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

Two cases of spontaneous multifocal ventricular parasystolic rhythm are described. One case showed double and the other fivefold parasystole. All seven foci had an enhanced rate of discharge, ranging from 57 to 102/min and at least three of them showed exit block. Though beats from three foci displayed very short coupling intervals, occasionally interrupting the terminal part of the preceding T wave, in none of the cases was repetitive firing or ventricular fibrillation seen. Both patients had organic heart disease and both are still alive six months after the arrhythmia was first recorded. Problems in the diagnosis of multiple parasystole and some mechanisms which may be responsible for irregular interectopic intervals are discussed. It is concluded that multiple parasystole is probably not a very rare arrhythmia if long strips of simultaneously recorded multiple leads are available.
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PMID:Multifocal ventricular parasystolic tachycardia. 6 57

13 male patients suffering from arteriosclerotic heart disease and/or arterial hypertension were monitored continuously before and after vascular surgical procedures using an arrhythmia computer. Heart rate, paroxysmal supraventricular tachycardias, ventricular extrasystoles, ventricular tachycardias, ventricular fibrillation and prematurity index (QnQe/QTn) were recorded numerically. Ventricular arrhythmias were detected as follows preoperatively in 12 patients, after operation in all patients, paired ventricular extrasystoles or episodes of ventricular tachycardia were found in 5 cases before and in 7 after operation, ventricular fibrillation in one case. The incidence of ventricular dysrhythmias increased significantly (p less than 0.05) early after operation, as did the heart rate during the observed postoperative period (p less than 0.001). The prematurity index dropped below 1.0 during the two days following operation. This differed significantly from the preoperative value (p less than 0.05). The incidence of ventricular extrasystoles was related to postoperative myocardial infarction and heart failure (p less than 0.01), which occurred in 6 cases, with a lethal outcome in three. Only occasionally controlled by trained staff in a normal surgical ward the "Servomed Dysrhythmiemonitor" yielded reliable numerical results during the main part of the monitored period. In two cases it led to immediate detection and rapid institution of treatment of severe tachyar rhythmias.
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PMID:[Postoperative cardiac arrhythmias (author's transl)]. 8 Sep 61

Eleven patients with short P-R intervals and narrow QRS complexes had ventricular tachycardia due to organic heart disease: mitral valve prolapse with mitral insufficiency (2 patients); alcoholic (?) cardiomyopathy (2 patients); and coronary artery disease (7 patients). Intracardiac studies showed short A-H intervals during sinus rhythm in all cases. The onset of ventricular fibrillation (which, to our knowledge, has not been observed in patients having short P-R and A-H intervals coexisting with narrow QRS complexes) was documented in 4 cases. Only 1 patient (with quinidine syncope) had been premedicated. In the 3 other patients the episodes of ventricular fibrillation appeared during bouts of atrial fibrillation with rapid ventricular rates which could have been an exprerssion of the "enhanced A-V conduction" that had been manifested in sinus beats by short P-R and A-H intervals. In clinical settings and physiological conditions proven to be hemodynamically unstable (such as transient ischemia or acute myocardial infarction) these rapid ventricular rates could have led to ventricular fibrillation; directly because of the R-on-T phenomenon, and/or indirectly due to decreased coronary perfusion. Ventricular tachycardia and ventricular fibrillation due to organic heart disease probably occur more often than suggested by the few reported cases in the literature. Its significance, however, has to be clarified by further prospective studies.
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PMID:Ventricular tachycardia and ventricular fibrillation in patients with short P-R intervals and narrow QRS complexes. 9 18

