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2.
Ann Cardiol Angeiol (Paris) ; 55(6): 339-41, 2006 Nov.
Article in French | MEDLINE | ID: mdl-17191593

ABSTRACT

The complications of definitive cardiac stimulation must not be forgotten or sub estimate. The aim of our Registry is to compare the complications of the implantation of a pacemaker in the national and international literature. The assessment of our professional practices has been achieved. We suggest improved procedures. The late complications are not exactly known.


Subject(s)
Arrhythmias, Cardiac/surgery , Pacemaker, Artificial , Wound Infection/prevention & control , Aged, 80 and over , Anti-Bacterial Agents/therapeutic use , Arrhythmias, Cardiac/drug therapy , Asepsis , Humans , Pacemaker, Artificial/adverse effects , Registries , Retrospective Studies , Risk Assessment , Wound Healing
3.
Arch Mal Coeur Vaiss ; 97(11): 1080-8, 2004 Nov.
Article in French | MEDLINE | ID: mdl-15609910

ABSTRACT

Atrial flutter may now be very frequently and definitely cured in a single session of radiofrequency ablation. However, the very name of atrial flutter gives rise to a certain confusion. Clinical experience from everyday activity in ablation laboratories, especially since the introduction of new mapping techniques, has shown that this entity is in fact multiple. Flutters may be classified by their electrocardiographic appearance and/or their electrophysiological mechanism with as many prognostic as therapeutic implications. This article reviews diagnostic features of typical and atypical flutter and the different treatments which may be proposed in different clinical situations.


Subject(s)
Atrial Flutter/diagnosis , Atrial Flutter/therapy , Diagnosis, Differential , Electrocardiography , Humans , Prognosis
4.
Arch Mal Coeur Vaiss ; 97 Spec No 4(4): 56-62, 2004 Dec.
Article in French | MEDLINE | ID: mdl-15714890

ABSTRACT

Various tachycardias presenting with positive P waves in the standard leads are described in this article. Sinus tachycardia may occur as a normal adaptation reaction to the environment or in the setting of autonomic dysregulation. It may also be mimicked by various arrhythmias which share the earliest depolarisation in the sinus node area. The authors expose a review of these mechanisms.


Subject(s)
Tachycardia/diagnosis , Electrocardiography , Heart Conduction System/physiopathology , Humans , Sinoatrial Node/anatomy & histology , Tachycardia/etiology , Tachycardia/physiopathology
5.
Eur Heart J ; 18(4): 685-91, 1997 Apr.
Article in English | MEDLINE | ID: mdl-9129902

ABSTRACT

OBJECTIVE: Between July 1992 and December 1994, 16 French hospital centres, mainly cardiological, participated in a non-controlled observational study on venous thromboembolic disease. The objective of this survey was to collect data concerning the current status of pulmonary embolism and deep venous thrombosis. PATIENTS: During this period, 547 patients were included: 446 with deep venous thrombosis and 387 with pulmonary embolisms. RESULTS: Mean age of patients was 63 +/- 21 years. There were no significant differences between the sexes. Pulmonary embolism and deep venous thrombosis tended to occur more frequently during the autumn and winter. In 30% of cases, prior deep venous thrombosis or pulmonary embolism was noted. No cause was found for the condition in 47% of cases. Ultrasound (echocardiography and/or venous ultrasound) was the most frequently requested investigation. Intravenous heparin remains the most widely used treatment (76%). Oral anticoagulation was begun before day 3 in less than 31% of cases. Thrombolytic treatment was used in 20% of pulmonary embolism cases, but was rarely prescribed for deep venous thrombosis (2.2%). The hospital recurrence rate (12/547 cases) was fairly low. The search for occult malignancy, performed in 48% of cases, seems to remain one of the major concerns of physicians. The combined pulmonary embolism and deep venous thrombosis mortality rate was 4.4%, while the death rate for pulmonary embolism alone was 6.2%.


Subject(s)
Pulmonary Embolism/epidemiology , Thrombophlebitis/epidemiology , Adult , Aged , Aged, 80 and over , Cross-Sectional Studies , Diagnostic Imaging , Female , France/epidemiology , Humans , Incidence , Male , Middle Aged , Pulmonary Embolism/diagnosis , Registries/statistics & numerical data , Thrombophlebitis/diagnosis
6.
Ann Cardiol Angeiol (Paris) ; 45(2): 74-82, 1996 Feb.
Article in French | MEDLINE | ID: mdl-8734139

ABSTRACT

83 patients were enrolled in a multicentre, randomized, open study to assess the efficacy of amlodipine in stable effort angina. Preselected patients were submitted to a one-week placebo wash-out period during which only nitrates or molsidomine were authorized. Patients were then randomized to receive either 5 mg of amlodipine as a morning dose, or 180 mg of diltiazem in three divided doses. After two weeks, the dosage was able to be increased (according to clinical efficacy) to 10 mg of amlodipine as a single dose or 240 mg of diltiazem in four divided doses. The antianginal efficacy of these two treatments was essentially evaluated in terms of the results of stress tests (ST) conducted at the end of the second week and fourth week of active treatment: and 24 hours after the last dose of the drug. The results of 63 patients who scrupulously complied with the protocol showed that amlodipine and diltiazem corrected or improved the ST parameters (time to onset and amplitude of ST depression, duration of ST, work performed). The anti-ischaemic action of amlodipine was maintained for at least 24 hours after the last dose and therefore provides better security (by covering the entire 24-hour period) and better compliance (by tolerating a dose omission of several hours).


