[Recording of atrial and ventricular signal averaged ECGs in patients with mitral valve prolapse syndrome]. / Rejestracja usrednionego sygnalu przedsionkowego i komorowego u chorych z wypadaniem platka zastawki mitralnej.

The aim of the study was to assess the time-domain parameters of atrial signal-averaged ECG (ASAECG) and ventricular signal-averaged ECG (SAECG) in patients with mitral valve prolapse (MVP) and healthy ones. Fifty patients with MVP (15 men, 35 women, mean age--37.1 +/- 8.9 years) and 50 healthy controls (36 men, 14 women, mean age 38.2 +/- 4.7 years) were studied). The following time-domain parameters of ASAECG were analysed: the root mean square voltage of the terminal 10, 20, 30 ms of filtered P wave (RMS10, 20, 30) and the total duration of filtered P wave (PWD). The atrial late potentials (ALP) were defined as the presence: RMS10 < 4 microV i PWD > 123 ms. As the time-domain parameters of SAECG we analysed: the root mean square voltage of the terminal 40, 50 ms of the filtered QRS (RMS 40, 50), the total filtered QRS duration (t-QRS) and the low-amplitude signal duration < 40 microV in the terminal QRS (LPD). The ventricular late potentials (VLP) were defined as the presence of at least two of the following criteria: t-QRS > 114 ms, RMS 40 < 20 microV i LPD > 38 ms. There was no difference in the time-domain parameters of ASAECG between patients with MVP and controls: RMS 10: 4.5 +/- 1.8 microV vs 4.8 +/- 1.9 microV, RMS 20: 6.3 +/- 2.2 microV vs 6.1 +/- 2.2 microV, RMS 30: 8.3 +/- 2.5 microV vs 7.1 +/- 2.7 microV and PWD 113 +/- 11.7 ms vs 116 +/- 15.2 ms, respectively. Three patients with MVP (6%) and 5 controls (10%) revealed ALP. THE time-domain parameters of SAECG did not differ in patients with MVP and controls: RMS 40: 40.2 +/- 29.1, microV vs 35.5 +/- 18.2 microV, RMS 50: 68.2 +/- 40.1 microV vs 64.4 +/- 33.6 microV and t-QRS-101.4 +/- 10.7 ms vs 101.8 +/- 10.9 ms i LPD--28.7 +/- 10.0 ms vs 28.3 +/- 10.0 ms, respectively. VLP were found in 7 patients with MVP (14%) and 5 controls (10%). Our findings suggest that time-domain parameters of ASAECG and SAECG could not differentiate patients with MVP and healthy ones. Moreover, the presence of ALP and VLP in MVP group did not correlate with supraventricular and ventricular arrhythmias recorded on ambulatory ECG.

[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.

[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.

[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 influence of organic myocardial damage on parameters of signal-averaged electrocardiogram in patients with electrically-induced atrial fibrillation]. / Wplyw organicznego uszkodzenia serca na parametry usrednionego sygnalu przedsionkowego u chorych z wystymulowanym migotaniem przedsionków.

The aim of this study was to assess the effects of myocardium organic damage on time-domain parameters of atrial signal-averaged ECG (ASAECG) in patients with electrically induced paroxysmal atrial fibrillation (PAF). The investigation was done in 120 patients with subjective symptoms of cardiac rhythm disorders suggesting atrial fibrillation and for further analysis were selected 51 patients in whom atrial PAF was induced during transoesophageal pacing (TEP). Patients were divided according to organic damage of myocardium-38 pts (24 male and 14 female, mean age 52.1 +/- 11.6-group I) and without-13 pts (9 male and 4 female, mean age 35.4 +/- 9.9 -group II). In all two dimensional echocardiographic examination, 24-hours Holter monitoring, exercise testing and TEP were made. Recording of ASAECG was done with a commercially available system HIPEC-200 HA Aerotel. 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 time duration of filtered P-wave (PWD) and also time duration of P-wave from Frank's leads X, Y, Z (XP, YP, ZP). Atrial late potentials (ALP) were defined as the presence of two parameters: RMS 10 < 4 microV and PWD > 123 ms. If we compared time-domain parameters of ASAECG between examined groups it occurred that only the values of PWD attained statistically significant differences, respectively 123.3 +/- 15.4 ms vs 115 +/- 11.2 ms, p < 0.05. In 14 (36.8%) patients from first group and in 2 (15.4%) patients from second ALP were confirmed. We concluded that presence of myocardium organic damage have essentially influenced on time duration of filtered P-wave.

