Effects of amiodarone on the P-wave triggered signal-averaged electrocardiogram in patients with paroxysmal atrial fibrillation and coronary artery disease.

The effects of a 6-week treatment with amiodarone on the P-wave triggered signal-averaged electrocardiogram in patients with paroxysmal atrial fibrillation and coronary artery disease have been studied. Amiodarone favorably influences P-wave triggered signal-averaged electrocardiographic parameters, predominantly in patients in whom amiodarone is effective in preventing paroxysmal atrial fibrillation.

[The influence of ischemia provoked by dobutamine and exercise on presence of late potentials in patients after myocardial infarction]. / Wplyw przejsciowego niedokrwienia prowokowanego testem dobutaminowym i wysilkowym na obecnosc póznych potencjalów komorowych u chorych po zawale serca.

UNLABELLED: The aim of this study was to examine the influence of transient exercise- and dobutamine-induced myocardial ischemia on time domain parameters of signal-averaged ECG (SAECG) and presence of late potentials (LP) in patients after myocardial infarction (MI). The investigation covered 85 patients after healing of MI, divided into two groups. Group I (24 males and 2 females, mean age 56.8 +/- 6.4 yrs) had exercise-induced ischemia and group II consisted of 59 patients (51 males and 8 females, mean age 58.3 +/- 8.5 years) with ischemia provoked by the intravenous dobutamine stress-testing. In each patient 2-D echocardiography, 24-h ambulatory Holter ECG, coronary arteriography were performed before stress testing. The ischemia was proven by using Tc-99m MIBI myocardial perfusion and standard 12-lead ECG monitoring. Recordings of SAECG were registered at rest and during ischemia under influence of stress-testing. The following time-domain parameters of SAECG were analysed: the root-mean-square voltage of the last 40 and 50 ms of the filtered QRS complex (RMS40, 50), total time duration of filtered QRS (t-QRS) and duration of signal lower than 40 muV (LPD). LP were detected when two or three of following criteria's had been registered: RMS 40 < 20 muV, t-QRS > 114ms, LPD > 38s. There was no statistically significant differences in all time domain parameters of SAECG between records at the baseline and during ischemia in each study group. At the baseline LP have been registered in 11.5% and in 15% patients, respectively of group I and group II. On the top of ischemia during treadmill exercise stress-testing LP have been recorded in 27% subjects. Under influence of dobutamine-provoked ischemia LP have been registered in 25% patients. CONCLUSIONS: Exercise- and dobutamine-induced ischemia triggers development of LP in small grade in post-infarction patients.

[The influence of exercise and dobutamine-induced ischemia on the presence of late potentials in patients after myocardial infarction]. / Wplyw przejsciowego niedokrwienia mienia serca prowokowanego testem dobutaminowym i wysilkowym na obecnosc póznch potencjalów komorowych u chorych po zawale serca.

UNLABELLED: The aim of this study was to examine the influence of transient exercise- and dobutamine-induced myocardial ischemia on time domain parameters of signal-averaged ECG (SAECG) and presence of late potentials (LP) in patients after myocardial infarction (MI). The investigation covered 85 patients after healing of MI, divided into two groups. Group I (24 males and 2 females, mean age 56.8 +/- 6.4 yrs) had exercise-induced ischemia and group II consisted of 59 patients (51 males and 8 females, mean age 58.3 +/- 8.5 years) with ischemia provoked by the intravenous dobutamine stress-testing. In each patient 2-D echocardiography, 24-h ambulatory Holter ECG, coronary arteriography were performed before stress testing. The ischemia was proven by using Tc-99m. MIBI myocardial perfusion and standard 12-lead ECG monitoring. Recordings of SAECG were registered at rest and during ischemia under influence of stress-testing. The following time-domain parameters of SAECG were analysed: the root-mean-square voltage of the last 40 and 50 ms of the filters QRS complex (RMS40, 50), total time duration of filtered QRS (t-QRS) and duration of signals lower than 40 microV (LPD). LP were detected when two or three of following criterias had been registered: RMS 40 < 20 microV, t-QRS > 114 ms, LPD > 38 s. There was no statistically significant differences in all time domain parameters of SAECG between records at the baseline and during ischemia in each study group. At the baseline LP have been registered in 11.5% and in 15% patients, respectively of group I and group II. On the top of ischemia during treadmill exercise stress-testing LP have been recorded in 27% subjects. Under influence of dobutamine-provoked ischemia LP have been registers in 25% patients. CONCLUSION: Exercise- and dobutamine-induced ischemia triggers development of LP in small grade in post-infarction patients.

