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

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

Intrauterine fetal supraventricular tachycardia (ISVT) is a rare condition which is connected with organic heart disease in only 4-10 per cent. However, neonatally these children develop heart failure in a high frequency (62 per cent). Intrauterine digitalization has been suggested as treatment, especially if the fetus is preterm. Fetal therapeutic concentrations might demand doses inconvenient to the mother. We hereby report one case of intrauterine SVT in the 26th gestational week treated with a standard dose of digoxin resulting in subtherapeutic umbilical digoxin levels. When no consistent influence on fetal heart rate could be seen, verapamil (80 mg x 3) was added to the treatment. A reversion of the tachycardia and the fetal ECG changes was achieved within two days. The verapamil treatment could be withdrawn after ten days, while the digoxin treatment was continued. An initial discrete heart enlargement also was reversed by the treatment. The delivery in gestational week 38 was uneventful and the child did well. A neonatal ECG showed a sinus rythm interfoliated with supraventricular extrasystoles. No signs of organic heart disease have appeared. When last seen at nine months of age, the ECG was normal and digoxin had been discontinued without recurrence of tachycardia.
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PMID:Treatment of intrauterine supraventricular tachycardia with digoxin and verapamil. 650 42

To determine the thresholds for transesophageal atrial capture, as well as factors that may influence the thresholds, we measured the minimal current and pulse width required to pace the atria through transesophageal bipolar lead systems in 12 patients, ranging in age from 1 day to 19 years, during 19 episodes of reentrant supraventricular tachycardia. Depending on the patients' age and size several electrode catheters were used. The protocol called for 1-msec step-wise increments in pulse width. At each pulse width the current was increased by 1 mamp until capture was achieved. The mean minimal pulse width and mean minimal current required for capture were 5.8 msec and 13.6 mamp, respectively. Atrial capture was achieved in 75% of attempts at a pulse width and current equal to or less than 6.5 msec and 17.5 mamp, respectively. No correlation between current and pulse width on the one hand and age, height, weight, or body surface area on the other was detected. Likewise neither electrode type nor existence of structural heart disease influenced the threshold required for capture. We conclude that atrial capture can be readily achieved through transesophageal electrodes and is not influenced by the subject's age or size.
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PMID:Thresholds for transesophageal atrial pacing. 651 15

Two cases of congestive heart failure in utero with fetal hydrops are reported. The diagnosis was made during pregnancy by means of echography. Cardiac failure, derived from supraventricular tachycardia not associated with structural anomalies of the heart, was observed in one of the patients. By digoxin administration and vagal stimulation the rhythm reverted to sinus, one hour after birth. In the second case fetal echography showed a fetus with serious bradycardia (45/min.) and ascites. On the bases of a median located and symmetric liver and of a complex heart malformation a diagnosis of "isomeric syndrome" was supposed. One hour after vaginal delivery, the newborn dead and autopsy confirmed a left isomeric syndrome with polisplenia and complex congenital cardiopathy (left ventricle and mitral hypoplasy, double outlet right ventricle, pulmonary stenosis, anomalous systemic and pulmonary venous return).
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PMID:[Fetal hydrops caused by cardiac failure in utero: description of 2 cases and pathogenetic considerations]. 653 1

Amiodarone was administered to 121 patients (82 males, 39 females; average age 59 years) with refractory atrial tachyarrhythmias. All patients had experienced recurrent atrial fibrillation, atrial flutter, or reentrant supraventricular tachycardia previously refractory to digitalis drugs, beta-adrenergic blocking agents, and an array of membrance-active preparations. Seventy-four of 121 patients (61.2%) had no evidence of organic heart disease, whereas 17 patients experienced arrhythmia as a result of coronary heart disease, nine had preexcitation syndromes, 16 had primary valvular heart disease, and five patients, had congenital heart disease. Atrial fibrillation alone or in combination with atrial flutter was the primary dysrhythmia in 95 of 121 patients (78.5%), whereas in 26 patients (21.5%) supraventricular tachycardia was the primary refractory dysrhythmia. Fifty-one patients (42%) had experienced tachyarrhythmias for more than 10 years prior to the use of amiodarone. During an average follow-up of 27.3 months, complete suppression of atrial arrhythmias occurred in 98 of 121 patients (81%), and partial suppression occurred in seven (5.8%). In 16 patients (13.2%) the drug was deemed ineffective, and in eight patients (6.6%) amiodarone was discontinued because of intolerable side effects. The average blood serum concentration among successfully treated patients was 1.9 micrograms/ml, whereas the average concentration for those with side effects was 2.3 micrograms/ml. Thus, amiodarone is an extremely effective (greater than 85%) agent for refractory atrial tachyarrhythmias. Once daily administration, generally tolerable side effects, and excellent patient tolerance render this agent an attractive option for the management of these dysrhythmias.
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PMID:Efficacy of amiodarone for refractory supraventricular tachyarrhythmias. 661 32