[The effects of long-term treatment of sotalol hydrochloride on time and frequency domain parameters of signal averaged electrocardiogram in patients with ischemic heart disease]. / Wplyw przewlekle stosowanego chlorowodorku sotalolu na parametry czasowe i czestotliwosciowe elektrokardiogramu wysokiego wzmocnienia u chorych na chorobe niedokrwienna serca.

The aim of this study was to assess the influence of sotalol hydrochloride on time- and frequency-domain parameters of signal-averaged electrocardiogram (SAECG) in patients with ischemic heart disease (IHD). The study population consisted of 25 patients (16 women and 9 men), mean age 56.6 +/- 8.3. Sotalol was orally used in dose 160 mg/day during 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 50ms of the filtered QRS (RMS 40 i RMS 50), 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 > 38ms. Frequency analysis of SAECG allowed to calculate the following parameters in logarithmic scale: energy spectrum > -60dB (A) and decibel drop at 40 Hz (Dd) and also in linear scale: area ratio 20-50/0-20 Hz (Ar) and magnitude ratio (MR1-7). The values of RMS40 and RMS50 and also t-QRS and LPD did not significantly change after sotalol treatment. At baseline the presence of LP was recorded in 7 (28%) cases, after 10 days of antiarrhythmic therapy only in 3 (12%), and after 6 weeks occurred in 6 (24%) cases. Moreover, sotalol hydrochloride did not statistically significant change frequency-domain parameters in logarithmic scale: A and Dd. On the other hand, the parameters in linear scale: MR1, MR4 and MR6 significantly change but these changes were not uniform. These findings suggest that oral treatment of sotalol hydrochloride did not significantly change time- and frequency-domain parameters of signal-averaged electrocardiogram in patients with ischemic heart disease.

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

The aim of this study was evaluation of intravenous propafenone hydrochloride effects on maintenance of atrial signal-averaged ECG (ASAECG) during time-domain and frequency-domain analyses in patients paroxysmal atrial fibrillation (PAF) accompanying ischemic heart disease (IHD). The study population of 20 patients included 12 women and 8 men (mean age 58.8 +/- 8.9). 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 duration of filtered P-wave (PWD). During frequency-domain analysis of the terminal part of P-wave the following parameters were calculated in the range from 40 Hz to 400 Hz: energy spectrum > -60 dB (A, YA) and decibel drop at 40 Hz (Dd, YDd) in logarithmic scale and area ratio 20-50/0-20 Hz (Ar, YAr), peak (P1-7, YP1-7), magnitude ratio (MR1-7, YMP1-7) in linear scale for a vector magnitude and Frank lead Y. Time-domain analysis of ASAECG did not show any significant changes--RMS10 increased from 5.2 +/- 2.5 microV to 5.9 +/- 2.6 microV, RMS20 from 6.9 +/- 3.4 microV to 7.3 +/- 2.5 microV and RMS30 from 8.4 +/- 3.1 microV to 8.5 +/- 2.2 microV after propafenone. Duration of filtered P-wave (PWD) increased from 125.1 +/- 21.9 ms to 128.4 +/- 22.7 ms (p > 0.05). During frequency-domain analysis both in linear and logarithmic scales no any significant differences after administration of propafenone were noted. The obtained results have indicated that intravenous propafenone hydrochloride did not change significantly time-domain and frequency-domain parameters of ASAECG in patients with PAF during IHD.

[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.

P-wave signal-averaged electrocardiogram in patients with idiopathic mitral valve prolapse syndrome and supraventricular arrhythmias.