[The effect of long term use of amiodarone hydrochloride on time and frequency domain parameters of signal averaged electrocardiogram in patients with ischemia heart disease]. / Wplyw przewlekle stosowanego chlorowodorku amiodaronu na parametry czasowe i czestotliwosc elektrokardiogramu wysokiego wzmocnienia u chorych na chorobe niedokrwienna serca.

The aim of this study was to assess the influence of amiodarone hydrochloride on time- and frequency-domain parameters of signal-averaged electrocardiogram (SAECG) in patients with ischaemic heart disease (IHD). The study population consisted of 33 patients (18 female and 15 male), mean age 59.2 +/- 7.7. Amiodarone hydrochloride was orally used in the initial dose 600 mg/day for 10 days, and subsequently 200 mg/days for 6 weeks. Recording of SAECG and ambulatory Holter monitoring were made at baseline and in 10 day and after 6 weeks of therapy. The following time-domain parameters were analyzed: the root mean square voltage of the last 40 and 50 ms of the filtered QRS (RMS40 i RMS50), total time duration of filtered QRS (t-QRS) and duration of low amplitude signals < 40 microV in the terminal part of QRS (LPD). Late potentials (LP) were recognized when at least two from three criteria were fulfilled: 1) RMS40 < 20 microV, 2) t-QRS > 114 ms, 3) LPD > 38 ms. Frequency analysis of SAECG allowed to calculate the following parameters in logarithmic scale: energy spectrum > -60 dB (A) and decibel drop at 40Hz (Dd) and also in linear scale: area ratio 20-50/0-20Hz (Ar) and magnitude ratio (MR1-7). The values of RMS40 and RMS50 did not significantly change during amiodarone therapy. The obtained values of t-QRS were significantly longer after antiarrhythmic therapy, respectively 97.8 +/- 9.1 ms at the baseline, 102.1 +/- 10 ms after 10 days (p < 0.05), and 104.1 +/- 10.4 ms after 6 weeks (p < 0.005). Moreover the values of LPD did not significantly change after amiodarone treatment. At the baseline the presence of LP were observed in 3 (9%), after 10 days were recorded in 8 (24%), and after 6 weeks in 7 (22%) cases. Only in one case the LP were observed during the whole antiarrhythmic therapy. Moreover, amiodarone hydrochloride did not statistically significant change frequency-domain parameters in logarithmic scale and in linear scale.

[Significance of atrial signal-averaged electrocardiogram analysis in diagnosis of paroxysmal atrial fibrillation in patients with mitral valve prolapse syndrome]. / Znaczenie analizy usrednionego sygnalu przedsionkowego w diagnostyce napadowego migotania przedsionków u chorych z wypadaniem platka zastawki dwudzielnej.

The aim of this study was to assess the clinical usage of recording time-domain parameters of atrial signal-averaged electrocardiogram (ASAECG) in diagnosis of paroxysmal atrial fibrillation (PAF) of patients with mitral valve prolapse (MVP). 85 patients with MVP recognized by echocardiography were divided into two groups: group I (MVP-PAG/+/) 41 pts (15 male and 26 female) mean age 37.1 +/- 8.9 with previously electrocardiographically documented episode of PAF, group II (MVP-PAF/-/) 44 pts (20 male, 24 female) mean age 39.1 +/- 14.3 without PAF. The control group III consisted of 35 persons: 24 male and 11 female in mean age 37.7 +/- 6.2 without any cardiovascular diseases. All patients underwent additional investigations included: T3, T4, electrocardiography, exercise-test with moving "running track", 24-hours monitoring ECG with Holter's method and ASAECG recording. The following time-domain parameters of ASAECG were calculated: the root mean square voltage of the terminal 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and total time duration of filtered P-wave (PWD). The adaptation of time-domain parameters of atrial signal-average in differential diagnostics of PAF during MVP has appeared as useless from clinical point of view.