A 39-year-old man twice experienced ventricular fibrillation and exhibited numerous ventricular premature beats. Coronary arteries were normal, and no impaired cardiac function was found upon catheterization. Evidence was adduced that the ventricular premature beats were related to higher nervous activity. The patient had serious psychiatric problems; the ventricular premature beats were provoked by psychophysiologic stress, increased during REM sleep, were reduced by meditation, and were controlled by beta-adrenergic blockade, phenytoin and digitalization. We conclude that psychologic and neurophysiologic factors may predispose to life-threatening cardiac arrhythmia in the absence of organic heart disease. Effective management of the recurrent ventricular arrhythmia involved; acute drug testing for assessing antiarrhythmic efficacy; use of programmed trendscription to provide on-line information on drug action; a treatment program involving more than one agent; and use of measures to reduce sympathetic nervous activity.
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PMID:Basis for recurring ventricular fibrillation in the absence of coronary heart disease and its management. 17 92

A three-year-old girl with congenital complete heart block presented with repeated bouts of ventricular tachycardia and ventricular fibrillation. The ECG was remarkable for both complete heart block and a long Q-T interval, when corrected for rate. The Q-T interval was longer than the Q-T interval of children with congenital complete heart block and of children without heart disease. Overdrive ventricular pacing was necessary to control the arrhythmias. A prolonged Q-T interval in patients with complete heart block, even in the presence of a normal QRS duration, may predispose the patient to sudden death. Permanent pacing can suppress these arrhythmias by overdriving.
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PMID:Congenital complete heart block and long Q-T syndrome requiring ventricular pacing for control of refractory ventricular tachycardia and fibrillation. 46 47

In this study, we describe the findings in 18 young patients (age range 4 days to 24 years, mean 16.6 years) who had ventricular tachycardia and/or ventricular fibrillation and were followed for 4--70 months (mean 22.4 months). Patients had a variety of problems associated with their arrhythmia, including mitral valve prolapse, cardiomyopathy, myocarditis, prolonged QT syndrome and hypokalemia. Six patients had no clinically recognizable cardiac abnormality. The ventricular tachycardia showed a left bundle branch block contour in 10 of 17 patients, right bundle branch block in four, was multiform in two and had an indeterminate contour in one. Sustained ventricular tachycardia was initiated and terminated reproducibly by atrial and ventricular stimulation in three of seven patients who did not have spontaneous episodes of ventricular tachycardia during the electrophysiologic study. In one other patient, short bursts of ventricular tachycardia were induced. Patients who had ventricular fibrillation, those who died, and those who are still symptomatic with poorly controlled ventricular arrhythmias had significant heart disease. In one patient, a ventricular tachyarrhythmia that had required more than 100 electrical cardioversions spontaneously disappeared after requiring 1 year of antiarrhythmic therapy.
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PMID:Ventricular tachycardia and ventricular fibrillation in a young population. 48 57

Disturbances of heart rhythm, observed during 700 heart catheterizations in infants and children, are discussed. Paroxysmal supraventricular tachycardia has been observed in 25 investigations (3,6%), sinus bradycardia in 18 (2,6%), junctional rhythm in 10 (1,4%), second degree AV-block in 9 (1,3%), ventricular fibrillation in 8 (1,1%), sinus tachycardia in 7 (1%), complete block in 7 (1%), asystole and atrial flutter in 2 (0,3%) each, and ventricular tachycardia in 1 (0,15%). Supraventricular tachycardia occurred equally in all ages without preference of a special malformation. The two patients with WPW-syndrome, however, showed this disorder in each of three catheterizations. Propranolol and verapamil succeeded in terminating the attacks. Junctional rhythm and sinus tachycardia presented equal behavior and benignity. Sinus bradycardia, second and third degree AV-block, and especially ventricular fibrillation occurred mostly in neonates and infants, many of them cyanotic and suffering from complex malformations and therefore needing multiple catheter manipulations. Bradycardia was in two, asystole in one of the very sick neonates associated with subsequent death within 24 hours. Once asystole resulted in immediate death after pulmonary angiography in a child with severe pulmonary hypertension. Ventricular fibrillation could be terminated promptly by DC countershock in all patients, but three of the children died subsequently. Complete block occurred only in children with systemic right ventricular pressure, 4 of the 7 patients having pulmonary hypertension, too. In two instances the block subsided spontaneously, the rest could successfully be treated with orciprenaline (Alupent R). Life threatening arrhythmias became less frequent as a consequence of earlier investigation, if severe heart disease was suspected, and by closer control of cyanosis, acidosis and temperature before, during, and after catheterization.
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PMID:[The risks involved in the heart catheter examination. A retrospective evaluation of the complications after 700 examination. III. Irregularities of heart (author's transl)]. 53 Jul 27

