[The value of the head-up tilt table test for with unexplained syncope in children and young adolescents]. / Znaczenie próby pionizacyjnej w diagnostyce nawracajacych stanów napadowych pod postacia zaburzen swiadomosci wystepujacych u dzieci i mlodziezy.

UNLABELLED: Syncope occurs in about 15% of children and young adolescents. The diagnosis of syncope of unknown origin is frequently difficult. In 1986, Kenny et al. introduced the Head-up Tilt Table Test (HUT), which enables to reproduce syncope. The aim of the study was to evaluate HUT in diagnosis of syncope in children and young adolescents. Ninety five children and young adolescents (57 females, 38 males, age range 7-18 years) with recurrent syncope of unexplained etiology were referred for HUT. The study group was divided into two subgroups: A--with history consistent with vasovagal syncope (VVS) and B--with non-characteristic symptoms for VVS. HUT was performed according to the Westminster protocol. The patient was tilted at 60 degree for 45 min. or until syncope occurred. Positive response to HUT was 36%. Negative outcome occurred in 59%. Non-diagnostic HUT was observed in 5%. The vasodepressive type of VVS was recognised in 35%, cardioinhibitory in 12% and mixed in 53%. In group A positive response of HUT occurred in 65% of pts., negative in 31%. In group B positive HUT was observed in 4% of pts. and negative in 89%. CONCLUSIONS: 1. In children and young adolescents head-up tilt test is a very useful diagnostic method. 2. In patients referred for the head-up tilt test the history of syncope should be taken into consideration.

[Esophageal stimulation of the heart: importance of the artifact inhibition system impulse in the quality of the ECG tracing from the stimulating electrode in the esophagus]. / Jícnová stimulace srdce: význam systému tlumení artefaktu stimulacního impulsu pro kvalitu EKG-záznamu z jícnové stimulacní elektrody.

The use of diagnostic possibilities of oesophageal stimulation of the heart depends on obtaining a readable and stable electrocardiogram from the stimulating electrode. The objective of the evaluating the importance of the electronic system eliminating the artefact of the stimulating impulse from the oesophageal tracing was to compare the quality of records obtained by the new and the traditional method. For stimulation an oesophageal cardiostimulator SP-5 manufactured by OBR, TEMED Zabrze was used. The atria and ventricles were stimulated by a fixed frequency and individual timed stimuli. In 58 subjects the tracings of the oesophageal ECG during stimulation of the atria were compared and in 45 subjects during oesophageal stimulation of the ventricles. The quality of the obtained tracings was evaluated by four grades where the first three grades include tracings not suitable for diagnostic interpretation. Contrary to the traditional method, the new method for obtaining tracings made it possible to obtain tracings the quality of which was in all instances suitable for interpretation. The assembled results provide evidence, due to the new system of recording, that there are great opportunities to extend diagnostic possibilities of oesophageal stimulation of the heart.

A method of esophageal electrogram recording for diagnostic atrial and ventricular pacing.

This study evaluates improvement of the electrogram sensed via an esophageal catheter with the sensing electrode adjacent to the stimulating electrode with and without a specialized artifact suppression system. In 100 patients (65 men and 35 women) aged 16-60 years (mean 48 years), esophageal recordings of left atrial activity were obtained during simultaneous transesophageal atrial pacing. Transesophageal ventricular pacing was performed in an additional 34 patients. Without the suppression system, ventricular paced activity, recorded from the esophagus, was not suitable for interpretation. About 10% of the atrial electrogram response could be recorded and evaluated during atrial pacing. With the stimulus artifact suppression system, interpretable recordings were obtained 100% of the time during atrial and ventricular recordings. The method described allows use of transesophageal diagnostic testing where previously only the intracardiac route was possible.

[Experimental studies of assisted circulation using left-ventricular assist devices with the pneumatic system (LVAD)]. / Badania doswiadczalne wspomagania lewej komory serca przy pomocy sztucznej lewej komory z napedem pneumatycznym (LVAD).

The results of short-term (acute) studies of assisting artificially produced (reversible) left ventricle insufficiency with an artificial, pneumatically driven left ventricle are discussed. Both mechanical left ventricle and driving devices are of Polish manufacture. The studies involved mongrel dogs and sheep and were fully hemodynamically and biochemically monitored. The results obtained with each design of the device were given to the producers. It seems that recent models are near to clinically acceptable ones and enable to assist left cardiac ventricle for a short time preceding elective transplantation of the heart.

[Transesophageal stimulation of the left atrium in children with arrhythmia (preliminary report)]. / Stymulacja przezprzelykowa przedsionka lewego w zaburzeniach rytmu serca u dzieci (doniesienie wstepne).

The conduction system of the heart was studied in 41 patients with cardiac arrhythmias by oesophageal stimulation of the left atrium. 31 children had a history of paroxysmal supraventricular tachycardia, 5 supraventricular or/and ventricular premature beats and 5 were studied because of suspected bradycardia-tachycardia syndrome. In all patients stimulation of the left atrium was well tolerated. There were no side effects or complications. The results showed that oesophageal stimulation of the left atrium was a faithful noninvasive method in diagnostic studies of the conduction system of the heart. This method was effective in studying the mechanism of supraventricular arrhythmias.

[Cardiac trans-esophageal pacing: significance of systemic damping of artifacts from stimulating impulses for ECG trace recordings recorded from a pacing trans-esophageal electrode. III]. / Stymulacja przezprzelykowa serca: znaczenie ukladu tlumienia artefaktu impulsu stymulujacego dla jakosci zapiscu ekg ze stymulujacej elektrody przelykowej. Czesc III.

Utilization of diagnostic abilities of the cardiac trans-esophageal pacing is related to necessity of obtaining the readable and stable ecg tracing from a pacing electrode. For that reason to evaluate the value of an electronic artifact suppression circuit of a pacing impulse from oesophageal ecg recording authors compared quality of obtained recordings using a new method with a traditional one. Trans-esophageal cardiac pacemaker SP-5 made by OBR, Temed, Zabrze was used. Atria and ventricles were stimulated using a constant pacing cycle length and a single programmable impulse. In 58 persons ecg transoesophageal recordings were compared during atrial pacing, and in 45 during ventricular one. Quality of obtained ecg recordings was estimated using 4-degree scale of which first three degrees comprised recordings the esophageal pacing electrode by a traditional method were unfit for diagnostic interpretation. As opposed to the pacing electrode allowed to obtain recordings with quality of which was suitable for diagnostic interpretation in all patients. Obtained results indicate on, thanks to the new recording circuit, existence of conditions to substantial extension of diagnostic abilities of transoesophageal cardiac pacing.