[Clinical significance of atrial signal-averaged electrocardiogram in patients with electrically-induced paroxysmal atrial fibrillation]. / Znaczenie kliniczne rejestracji usrednionego sygnalu przedsionkowego u chorych z wystymulowanym migotaniem przedsionków.

UNLABELLED: The aim of this study was to assess the diagnostic possibilities of recording of time-domain parameters of atrial signal-averaged electrocardiogram (ASAECG) in patients with electrically-induced paroxysmal atrial fibrillation (PAF). The investigation was done in 53 patients (34 male and 19 female) mean age 47.6 +/- 13.1 with electrically induced sustained PAF- > 30 sec (group I). As a controls were forty patients (28 male and 12 female) mean age 46.2 +/- 15.3 (group II). The following time-domain parameters of ASAECG were calculated: the root mean square voltage of the terminal 10,20,30 ms of the filtered P-wave (RMS10,20,30) and total duration of filtered P-wave (PWD) and also time duration of P-wave from Frank's leads X,Y,Z (XP,YP,ZP). The values of RMS10,20,30 were statistically significant lower in patients with PAF than in controls, respectively RMS10: 3.9 +/- 1.4 microV vs 5.4 +/- 2.3 microV, p < 0.005, RMS20: 5.3 +/- 2 microV vs 6.8 +/- 2.2 microV, p < 0.001 and RMS30: 6.8 +/- 2.1 microV vs 7.4 +/- 3.6 microV, p < 0.05. Also the values of PWD were significantly longer in group I: 121 +/- 14.6 ms than in group II: 113.9 +/- 13.5 ms, 1 p < 0.02. Analysing the values of XP,YP,ZP it's occurred that only YP in PAF patients was statistically longer than in control, respectively 111 +/- 14.8 ms vs 96.7 +/- 13.8 ms, p < 0.001. The best differential criteria for identification of patients with electrically-induced PAF were RMS20 < 6 microV and PWD > 118 ms and gave sensitivity of 52%, specificity of 79%, positive predictive value of 68%, negative of 66% and diagnostic accuracy of 67%. CONCLUSIONS: 1. In patients with electrically-induced PAF the lower values of RMS10,20,30 and longer PWD were detected. 2. The criteria for identification of patients with electrically-induced paroxysmal atrial fibrillation were the values of RMS20 < 6 microV and PWD > 118 ms.

[Transient myocardial ischemia in patients after myocardial infarction and late cell potentials]. / Przejsciowe niedokrwienie u chorych po zawale miesnia sercowego a pózne potencjaly komorowe.

The role of myocardial ischaemia in the development of late potentials (LP) on the signal-averaged ECG (SAECG) in patients with coronary artery disease (CAD) remains controversial. The aim of the study was to assess the influence of transient, scintigraphically-proven (Tc-99mMI-BI), exercise-induced ischaemia on the presence of LP in 51 pts with angiographically documented CAD. Patients were divided into 2 groups: 26 pts (mean age 53 +/- 7.7) without the history of myocardial infarction (MI) (Group I) and 25 pts (mean age 56.8 +/- 6.4) after MI (Group II). SAECG recording were performed at baseline (A) and during exercise-induced ischaemia (B). The following time-domain parameters of SAECG were analyzed: the root mean square voltage of the last 40 and 50 ms of filtered QRS (RMS40, 50), total time duration of filtered QRS (t0QRS) and time duration potentials < 40 microV (LPD). The ventricular late potentials (LP) were defined as the presence of at least two of the following criteria: tQRS > 114 ms, RMS 40 < 20 mV and LPD > 38 ms. We conclude that transient exercise-induced ischaemia increased the presence of LP in pts with CAD after MI but did not alter the arrhythmogenic substrate for LP in those without the history of MI.

