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Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Because sympathetic stimulation has been implicated in the genesis of arrhythmias, we studied the effects on arrhythmias of electroconvulsive therapy (ECT). Fifteen psychiatric patients (male: 8, female: 7, age: 19-51, mean: 29.8) without known heart disease underwent 24-hout Holter recordings before, during, and after ECT (25 episodes). All patients were taking psychotropic drugs and received atropine (0.4-1.2 mg, mean: 1.1 mg IV), methohexital, and succinylcholine prior to ECT. Following ECT, mean maximum heart rate increased (106 +/- 3.2 to 142 +/- 6.0 beats/min, p less than .001), PR interval decreased (149 +/- 3.3 to 131 +/- 3.7 msec, p less than .001) and QTc interval increased (132 +/- 6.5 to 454 +/- 9.7 msec, p less than .001) compared to values obtained after atropine administration. Mean PVC or PAC frequently immediately after ECT or per 24 hours did not change significantly (PVC per 24 hours 6.8 +/- 3.2 to 10.4 +/- 6.4, NS; PAC per 24 hours 0.4 +/- 0.3 to 0.3 +/- 0.2, NS) and no complex arrhythmias were noted. Rate and PR changes suggest adrenergic effects of ECT and QTc increase may be due to imbalanced sympathetic discharge. Autonomic stimulation produced by ECT did not induce arrhythmias in these patients without heart disease. The possible antiarrhythmic role of psychotropic agents or premedication is unknown.
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PMID:Effect of electroconvulsive therapy on cardiac rhythm, conduction and repolarization. 8 30

Atrial premature complexes (APC) were identified in 16 cows over a 2-year period. Fourteen cows had concurrent gastrointestinal disease. Variation in the intensity of the first heart sound and an occasionally irregular heart rhythm were evident during thoracic auscultation. Neither cardiac murmurs nor pulse deficits were detected in any cows, and clinical signs of heart failure were lacking. Three cows had APC immediately prior to or after development of atrial fibrillation. The heart rate when APC were diagnosed ranged from 48 to 124 beats/min (mean, 77 +/- 20 beats/min), and the APC frequency ranged from less than 1 to 23/min (mean 9.4 +/- 8.0). The P-wave morphologic characteristics in 4 cows with APC was abnormal. The coupling index of the APC varied between 0.44 and 0.95, with a mean of 0.73. Aberrant ventricular activation was usually associated with a short coupling interval (coupling index less than 0.60) and was observed in 3 cows. Ten cows were determined to be hypocalcemic and 4 cows hypokalemic when APC were identified. Atrial ectopic activity could not be detected in 12 cows after resolution of the concurrent gastrointestinal disorder or electrolyte abnormality. Atrial premature complexes may be a functional cardiac disorder in cattle, unrelated to structural heart disease. The potential for APC to progress to sustained atrial arrhythmias such as atrial fibrillation should be considered.
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PMID:Clinical and electrocardiographic characterization of cattle with atrial premature complexes. 225 43

The authors examined the prevalence and significance of cardiac rhythm disturbances in healthy elderly individuals. They selected 26 men with active lifestyles, aged 70-81 years, after clinical, routine blood tests, chest radiographs, echocardiography, resting and exercise electrocardiography, and Gated cardiac blood imaging evaluations. The men were submitted to continuous electrocardiographic monitoring during their daily routine. The recording time ranged from 838 to 1,432 min (average = 1,307 +/- 153 min). Clinical follow-up was done every six months. Sinus rhythm predominated in all subjects. The maximal, minimal, and average heart rate ranges (beats/min) were, respectively: during sleeping periods, 60-115 (85.8 +/- 13.2), 42-80 (56.6 +/- 8.7), 51-85 (64.0 +/- 8.8); and during awake periods, 85-150 (118.4 +/- 16.4), 50-85 (64.1 +/- 9.1), 61-90 (75.3 +/- 8.3). The longest sinus pauses were observed during sleep and ranged from 0.8 to 2.5 sec (1.25 +/- 0.34 sec). Atrial ectopic beats were observed in 20 individuals (76.9%). They were frequent in four (15.4%) and repetitive in nine (34.6%) of them. Short-lasting episodes of paroxysmal atrial tachycardia and paroxysmal atrial flutter were observed in one case each. Ventricular ectopic beats were recorded in 20 individuals (76.9%). They were frequent in 6 (23%) and multiform in 13 (50%) of them. Couplets were observed in 5 cases (19.2%) and episodes of nonsustained ventricular tachycardia were present in 3 individuals (11.5%). No symptoms were referred by any individual during recording. No clinical signs of heart disease or symptoms were noticed during the average 40 +/- 7.2 months of follow-up.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Frequency and significance of cardiac rhythm disturbances in healthy elderly individuals. 234 17