A surveillance system identified all out-of-hospital victims of cardiac arrests who received emergency aid in King County, Washington, as well as the etiologic condition and cardiac rhythm causing each arrest. During an 18-month period, 649 cardiac arrests occurred (annual incidence 7.2/10,000). Primary heart disease was the cause in 81%. Ventricular fibrillation was the associated rhythm in 57% of cardiac arrests. Based upon the incidence of cardiac arrest in the community and the likelihood of resuscitation under optimal conditions, we estimate the maximum incidence of lives saved to be 2.0/10,000 annually.
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PMID:Epidemiology of cardiac arrest and resuscitation in a suburban community. 53 62

Clinical and pathologic changes in 87 patients who could not be resuscitated from an episode of sudden cardiovascular collapse are described and compared with observations from patients in the same community who were successfully resuscitated from ventricular fibrillation. Findings in patients who died suddenly generally did not differ when the patients were groups by electrocardiographic rhythm on arrival of the mobile coronary aid unit. The pathologic changes of acute thrombosis and recent myocardial infarction did not occur with sufficient frequency in the entire group to be considered causally related to the sudden collapse, occurring in 10 and 5 percent of cases, respectively. Although most patients had evidence of obstructive coronary disease and old myocardial infarction, 8 percent had no significant vascular disease, acute thrombosis, myocarditis or valve disease that might be implicated as a factor in sudden death. There was no relation between age and severity of obstructive coronary disease or frequency of old myocardial infarction in patients who died suddenly. Complete atherosclerotic occlusion in one or more coronary vessels occurred in 51 of 87 (59 percent) and old myocardial infarction in 48 of 87 (55 percent). Although the mean age of this autopsy population was similar to that of all patients in the community who have had ventricular fibrillation on arrival of the aid unit, the nonsurvivors had a greater incidence of myocardial infarction and symptomatic heart disease (73 of 87) than did survivors. Comparison of this autopsy group with persons from the community who were resuscitated from ventricular fibrillation and subsequently had coronary angiograms indicates that the severity of coronary stenosis does not distinguish between survivors and nonsurvivors of an episode of ventricular fibrillation and suggests that other factors influence the outcome of an episode of ventricular fibrillation.
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PMID:Pathology of the heart in sudden cardiac death. 87 Nov 13

A long-term follow-up report is given on three children with stress-induced bursts of ventricular activity, occasionally proceeding to ventricular fibrillation causing syncope. All patients were treated with a beta-blocking agent as prophylaxis for 12, 10 and 6 years, respectively. Case 1 has no signs of organic heart disease. She has been followed from the age of 8 years and had her last syncope in 1974. She was last seen in Nov. 1976, doing well at the age of 20. Case 2 started having syncopes after an attack of measles at the age of 8 years, at which time she probably acquired some damage to her myocardium. She had persistent bradycardia but no other signs of heart disease. She had an uneventful pregnancy and delivery in 1973 and gave birth to a normal child. She died suddenly in 1974, at the age of 22, four years after her last syncopal attack. Case 3 had cardiomyopathy with increasing heart size and exertional dyspnoea and marked ischaemic ECG changes during exercise. He was followed from the age of 7 years. He died suddenly in 1974 at the age of 16, four years after his last syncope.
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PMID:Paroxysmal ventricular fibrillation in children. Long-term follow-up of three cases treated with beta-blocking agents. 92 Feb 65


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