The aim of the study was to assess whether the P-wave triggered signal-averaged ECG (SAECG) used in patients with idiopathic mitral valve prolapse syndrome could predict the risk of the development of supraventricular arrhythmias. Fifty patients with idiopathic mitral valve prolapse syndrome (15 men, 35 women, mean age: 37 +/- 9 years) were prospectively studied. P-wave triggered SAECG was recorded with a commercially available system (HIPEC-200HA Aerotel). The following parameters were calculated: the root-mean-square voltage for the terminal 10, 20, 30 ms of filtered P-wave (RMS10,20,30) and time duration of filtered P-wave (PWD). Nine patients with mitral valve prolapse syndrome (18%) revealed the occurrence of supraventricular arrhythmias on Holter monitoring whereas of the remaining 41 (82%), no clinically relevant supraventricular arrhythmias were detected. We found PWD values to be significantly longer in patients with supraventricular arrhythmias when compared with those without arrhythmias: 119.8 +/- 6.9 ms vs. 111.7 +/- 12.1 ms, respectively, P < 0.02. We conclude that P-wave triggered SAECG could be a useful technique for detecting patients with idiopathic mitral valve prolapse syndrome at risk of paroxysmal supraventricular arrhythmias.

[Effect of pharmacologic blockade of the autonomic system on time domain parameters of atrial and ventricular signal-averaged ECG in subjects with mitral valve prolapse]. / Wplyw farmakologicznej blokady ukladu autonomicznego na parametry czasowe usrednionego sygnalu przedsionkowego i komorowego u osób z wypadaniem platka zastawki mitralnej.

The aim of this study was evaluation of pharmacologic autonomic blockade on time-domain parameters of atrial (ASAECG) and ventricular signal-averaged ECG (SAECG) in patients with mitral valve prolapse syndrome (MVP) regarded 20 subjects with MVP (mean age 34.9 +/- 5.3) (group I) were studied as well as a control group consisting of 20 healthy subjects (mean age 37.5 +/- 4.6) (group II). Initially, two dimensional echocardiography with color doppler examination, ambulatory Holter monitoring, multistage treadmill exercise test, transoesophageal pacing (TEP), recording of ASAECG and SAECG were made. Subsequently, pharmacologic autonomic system blockade was done by using intravenously propranolol (0.1 mg/kg) and atropine (0.02 mg/kg). The following time-domain parameters of ASAECG were calculated: the root mean square voltage for the last 10, 20, 30 ms of filtered P-wave (RMS 10, 20, 30) and time duration of filtered P-wave (PWD). Moreover, the following parameters of SAECG were analyzed: the root mean square voltage of the signals in the last 40 and 50 ms of the filtered QRS (RMS 40, 50), the total time duration of QRS(t-QRS) and the duration of low amplitude signals < 40 microV (LPD). The autonomic blockade did not change significantly the obtained values of RMS 10, 20, 30 in subjects with MVP as follows: RMS 10 from 5.5 +/- 2.9 microV to 6.3 +/- 2.4 microV, RMS 20 from 8 +/- 3.7 microV to 8.5 +/- 2.4 microV and RMS30 from 10.2 +/- 4.9 microV to 10.3 +/- 3.3 microV. On the other hand, also the values of RMS 10 did not change statistically significant after blockade in control group (from 5.8 +/- 2.2 microV to 5.6 +/- 1.7 microV, p > 0.05), but the values of RMS20 i RMS30 increased significantly in this group, respectively from 7 +/- 3.1 microV to 8.3 +/- 3 microV (p < 0.02) and from 8.4 +/- 3.1 microV to 10.1 +/- 3.6 microV, (p < 0.05). The values of PWD have changed differently in the examined groups being under the influence of the autonomic blockade: in group I decreased from 119 +/- 12 ms to 114 +/- 28 ms (p > 0.05), whereas in group II increased from 110 +/- 13 ms to 116 +/- 9 ms (p < 0.02).(ABSTRACT TRUNCATED AT 400 WORDS)

[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.

[Effect of penicillamine treatment on the occurrence of heart rhythm disturbances in patients with rheumatoid arthritis]. / Wplyw leczenia penicylamina na wystepowanie zaburzen rytmu u chorych z reumatoidalnym zapaleniem stawów.

An ECG examination, prolonged over several hours was carried out in 30 patients aged from 29 to 66 years (mean age 51.3) with the diagnosis of rheumatoid arthritis made on the basis of the WHO criteria, before, and in the second and third month of treatment with penicillamine. The values were evaluated of the mean, minimal, and maximal heart rate per minute, and supraventricular and ventricular heart rhythm disturbances, and also conduction disturbances were assessed. In the study no statistically significant changes were recorded in the individual periods of the examination of the values of mean, minimal and maximal heart rate/min. In the initial examination, supraventricular arrhythmia occurred in 80% of patients, and ventricular arrhythmia in 33% of cases. As a result of the applied treatment a decrease was observed of incidence of arrhythmia both supraventricular and ventricular.