[Evaluation of electrophysiologic properties of the heart atrium in patients with electrically induced atrial fibrillation]. / Ocena wlasciwosci elektrofizjologicznych przedsionka u chorych z wystymulowanym migotaniem przedsionków.

Paroxysmal palpitation is a frequent non-specific symptom observed in clinical practice. It is not always possible to identify the arrhythmogenic cause of this complaint. The induction of paroxysmal atrial fibrillation (PAF) during transoesophageal pacing (TEP) was found to be particularly useful when arrhythmia paroxysms were not evidenced by standard electrocardiography or by 24-hour Holter monitoring. The objective of the present study was a comparative assessment of the electrophysiological parameters obtained from a patient group with PAF induced during TEP and from a patient group with no arrhythmia, in order to determine the hazard of spontaneous PAF occurrence. The study included 116 patients complaining of palpitations who underwent TEP. Of these, 53 were selected (34 males and 19 females; mean age, 47.6 +/- 13.1) in whom a sustained PAF episode (> 30 sec) had been induced during TEP. These patients are referred to Group I. Group II (control) comprised the remaining 63 patients (38 males and 25 females; mean age 45.5 +/- 8.5) in whom no PAF episode had been induced during TEP. All patients (Group I and Group II) underwent echocardiography, 24-hour Holter monitoring, exercise test and TEP. During TEP the following parameters were evaluated: left atrial effective refractory period (AERP), sinoatrial conduction time (SACT), maximal and corrected sinus node recovery time (SNRT and CNRT), Wenckebach periodicity (WP) and mean cycle duration (CD). Thus, the AERP value amounted to 299.8 +/- 42.4 msec and 259.5 +/- 54.9 msec (p < 0.001) for Group I and Group II, respectively. The SACT and SNRT values totalled 132.3 +/- 45.1 msec and 1011.1 +/- 165.6 msec in Group I, and 103.2 +/- 29.9 msec and 838.3 +/- 172.7 msec in Group II, respectively (p < 0.001). Compared to the control (235 +/- 95.7 msec; 200.3 +/- 64.9 msec, respectively), the group of patients with electrically-induced PAF (Group I) showed significantly longer CNRT (383.4 +/- 172.5 msec, p < 0.001) and WP (350.8 +/- 59.3 msec, p < 0.001). The study had led to the following finding: patients with electrically-induced PAF had significantly longer left effective refractory periods, sinoatrial conduction times, maximal and corrected sinus node recovery times and Wenckebach periodicities.

[The influence of myocardial ischemia on the electrocardiogram under stress]. / Wplyw niedokrwienia miesnia sercowego na elektrokardiogram wysokiego wzmocnienia.

Ventricular late potentials (LP) seem to reflect mixed, anatomic and electrophysiologic substrate for ventricular reentrant tachyarrhythmias. Ischemic events can perform areas of delay and dispersion of conduction and refractoriness in patients with ischaemic heart disease (CAD), especially after myocardial infarction (MI). These electrophysiological disturbances can induce the reentry phenomenon. LP are present in 18-53% patients with CAD, but in selected groups of patients after MI with ventricular tachycardia or/and cardiac arrest in the past, LP are registered in 63-92% objects. The influence of acute ischemia provoked by the effort and pharmacological stress testing isn't significant in groups with CAD without MI. Occurrence of LP increase in a small grade only in post-MI patients but differences of time domain parameters of signal-averaged ECG (SAECG) are not statistically significant. There are no correlations between LP incidence during ischemia and left ventricle wall motion disturbances, ejection fraction, localisation of MI, date of MI and number of occluded coronary vessels in the greater part of investigations, but the results are divergent and the matter has to be studied. Time domain SAECG is one of admitted methods of risk stratification of incidence of sustained ventricular tachycardia in patients with CAD, but the parameters of frequency domain SAECG still are not standardized, so its clinical usefulness isn't clear.

[The effect of sotalol hydrochloride therapy on atrial signal-averaged ECG in patients with paroxysmal atrial fibrillation]. / Wplyw chlorowodorku sotalolu na usredniony sygnal przedsionkowy u chorych z napadowym migotaniem przedsionków.