To examine the effects of theophylline toxicity on cardiac rhythm, patients underwent continuous ambulatory ECG recording during acute theophylline toxicity and recovery. The patients, who were recruited form inpatient wards, intensive care units, and emergency departments of a University Medical Center and a Veterans Administration Medical Center, had serum theophylline concentrations (STC) greater than 30 mg/L. There were 14 men and two women with a mean age of 66 years. Fourteen patients had COPD and developed toxicity following long-term theophylline overmedication. Two patients had asthma and ingested an intentional overdose. The STC at the onset of ECG recording ranged from 23 to 67 mg/L. The principal rhythm was sinus in 15 patients; one patient had atrial fibrillation. Sinus tachycardia (heart rate greater than 100/min) was common, and heart rate fell in proportion to STC as toxicity resolved. Supraventricular ectopic beats (SVEs) were noted in seven patients with multiple runs of SVE being present in four. One patient developed multifocal atrial tachycardia (MAT) during toxicity that resolved spontaneously. During the 11 +/- 8 hours of recording during toxicity (STC greater than 20 mg/L), 80 percent of patients had ventricular premature beats (VPBs), 44 percent had paired VPBs, and 25 percent had ventricular runs. One elderly patient with heart disease developed sustained ventricular tachycardia (VT) when STC = 66 mg/L. No other patient had ventricular ectopy that required intervention. During the 10 +/- 6 hours of recording during the "recovery phase" (STC less than 20 mg/L), all patients with VPBs continued to have ectopy; however, the number of VPBs declined significantly. A follow-up 24-hour ECG recording obtained one week after recovery from toxicity in the patient with sustained VT demonstrated marked reduction in the frequency and complexity of VPBs. Patients with frequent (greater than 10/h) or repetitive VPBs were older (p less than 0.05) than those without complex ectopy. There was a trend (p = 0.07) suggesting patients with underlying heart disease were at risk for having complex ventricular ectopy. We conclude that sinus tachycardia, SVE, and VPBs are common among patients with theophylline toxicity; however, sustained ventricular or supraventricular tachyarrhythmias that require antiarrhythmic therapy are uncommon.
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PMID:Cardiac arrhythmias during theophylline toxicity. A prospective continuous electrocardiographic study. 188 98

To obtain information on the cardiac rhythm characteristics of subjects without heart disease during their daily work, we examined the continuous 24-hour electrocardiographic recordings of 400 workers from 4 factories in Eastern France presenting with criteria of cardiac normality. Sex, age and socio-professional category were taken into account. Supraventricular extrasystoles were extremely common, being observed in 52 p. 100 of men and 39 p. 100 of women. In men, the frequency of these extrasystoles increased with age (p less than 0.001), and their number was less than 20 per 24 hours in 90 p. 100 of the cases. Ventricular extrasystoles were detected in 40 p. 100 of men and 32 p. 100 of women. They too were age-related, though not significantly. Their number was less than 10 per 24 hours in 68 p. 100 of the cases and 10 to 50 per 24 hours in 28 p. 100. These ventricular extrasystoles usually were monomorphous, regularly coupled (92 p. 100) and isolated. However, 2 attacks of tachycardia were discovered. Episodes of bradyarrhythmia (RR superior or equal to 1500 ms) were present in 25 p. 100 of men and 19 p. 100 of women. They occurred more frequently before the age of 35 than later (p less than 0.001) and the recordings confirmed that they were predominantly nocturnal. Recordings without "disorders of rhythm" were relatively rare (20 p. 100 of men, 28.5 p. 100 of women). Finally, there was no clear-cut correlation between the prevalence or characteristics of these various "rhythmic abnormalities" and the type of professional activity.
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PMID:[Cardiac arrhythmia observed in 400 workers without obvious heart disease by Holter monitoring]. 314 28