[Diurnal fluctuations of arterial blood pressure and heart rate in patients with atrial fibrillation]. / Dobowe wahania cisnienia tetniczego i czestosci serca u chorych z migotaniem przedsionków.

In patients with atrial fibrillation and in patients with sinus rhythm aged below and over 40 years 24-hour automatic measurement of systolic and diastolic arterial blood pressure was carried out. The systolic and diastolic arterial blood pressure in atrial fibrillation was higher than in patients with sinus rhythm, both during daily activities and during night rest. The heart rate in those below 40 years showed greater diurnal fluctuations than in atrial fibrillation and patients aged over 40 years. Moreover, circadian systolic and diastolic blood pressure recordings were lower in night hours, similarly as heart rate values an all the studied groups, and only in the group of atrial fibrillation the differences between the parameters recorded during the night and in daytime were not so evident as in the groups with sinus rhythm.

[Effect of salbutamol on heart rate in patients with atrial fibrillation]. / Wplyw salbutamolu na czestosc serca u chorych z migotaniem przedsionków.

The influence of salbutamol aerosol on heart rate in patients with chronic atrial fibrillation was examined. The study comprised 15 patients (9 women and 6 man) in age 47-79 (mean 60) treated because of chronic obstructive pulmonary disease (COPD) with concomitant atrial fibrillation. The influence of salbutamol on heart rate was investigated during six hours ecg Holter monitoring (3 hours before and 3 hours after using salbutamol). The analysis showed that salbutamol aerosol in two doses increased heart rate calculated as mean heart rate per hour from 3-hours intervals from 4061 congruent to 1022.5 to 4185 congruent to 976 (p greater than 0.05). Mean value of blood pressure in one hour intervals did not change significantly. In patients with concomitant chronic atrial fibrillation and COPD salbutamol increased heart rate but difference between mean values before and after administration was not significant.

[Clinical value of indirect automatic blood pressure determination in patients with atrial fibrillation]. / Znaczenie kliniczne automatycznego pomiaru cisnienia tetniczego metoda posrednia u chorych z migotaniem przedsionków.

The value of indirect blood pressure in patients with atrial fibrillation was studied. Three methods were compared; single measurement, mean of three measurements and mean value of automatic measurement during 2-hours and whole day. The study comprised 13 patients; 7 men and 6 women aged 52-77 (mean 62.8 congruent to 6.6) hospitalized for cardiac diseases. The measurement were done using the mercury sphygmomanometer and auscultatory Korotkoff technique and automatic blood pressure monitoring (Acutracker--Medilog Oxford). The investigations showed that systolic and diastolic blood pressure during 24-hours monitoring were lower than single or repeated three measurements. The highest correlation coefficient to 24-hours recording was found for the mean value of 2-hours recording. It seems that blood pressure measurement in patients with atrial fibrillation (3-times in few minutes intervals) should be verified by using prolonged automatic recording.

[Effect of pharmacologic blockade of the autonomic nervous system on electrophysiologic properties of the accessory pathway and atrioventricular node in patients with Wolff-Parkinson-White syndrome]. / Wplyw blokady farmakologicznej wegetatywnego ukladu nerwowego na wlasciwosci elektrofizjologiczne drogi dodatkowej i wezla przedsionkowo-komorowego u chorych z zespolem Wolffa-Parkinsona-White'a.

In 17 patients aged 21-61 (mean 32) with WPW syndrome the transoseophageal stimulation was performed before and after intravenous administration of propranolol (0.1 mg/kg b.w.) and atropine (0.02 mg/kg b.w.). Pharmacological blockade of the autonomic nervous system resulted in statistically significant increase of heart rate (from 81 to 111/min), shortening of a-v nodal and atrial refraction (from 298 to 272 ms) as well as in shortening of stimuli cycle length revealing Wenckebach's point (from 324 to 291 ms). The Kent bundle refraction did not at the average change (333 and 324 ms), while in individuals great differences were observed. Generally, pharmacological blockade of the autonomic nervous system improves a-v nodal conduction, but in patients with WPW syndrome does not significantly effect on the accessory pathway.