The aim of this study was to evaluate of oral sotalol hydrochloride effects on atrial signal-averaged ECG (ASAECG) during time- and frequency-domain analysis in patients with paroxysmal atrial fibrillation (PAF) during ischemic heart disease (IHD). The study population of 27 was composed of 16 female and 11 male, mean age 56.1 +/- 8.4. The dose of oral sotalol was 160 mg/day for all days. Recording of ASAECG and 24-hours Holter monitoring were made at baseline, after 10 days and after 6 weeks of sotalol therapy. For ASAECG were calculated time-domain parameters: the root mean square voltage of the signals in the last 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and total time duration of filtered P-wave (PWD) and time duration of P-wave for Frank leads X, Y, Z (XP, YP, ZP). During frequency-domain analysis of the terminal part of P-wave we calculated the following parameters in range from 40 Hz to 400 Hz: energy spectrum > -60 dB (A) and decibel drop at 40 Hz (Dd) in logarithmic scale and area ratio 20-50/0-20 Hz (Ar), magnitude ratio (MR1-7) in linear scale for a vector magnitude. Supraventriculat arrhythmias were estimated quantitatively and qualitatively during Holter monitoring. The following parameters were estimated in a case of PAF recording: time of manifestation, duration, number of PAF episodes per day, mean heart rate during PAF and subjective symptoms. Moreover, comparable analysis of the following parameters: dimension of left atrial, age, gender, time duration of IHD and PAF and wall motion disturbances-hypokinesis and also left ventricular ejection fraction, mitral regurgitation was done between patients with effective and no effective of antiarrhythmic therapy. Our observation have indicated that oral sotalol therapy are responsible for statistically significant decrease of total time duration of filtered P-wave (PWD) and time duration of P-wave for Frank leads X, Y, Z (XP, YP, ZP) and increase area ratio 20-50/0-20 Hz in patients with PAF during IHD. Moreover, comparable analysis of above-mentioned parameters have not showed statistically significant differences between examined patients with effective and lack of effective sotalol therapy.

[Use of body surface heart potential mapping for registration of electrical phenomenal in the atrium]. / Zastosowanie powierzchniowego mappingu potencjalów serca do rejestracji zjawisk elektrycznych w przedsionkach.

Research on body surface potential mapping concerned predominantly the ventricular excitation process. There is only very limited data available documenting surface potential distribution during atrial electric events. The goal of this study was to establish the pattern and criteria of the atrial potential maps in the healthy population, which is substantial for a prospective usefulness of the noninvasive registrations of surface maps in atrial arrhythmias. A group of 54 subjects in whom there was no clinical evidence of cardiac dysfunction underwent a procedure of body surface potential mapping. The recordings were performed using the HPM-7100 system simultaneously from 87 leads covering the entire thorax. Isopotential maps registered during the P wave were subjected to the statistical analysis by means of the own system "Heart Map" enabling the qualitative and quantitative estimation of the atrial maps. To avoid a problem of variable heart rate, a time standardization, by the division of the P wave into 10 time intervals, was applied. In order to eliminate an interindividual variability of heart location in the thorax, a distribution of the constituent values without subordinating them to the individual electrodes was proposed. In consequence, the group-mean isopotential maps of the wave P for the normal subjects were created. According to the migration of the maximum throughout the thoracic surface during the P wave, three phases of the isopotential atrial maps were determined: phase 1 (P1-P4) comprising initial 40% of the P wave, phase 2 (P5,P6)-next 20% of the P wave and phase 3 (P7-P10)-the terminal 40% of the P wave duration. These phases reflect the successive sequences of atrial excitation. During the whole atrial depolarization the minimum of potential, changing its value, was located around lead D7. Furthermore, in the results of the analysis of the constituent values sequences, for the P wave time intervals the additional quantitive parameters were calculated, i.e. areas designated by positive and negative potential and the ratio of these areas. The presented findings revealed that surface maps give the precious insight into spread of atrial excitation. Establishing of the distribution pattern and the criteria of the atrial potential maps for normals enables to undertake the further research on the use of this technique in a various atrial pathology.