Arrhythmia profiles and heart rates, obtained by 24-hour ECG monitoring, were analysed in 48 patients with hyperthyroidism before (T3 level: 331 +/- 108 ng/100 ml, heart rate: 95 +/- 13/min), during (T3 level: 202 +/- 98 ng/100 ml, heart rate: 85 +/- 11/min) and after (T3 level: 149 +/- 41 ng/100 ml, heart rate: 79 +/- 9/min) antithyroid treatment. 50 persons in whom organic heart disease has been excluded by invasive and noninvasive tests served as controls. Only 6% of patients had repetitive ventricular arrhythmias (Lown group IV) before treatment (controls: 4%; P greater than 0.05). Supraventricular extrasystoles were common both before and after treatment (P less than 0.001), especially in elderly patients. The number of patients with supraventricular tachycardias decreased in the course of treatment from eleven to two. There was a clear correlation between the T3 level and nocturnal heart rate (r = 0.74; P less than 0.001). A day-night difference in heart rate (a ratio of greater than or equal to 1.10) was present in 43 patients and higher than in the controls (P less than 0.001). Thus with respect to ventricular arrhythmias hyperthyroid patients had a normal profile, but a marked tendency towards supraventricular arrhythmias which was partly age-related. Antithyroid treatment affected only the incidence of supraventricular tachycardias, while day-night differences in heart rate remained unchanged.
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PMID:[Arrhythmia profile and heart rate in hyperthyroidism]. 335 32

The late radiation response of the heart is of concern because of many reports of heart disease following radiation therapy of thoracic tumors. This study was done because of the clinical relevance of the pathophysiology of cardiopulmonary irradiation and because the heart is a good model for late effects of vasculoconnective tissue due to its lack of acutely responding parenchymal cells. Thoracic irradiation of adult beagle dogs including the heart and one third of the lung volume produced an early response in the heart at 1 and 3 months which consisted of an increase in left ventricle and septal wall thickness, decreased left ventricle ejection fraction, increased heart rates, intraventricular conduction disturbances and a high probability for pericardial effusion at 3 months. Radiation doses were 36, 44, or 52 Gy given in 4 Gy fractions in 4 weeks. Premature atrial contractions, paroxysmal atrial tachycardia, sustained atrial tachycardia and atrial fibrillation occurred at all dose levels. Evidence suggests that both early and late responses were due, at least in part, to direct injury to the cardiac microvasculature. The later effects appeared to be enhanced by injury to the lung. The early response appeared to resolve in 6 to 9 months, after which there was thinning of the myocardium at higher doses and resolution of pericardial effusions. At 12 months, elevations in right atrial pressure, but not pulmonary wedge pressure, were suggestive of right-sided congestive heart failure. Pulmonary hypertension was also present at 12 months presumably due to partial lung irradiations, and may have exacerbated right-sided congestive heart failure. The radiation injury may continue to increase with time leading to serious deficits in cardiopulmonary function. The functional studies may aid in predicting late effects and evaluating residual injury.
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PMID:Canine cardiomyopathy after whole heart and partial lung irradiation. 338 19