Programmed electrical stimulation of the heart to initiate and terminate tachycardia and analysis of the temporal relation between ventricular and atrial activation during tachycardia have been useful in the evaluation of supraventricular tachycardia (SVT). Such techniques have rarely been applied to evaluate infants with SVT. We used a silicone rubber-coated bipolar electrode catheter (15 or 22 mm interelectrode spacing), positioned in the esophagus, for electrical stimulation of the heart and recording of electrograms for the evaluation of 14 infants aged 1 to 84 days with SVT. Three infants had electrocardiographic features of Wolff-Parkinson-White syndrome, and no infant had other manifestations of congenital heart disease. Tachycardia cycle lengths ranged from 180 to 295 ms and ventriculoatrial intervals recorded from the esophagus were 80 to 220 ms. In 12 infants, transesophageal atrial stimulation was used to terminate and initiate SVT using stimuli of 9.9 ms and 10 to 20 mA. Initiation and termination of SVT by electrical stimulation suggest that SVT in infants is due to reentry, and the presence of ventriculoatrial intervals greater than 70 ms further suggests that accessory atrioventricular connections (usually concealed) constitute a portion of the reentry circuit.
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PMID:Transesophageal study of infant supraventricular tachycardia: electrophysiologic characteristics. 663 15

Ten patients with an unusual form of ventricular tachycardia (VT) are described. All were young (mean age 21 years) at the onset of VT, symptoms were of long duration (mean 7 years), none had symptomatic organic heart disease, VT was induced by atrial and ventricular stimulation, VT had a characteristic QRS morphologic picture resembling right bundle branch block with left-axis deviation and 9 had early retrograde His deflections during VT. Supraventricular tachycardia (SVT) was excluded in every patient by electrophysiologic study, although QRS morphologic characteristics and clinical stability of these patients during tachycardia frequently led to the diagnosis of SVT before referral. Four patients received verapamil during electrophysiologic testing. Verapamil slowed and terminated VT in all. Three patients are being treated chronically with oral verapamil, 3 patients with conventional antiarrhythmic agents and 1 with a radiofrequency ventricular pacemaker.
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PMID:Ventricular tachycardia induced by atrial stimulation in patients without symptomatic cardiac disease. 665 Apr 8

Supraventricular tachycardia is one of the most frequent arrhythmias in childhood. It may accompany congenital heart disease. W.P. W. syndrome, or a normal state of health. A re-entry circuit is the most commonly observed electrophysiological mechanism. Persistence is followed by decompensation. Drug management is based on digitalis, ATP, amiodarone, and verapamil. Atrial and ventricular pacing and surgery are alternatives when other means fail. Persistent tachycardia (i.e. its presence over long periods) is much less frequent that the paroxysmal form, and its aetiology is generally unknown. Even here, the clinical picture is substantially related to decompensation. Digitalis + amiodarone is the best treatment, though the arrhythmia may resolve spontaneously.
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PMID:[Supraventricular tachycardia in children]. 665 30

A case of the rare heart disease Wolf-Parkinson-White-syndrome in the dog is described. ECG-findings typical of the syndrome are shortened P-R interval, widened QRS-complex with an initial delta-wave, and supraventricular tachycardia. Pre- (Fig. 1) and post-treatment (Fig. 2) ECG's are analyzed. Different kinds of treatment are discussed.
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PMID:The Wolff-Parkinson-White-syndrome. A rare ECG diagnosis in the dog. 667 36

We performed a mail solicitation and obtained the records of 31 patients with documented torsade de pointes (TDP) due to quinidine. All 31 patients had heart disease: ischemic = 11 patients (36%), rheumatic = five patients (16%), hypertensive = four patients (13%), cardiomyopathic = four patients (13%), other = seven patients (22%). Quinidine was administered to these patients for the following reasons: atrial fibrillation or flutter = 22 patients (71%), ventricular premature beats = six patients (19%), ventricular or supraventricular tachycardia = three patients (10%). The 31 patients were receiving quinidine, 650 to 2400 (mean 1097) mg/day, and 14 patients had serum quinidine levels of 1.4 to 10.6 (mean 3.7) micrograms/ml. TDP occurred within 1 week of initiation of quinidine therapy in 23 (74%) of the patients. Twenty-eight (90%) of the 31 patients were receiving digoxin, and 5 (24%) of 21 patients had hypokalemia at the time of TDP. Off of quinidine therapy, corrected QT (QTc) intervals in 24 patients ranged from 390 to 580 (mean 470) msec and were prolonged in 17 patients (71%). On quinidine therapy, QTc intervals in 23 patients ranged from 390 to 630 (mean 510) msec and were prolonged in 21 patients (91%). In summary, patients with TDP due to quinidine usually had heart disease complicated by atrial fibrillation, were receiving digoxin, and were receiving moderate dosages of quinidine for less than 1 week prior to TDP. Approximately two thirds of patients with TDP due to quinidine had long QT intervals while off of quinidine.
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PMID:Torsade de pointes due to quinidine: observations in 31 patients. 669 83


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