[The effect of paroxysmal atrial fibrillation during ischemic heart disease on parameters of atrial signal-averaged electrocardiography]. / Wplyw czasu trwania napadowego migotania przedsionków w przebiegu choroby niedokrwiennej serca na parametry usrednionego sygnalu przedsionkowego.

The aim of this study was assess the correlation between duration of paroxysmal atrial fibrillation (PAF) during ischemic heart disease (IHD) and atrial signal-averaged electrocardiogram (ALP). The study population consisted of 75 patients with PAF during IHD whose were divided according to duration of PAF into three groups; gr. I- < 1 year, gr. II-1-5 years, gr. III- > 5 years. The control group (gr. IV) composed of 50 healthy. Recording of ALP were carried out by HIPEC-200 HA. We calculated time domain parameters of ALP; root mean square voltage of the signals in the last 10, 20 and 30 ms of the filtered P-wave and filtered P-wave duration. During frequency analysis of ALP we calculated frequency parameters in range from 40 to 400 Hz in linear scale; area ratio 20-50/0-20 Hz and marked the highest peak amplitude of signals and in logarithmic scale; defined energy spectra of frequency component > -60 dB and value of frequency component 40 Hz. Our results suggest that: 1. The values of root mean square voltage of the signals in the last 10 ms of the filtered P-wave have been decreasing according to passage of duration PAF. 2. Patients with longer anamnesis of PAF have had longer duration of filtered P-wave. 3. Proposed parameters of frequency analysis of ALP in both scales (linear and logarithmic) seemed useless in differential diagnosis of patients with PAF during IHD and healthy.

[Correlations between left atrial size and parameters of averaged atrial signal in patients with paroxysmal atrial fibrillation in the course of ischemic heart diseases]. / Korelacje miedzy wielkoscia lewego przedsionka a parametrami usrednionego sygnalu przedsionkowego u chorych z napadowym migotaniem przedsionków w przebiegu choroby niedokrwiennej serca.

The aim of this study was to assess the correlation between left atrial size and atrial signal-averaged electrocardiogram (ALP) in time-domain and frequency analysis in patients with paroxysmal atrial fibrillation (PAF) during ischaemic heart disease (IHD). The study population consisted of 75 patients with PAF during IHD who were divided into two groups; gr. I (left atrial dimension 40 mm) and gr. II (left atrial dimension 40 mm). The control group (gr. III) consisted of 50 healthy subjects. Recording of ALP was carried out by HIPEC-200HA. The high gain ECG was recorded during basic rhythm with orthogonal Frank leads X,Y,Z. These signals were amplified, averaged and filters. The filtered signals were combined into a vector magnitude and time-domain and frequency analysis was done. These findings suggest that the size of the left atrium does not change time-domain and frequency parameters of ALP in patients with PAF and IHD. We noticed significant influence of IHD on these parameters. On the other hand frequency analysis of ALP did not show any uselessness in diagnostic identification of patients with PAF during IHD and healthy subjects.

[The effect of intravenously given amiodarone on maintenance of ventricular signal averaged electrocardiogram in patients with ischemic heart disease]. / Wplyw dozylnie podanego amiodaronu na zachowanie sie usrednionego sygnalu komorowego u chorych na chorobe niedokrwienna serca.