Subject(s)
Amlodipine/therapeutic use , Angina Pectoris/drug therapy , Calcium Channel Blockers/therapeutic use , Diltiazem/therapeutic use , Physical Exertion , Vasodilator Agents/therapeutic use , Adult , Aged , Amlodipine/adverse effects , Angina Pectoris/physiopathology , Blood Pressure , Calcium Channel Blockers/adverse effects , Diltiazem/adverse effects , Exercise Test , Heart Rate , Humans , Male , Middle Aged , Vasodilator Agents/adverse effects
7.
Arch Mal Coeur Vaiss ; 88(1): 27-33, 1995 Jan.
Article in French | MEDLINE | ID: mdl-7646246

ABSTRACT

The prevalence of arrhythmia increases with age. Considered as an "ordinary" event in elderly patients, these arrhythmias may nevertheless have serious consequences. This study was undertaken to determine the clinical, aetiological and prognostic features of serious arrhythmias in a population of elderly subjects (> or = 70 years) hospitalised over a 20 months period and comprising 202 patients (103 women, 99 men, mean age 79.6 +/- 5.9 years). Supraventricular arrhythmias are the most common by far (84.2%): 51.4% of patients had atrial fibrillation, 15.3% had atrial flutter; 12.9% had focal atrial tachycardia, 4.5% had junctional tachycardia. Of the ventricular arrhythmias (15.8%), there were 12 sustained ventricular tachycardias, 4 torsades de pointes and 1 ventricular fibrillation. The increased duration of hospital stay (10 +/- 6 days on average) is related not to age but to the type of arrhythmia (longer for ventricular arrhythmias) and to left ventricular dysfunction. The main complications of arrhythmias were cardiac failure (52.4%), neurological deficits (37.4%) and angina (18.6%). Electrocardiographic signs of atrioventricular block were present in 62% of cases and QRS changes in 47.3% of cases. Ventricular arrhythmias were more commonly associated with intraventricular conduction defects, signs of myocardial necrosis and prolongation of the QT interval; they were also common in patients with left ventricular dysfunction and when the left ventricle was dilated. The aetiology of ventricular arrhythmias was mainly iatrogenic (50%) and ischaemic (21.8%), whereas the aetiologies of the supraventricular arrhythmias were varied, 14.7% of cases being idiopathic. Conversion to stable sinus rhythm was obtained in half the patients. A pacemaker was implanted in 10.8% of cases. The hospital mortality was 4.9%.(ABSTRACT TRUNCATED AT 250 WORDS)


Subject(s)
Aged , Arrhythmias, Cardiac/physiopathology , Aged, 80 and over , Aging , Arrhythmias, Cardiac/etiology , Arrhythmias, Cardiac/therapy , Echocardiography , Electrocardiography , Female , Humans , Iatrogenic Disease , Length of Stay , Male , Prospective Studies , Time Factors
10.
Ann Cardiol Angeiol (Paris) ; 41(4): 191-5, 1992 Apr.
Article in French | MEDLINE | ID: mdl-1642435

ABSTRACT

The cardiac toxicity of 5 fluoro-uracil, an antimitotic agent widely used in various protocols, has been known for 16 years. Several cases have been reported in the literature, leading to the suggestion, without formal evidence, that the chief mechanism responsible for this cardiac toxicity is "classical" coronary spasm. However, certain clinical aspects already described may shed doubt on this theory. On the basis of 8 cases, the authors report different clinical pictures all caused by cardiac toxicity of 5FU. It is of interest to note that chest pain with the classically described electrocardiographic changes did not apply in the majority of cases. The commonest pattern was asymptomatic electrocardiographic abnormalities and/or arrhythmias without angina. Among the reported cases, one patient had pain with electrocardiographic abnormalities, recurrent after the withdrawal of 5FU and resistant to maximal medical treatment, despite the absence of any coronary disease or signs of spasm. One patient had a first myocardial infarction, later rechallenge with the drug resulting in failure. In another patient, with known coronary disease, 5FU probably cause cardiogenic shock. In total, some of our cases, as well as other features described in the literature, raise questions as to the pathophysiology of the cardiac toxicity of 5FU.


Subject(s)
Fluorouracil/adverse effects , Heart Diseases/chemically induced , Adult , Aged , Arrhythmias, Cardiac/chemically induced , Cardiomyopathies/chemically induced , Coronary Disease/chemically induced , Heart Diseases/physiopathology , Humans , Male , Middle Aged
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