ABSTRACT
Different anesthesias were used in 197 patients operated for supraventricular tachiarrhythmias through a transvenous access. Hypnoanalgesia based on preventive injection of a potent nonnarcotic antiinflammatory agent xefocame (lornoxicame), drip infusion of propofol (2-3 mg/kg/h), and bolus injection of dormicum under conditions of spontaneous respiration proved to be the best method.
Subject(s)
Catheter Ablation , Piroxicam/analogs & derivatives , Tachycardia, Supraventricular/surgery , Adolescent , Adult , Aged , Anesthesia, Intravenous , Anesthetics, Intravenous/administration & dosage , Anesthetics, Intravenous/pharmacology , Anti-Inflammatory Agents, Non-Steroidal/administration & dosage , Anti-Inflammatory Agents, Non-Steroidal/pharmacology , Humans , Hypnotics and Sedatives/administration & dosage , Hypnotics and Sedatives/pharmacology , Midazolam/administration & dosage , Middle Aged , Piroxicam/administration & dosage , Preoperative Care , Propofol/administration & dosage , Propofol/pharmacologyABSTRACT
The paper summarizes the experience on 27 implantations of sensory multiprogrammable pacemakers (two-chamber Synchrony-II and one-chamber Sensolog-III) produced by Siemens-Elema. The implantations were performed in the Moscow Cardiostimulation Center in 1993. Primary pacemaker implantation was performed in 19 patients, 8 patients needed the replacement of one-chamber pacemakers because of the power source exhaustion or circulatory insufficiency. The two-chamber pacemaker was implanted to 14 patients with a complete AV-block and chronotropic sinus node incompetence and to 4 patients with sick sinus syndrome in intact AV-conduction. In 6 patients the one-chamber pacemaker was implanted to stimulate the right ventricle. They had permanent bradysystolic auricular fibrillation and complete AV block with persistent or transitory tachysystolic auricular fibrillation. 3 patients with sick sinus syndrome received one-chamber pacemaker. The authors think their experience with sensory Siemens-Elema pacemakers positive.
Subject(s)
Pacemaker, Artificial , Adolescent , Adult , Aged , Child , Electrocardiography, Ambulatory , Equipment Design , Equipment Failure , Female , Heart Block/therapy , Humans , Male , Middle Aged , Myocardial Ischemia/therapy , Sick Sinus Syndrome/therapySubject(s)
Pacemaker, Artificial , Aged , Aged, 80 and over , Equipment Design , Evaluation Studies as Topic , Female , Heart Block/physiopathology , Heart Block/therapy , Hemodynamics , Humans , Male , Middle Aged , Sensitivity and Specificity , Sick Sinus Syndrome/physiopathology , Sick Sinus Syndrome/therapy , TransducersABSTRACT
The comparative analysis of 141 electrocardiograms showing premature atrial contraction from 43 patients with the sick sinus syndrome and 19 subjects with normal sinus nodal function revealed new electrocardiographic signs suggesting sinus dysfunction: an increase in the postextrasystolic pause by more than 135% of the preextrasystolic interval; greater full compensatory pause values; extrasystolic appearance of a full compensatory pause with the coupling interval of less than 68% of the presystolic interval; an increase in the sinus cycle followed the postextrasystolic pause by greater than 50 msec. The proposed criteria show a 5.7-fold increase in the informative value of ECG analysis in the diagnosis of the sick sinus syndrome in premature atrial contraction.
Subject(s)
Cardiac Complexes, Premature/diagnosis , Electrocardiography , Sick Sinus Syndrome/complications , Adolescent , Adult , Aged , Cardiac Complexes, Premature/etiology , Female , Humans , Male , Middle Aged , Sick Sinus Syndrome/physiopathologyABSTRACT
The diagnostic value of routine evaluations of sinus function and of analysis of sinus pause lengths were compared in 31 patients with a brady- and tachycardia types of the sick sinus syndrome after abolishing the tachyarrhythmic paroxysms provoked during an electrophysiological study. The study was performed by transesophageal electric stimulation. The sensitivity of the two modes of diagnosing the sick sinus syndrome was comparable: 55.5-65.2% for the former and 47.7-69.6% for the latter mode. Their concomitant application increases the diagnostic value of electrophysiological studies in patients with suspected brady- and tachycardia types of the sick sinus syndrome by more than 17%.
Subject(s)
Sick Sinus Syndrome/diagnosis , Sinoatrial Node/physiopathology , Tachycardia, Supraventricular/physiopathology , Adolescent , Adult , Aged , Cardiac Pacing, Artificial/methods , Esophagus , Heart Atria/physiopathology , Humans , Middle Aged , Sick Sinus Syndrome/physiopathology , Tachycardia, Supraventricular/etiologyABSTRACT
The authors provide the results of examining the conduction system of the heart in 623 patients with different disorders of heart conduction and rhythm by means of transesophageal pacing (TEP). The non-invasive electrophysiological examination of patients with sick sinus syndrome with latent disorders of atrioventricular (AV) conduction, and with supraventricular tachyarrhythmias turned out to be of high diagnostic value, inducing no complications. Application of programmed TEP (scanning extrastimulus on basis pacemaking) employed by the authors for the first time during TEP considerably widens the diagnostic possibilities of the technique permitting the measurement of the refractory periods of the conduction system (the refractory periods of the sinus node, atria, and AV-conduction system along normal and additional pathways), the performance of the trigger and removal of supraventricular arrhythmias with diagnostic and treatment purposes in view. The use of TEP for the treatment of patients with the syndrome of the prolonged QT interval and ventricular premature heart beat accelerates the choice of adequate antiarrhythmic therapy and raises its efficacy.