Recording of ventricular signal-averaged ECG (VSAE) were carried out in 19 patients suffering from ischemic heart disease before and after intravenously administration of amiodarone using a commercially available machine HIPEC-200 HA device of Aerotel's. The high gain ECG was recorded during basic rhythm with orthogonal Frank leads X, Y, Z. These combined into a vector magnitude and the QRS duration (QRS), the duration of low amplitude signals < 40 microV (LPD) and the root mean square voltage of the signals in the last 40 and 50 ms of the filtered QRS (RMS 40,50) were calculated for VSAE. It was time-domain analysis of VSAE. In frequency domain analysis were calculated the following parameters in range from 40 Hz to 400 Hz in linear scale: area ratio 20-50 Hz/0-20 Hz, peak and magnitude ratio and in logarithmic scale: energy spectrum > -60 dB and decibel drop at 40 Hz. Subsequently amiodarone hydrochloride was given intravenously 5 mg/kg c.c. and again time-domain and frequency domain analysis were done. Data presented are mean +/- standard deviation. Statistical comparisons were performed with paired t-Student test. Significance refers to a p values < 0.05. Time-domain analysis of VSAE didn't show any significant differences after amiodarone injection. During frequency-domain analysis of VSAE statistically significant differences were displayed in Frank lead X and Y for energy spectrum > -60 dB. In Frank lead X decrease of this parameter after amiodarone (from 3322 +/- 1057 dB-Hz to 2628 +/- 733) and in lead Y increase (from 2793 +/- 500 dB-Hz to 3199 +/-938 dB-Hz) was noticed. Our observation have indicated that intravenously application of amiodarone hydrochloride didn't change parameters in time-domain analysis. Statistically significant differences were noticed only during frequency analysis VSAE in logarithmic scale -energy spectrum > -60 dB but only in two leads X and Y.

[Effect of propafenone hydrochloride on atrial signal-averaged ECG in patients with paroxysmal atrial fibrillation]. / Wplyw chlorowodorku propafenonu na usredniony sygnal przedsionkowy u chorych z napadowym mitgotaniem przedsionków.

Oral propafenone hydrochloride effect was studied on atrial signal-averaged ECG (ASAECG) during time- and frequency-domain analysis in patients with paroxysmal atrial fibrillation (PAF) during ischemic heart disease (IHD). The study comprised 26 patients (15 female and 11 male) mean age 60.8 +/- 6.2. The dose of oral propafenone was 450 mg/day for all days. Recording of ASAECG and 24-hours Holter monitoring were made at baseline, after 10 days and after 6 weeks of propafenone therapy. Time-domain parameters were calculated for ASAECG: the root mean square voltage of the signals in the last 10, 20, 30 ms of the filtered P-wave (RMS 10, 20, 30) and total time duration of filtered P-wave (PWD) and time duration of P-wave for Frank leads X, Y, Z (XP, YP, ZP). During frequency-domain analysis of the terminal part of P-wave the following parameters were calculated in range from 40 Hz to 400 Hz: energy spectrum > -60 dB (A) and decibel drop at 4 Hz (Dd) in logarithmic scale and area ratio 20-50/0-20 Hz (Ar), magnitude ratio (MR1-7) in linear scale for a vector magnitude. Supraventricular arrhythmias were estimated quantitatively and qualitatively by Holter monitoring. The following parameters were estimated in a case of PAF recording: time of manifestation, duration, number of PAF episodes per day, mean heart rate during PAF and subjective symptoms. Moreover, comparable analysis of the following parameters: dimension of left atrial, age, sex, time duration of IHD and PAF and wall motion disturbances--hypokinesis and also left ventricular ejection fraction, mitral regurgitation was done between patients with effective and no effective of antiarrhythmic therapy. Our observation have indicated that oral propafenone therapy does not influence any statistically significant differences all time- and frequency-domain parameters of ASAECG in patients with PAF during IHD. Moreover, comparable analysis of above mentioned parameters has not showed statistically significant differences between examined patients with effective and lack of effective propafenone therapy.

[Characteristics of ischemic heart disease patients with late ventricular potentials]. / Charakterystyka chorych na chorobe niedokrwienna serca z obecnoscia póznych potencjalów komorowych.

The purpose of this study was to compare ischemic heart disease (IHD) patients with and without late potentials (LP) by using noninvasive diagnostic methods as: echocardiographic examination, exercise testing, 24-hours Holter ambulatory monitoring, recording of atrial and ventricular signal-averaged ECG. Examination covered 25 IHD pts (12 male and 13 female) with LP, mean age 58.6 +/- 7.3 (group I) and 100 IHD pts (65 male and 35 female) without LP, mean age 56.8 +/- 8.5 (group II). Summing up, it should be stated that despite showing tendencies to much often occurrences of ventricular arrhythmias on Holter monitoring and silent ischemia during exercise testing in IHD pts with LP we were unable to indicate distinctive differentiating parameters between investigated groups.