In a prospective randomized study we searched for arrhythmogenic effects of the tetracyclic antidepressant, a maprotiline, and the tetrahydroisoquinoline derivative, nomifensine. Forty depressive patients from the psychiatric outpatients department were included in the study. Twenty patients in each group received maprotiline or nomifensine over three weeks in the recommended daily dosage of 75 mg. Rhythm analysis was performed before therapy, at the end of 3 weeks therapy, and 1 week after withdrawal from medication using a dual channel long-term ECG with monitoring periods of 10 h during normal daily activities. Before treatment, spontaneous incidence of all ventricular ectopics and of their complex forms was within the normal range when compared with ectopic activity of 121 "normal subjects" without detectable heart disease. No significant increase could be demonstrated during therapy with maprotiline or nomifensine, nor was any change observed 1 week after medication had been stopped. The same was true for supraventricular extrasystoles; atrial tachycardia, atrial flutter, and fibrillation were never seen. Sinoatrial (n=2) and atrioventricular block (n=1) were rare findings independent of and not affected by treatment. No bundle branch blocks were observed before, during, and after treatment. In contrast, despite the conservative dosage of both drugs, a therapy-dependent increase in average heart rate was found (p less than 0.001). This increase was significantly higher in patients receiving nomifensine than in those treated with maprotiline (p less than 0.001), suggesting a lower intrinsic anticholinergic activity of the latter compound.
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PMID:Incidence of cardiac arrhythmias during antidepressant therapy with maprotiline or nomifensine. 617 91

The implications of the minor ECG abnormalities that I have dealt with may be categorized as follows. Innocent: 1. Sinus arrhythmia, with or without nodal escape beats 2. Atrial extrasystoles 3. Incomplete right bundle-branch block 4. Parabolic depression of the ST segment in association with a rapid heart rate 5. Elevation of the ST segment in the right precordial leads 6. Positive/negative T waves in the transitional zone. Not necessarily indicating disease: 1. Ventricular indicating disease: 1. Ventricular extrasystoles 2. Complete right bundle-branch block 3. Left anterior or posterior hemiblock 4. Abnormally directed T-wave vectors. Probably indicating disease: 1. Plane or downward-sloping ST depression, at rest or on exercise, of more than 1 mm 2. Pyramidal arrowhead T waves, with or without an abnormally directed T-wave vector 3. Negative/positive T waves in leads facing the left ventricle 4. Inverted U waves. It is clear that careful assessment must be made before minor ECG abnormalities in presumptively normal individuals are accepted as indicators of the presence of heart disease.
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PMID:Symptomless abnormalities. Minor ECG abnormalities. 618 Jul 89

Continuous 24 hour electrocardiography (Holter method) was carried out during work time in 64 workers. They were divided into two groups: the first group comprised 34 subjects with either organic heart disease (coronary artery disease, valvular heart disease, operated coarctation, hypertrophic cardiomyopathy) or a documented arrhythmia without proven underlying cardiac disease; the second group comprised 30 subjects without known cardiac disease but complaining of symptoms suspected to be of cardiac origin or with isolated electrocardiographic abnormalities. At the end of the study we concluded that Holter monitoring is possible in subjects performing physical occupations even in difficult conditions. The trends of heart rate, especially mean heart rate calculated over 10 minute periods, confirmed the relationship between heart rate and the intensity of the physical activity. Atrial extrasystoles and episodes of supraventricular tachycardia were as common in the first as in the second group (20% and 18% respectively). This did not apply to ventricular extrasystoles: they were observed in both groups but were significantly more common in the first group (55% compared to 33%); ventricular extrasystoles, usually of a single configuration and isolated, were more common in the first group, especially amongst the coronary patients. Sinus node dysfunction was only observed in the second group (12.5%), in young subjects, and this occurred with only one exception at night. These findings support previous reports in the literature. However, the interpretation of these results is difficult because of the absence of well established normal values.
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PMID:[Continuous electrocardiographic registration in occupational medicine]. 642 4


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