functional diagnosis rooms.
Subject(s)
Arrhythmias, Cardiac/diagnosis , Electrocardiography , Monitoring, Physiologic , Pacemaker, Artificial , Adams-Stokes Syndrome/diagnosis , Adams-Stokes Syndrome/therapy , Aged , Aged, 80 and over , Arrhythmias, Cardiac/therapy , Electrocardiography/instrumentation , Female , Heart Block/diagnosis , Heart Block/therapy , Humans , Male , Middle AgedSubject(s)
Atrial Fibrillation/surgery , Atrioventricular Node/surgery , Coronary Artery Bypass , Coronary Disease/surgery , Electrosurgery/methods , Heart Conduction System/surgery , Atrial Fibrillation/etiology , Coronary Disease/complications , Humans , Male , Middle Aged , Pacemaker, Artificial , Postoperative CareABSTRACT
The article generalizes 17-year experience in the organization of surgical service for patients with disturbed rhythm and conductivity of the heart in Leningrad and the northwest region of the USSR. The work of the city center of surgery of arrhythmias is analysed. Prospective calculations were made. Basically new approaches to determining the regular number of persons on the staff and the number and type or operative interventions are suggested.
Subject(s)
Arrhythmias, Cardiac/surgery , Cardiac Surgical Procedures/organization & administration , Adult , Age Factors , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Russia , Sex FactorsABSTRACT
The implantation of a home programmed device "ECS-500" was performed in 121 patients with different disturbances of the cardiac rhythm. Programmed ECSs were used in 103 patients with echocardiography and integral rheography. Seventy six patients were observed in terms from 2 months to 1.5 year. Optimum frequencies of electrostimulation (ES) were determined for different groups of patients. Lower frequencies of ES allowed to lessen manifestations of angina pectoris in patients with ischemic heart disease. Higher amplitude of the impulse prevented reoperations in 4 patients with "block of output" of electrodes. The experience allows "ECS-500" to be recommended for introduction into clinical practice.
Subject(s)
Heart Block/therapy , Heart Rate/physiology , Pacemaker, Artificial , Sick Sinus Syndrome/therapy , Tachycardia, Supraventricular/therapy , Adolescent , Adult , Aged , Child , Child, Preschool , Electrocardiography , Electrodes, Implanted , Female , Heart Block/physiopathology , Humans , Infant , Male , Middle Aged , Monitoring, Physiologic , Sick Sinus Syndrome/physiopathology , Tachycardia, Supraventricular/physiopathology , Time FactorsABSTRACT
Thirty-two patients with disturbed atrioventricular conduction underwent operation for continuous P-wave electrostimulation (ES) with implantation of Soviet-made serial KC-320 apparatuses by the myocardial (28 patients) and endocardial (4 patients) methods. The patients were examined in postoperative periods of 3 to 15 months. Stable bio-controlled ES with a good clinical result was recorded in 29 patients, dislocation of the atrial endocardial electrode--in one patient; the development of frequent paroxysms of atrial flutter-fibrillation made it necessary to change the ES regimen. The authors' experience allows KC-320 to be recommended in wide clinical practice.
Subject(s)
Heart Block/therapy , Pacemaker, Artificial , Adolescent , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Time FactorsABSTRACT
One case of a rare complication of the permanent heart electrostimulation is observed among many patients treated with such method for many years. A 77-year-old man having a permanent electrostimulation during 13 years because of a complete atrioventricular heart blockade, developed a defect of the tricuspid valve resulting from two endocardial electrodes. Narrowing of the right atrioventricular aperture and a severe dilatation of the right atrium worsened the circulation deficiency. More frequent use of various methods of the nonfunctioning endocardial electrode elimination is recommended. Transvenous destruction of the fibrous capsule at the end of endocardial electrodes is an efficient method developed by the authors for their elimination.
Subject(s)
Iatrogenic Disease , Pacemaker, Artificial , Tricuspid Valve/injuries , Aged , Chronic Disease , Electrodes, Implanted , Heart Block/complications , Heart Block/pathology , Heart Block/therapy , Humans , Male , Tricuspid Valve/pathologyABSTRACT
Principles of psychological rehabilitation of patients with implanted cardiac pacemakers are examined. A scheme of stage-by-stage psychoprophylactic and psychotherapeutic measures is proposed. The influence of the psychocorrective action on the process of sociopsychological adaptation of patients is discussed.
Subject(s)
Arrhythmias, Cardiac/therapy , Neurocognitive Disorders/therapy , Neurotic Disorders/therapy , Pacemaker, Artificial , Adult , Aged , Arrhythmias, Cardiac/psychology , Humans , Middle Aged , Neurocognitive Disorders/etiology , Neurocognitive Disorders/rehabilitation , Neurotic Disorders/etiology , Neurotic Disorders/rehabilitation , Psychotherapy , Social AdjustmentABSTRACT
Under analysis were results of the outpatient aid to patients in the center of surgery during 5 years. Every year the consultative and ambulatory aid was given to 1200 patients. A conclusion was made that organization of the city consultative-diagnostic center for patients requiring surgical treatment of arrhythmia with a special staff and equipment for performing electrophysiological and other investigations, organization of the zone consultation units in large polyclinics for electrophysiological investigations will improve the quality and efficiency of treatment of patients with complex disorders of the heart rhythm and conduction.
Subject(s)
Arrhythmias, Cardiac/surgery , Referral and Consultation , Surgicenters/organization & administration , Adolescent , Adult , Aged , Arrhythmias, Cardiac/diagnosis , Child , Electrocardiography , Humans , Middle Aged , Russia , Urban PopulationABSTRACT
Continuous atrial (73) or ventricular (77) electrostimulation, alone or combined with transvenous endocardial electrodestruction of the AV junction (24) was performed in 150 patients with sick sinus syndrome (SSS). Five-year follow-up of 148 patients identified groups of patients with impaired atrioventricular conductivity and bradytachy-arrhythmic SSS syndrome. Prolonged atrial electrostimulation is shown to be possible in cases of moderately impaired atrioventricular conductivity. Antiarrhythmic efficiency of atrial and ventricular electrostimulation was found to be insufficient for the prevention of atrial fibrillation paroxysms. It is concluded that transvenous electrodestruction of the atrioventricular junction in combination with ventricular electrostimulation is highly effective in cases of bradytachy-arrhythmic SSS syndrome. Surgical strategy is proposed for different types of the SSS syndrome.