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

Long term clinical courses of a patient and her family with idiopathic cardiomyopathy and WPW syndrome were described. The mother and her brother (the first generation) had died of heart disease, and 1 sibling had also died suddenly of heart disease when the study began. Seven out of the 8 siblings (the second generation) were followed for 17 years from 1958 to 1976. The 4 siblings had both typical or atypical WPW syndrome and cardiomegaly in 1958, 2 of them died suddenly and unexpectedly, 1 of them died of congestive heart failure, and 1 of them did not have any complaint during the period. One was normal in 1958 but developed cardiomegaly and atypical WPW syndrome in 1976. The other 2 were normal in both 1958 and 1976. The 2 children of the second sibling (the third generation) were followed simultaneously for 15 years. Both had WPW syndrome without cardiomegaly. It was suggested that a late onset of the disease could occur in the family with young onset, that the clinical course might become different mainly by sudden cardiac death which occurred only in the members with abnormal findings, and that WPW syndrome and cardiomegaly could be inherited or occur together in the same generation but separately in the different generation.
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PMID:A 17-year follow-up study of a family with idiopathic hypertrophic cardiomyopathy and WPW syndrome. 56 5

In a patient with intermittent type A Wolff-Parkinson-White (WPW) syndrome, the echocardiogram revealed late "double peaked" anterior motions (the former in the late systole, the latter in the early diastole) of left ventricular posterior wall during WPW conduction. In the same condition, phonocardiographic and mechanocardiographic observations indicated a prolonged electromechanical interval, but the external isovolumic contraction time (EICT) and left ventricular ejection time/EICT ratio remained unaltered. In addition, definite but slight alteration in the spatial ventricular gradient was observed. These observations by non-invasive methods present additional informations supporting the concept that conduction abnormalities per se are not responsible for abnormalities of ventricular function unless there is severe underlying heart disease.
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PMID:Echocardiographic features, left heart events and the spatial ventricular gradient in a case with intermittent type A Wolff-Parkinson-White syndrome. 60 50

A 14 year old girl with Ebstein's anomaly and Wolff-Parkinson-White syndrome without supraventricular tachycardia underwent closure of an atrial septal defect and tricuspid valve commissurotomy. Her postoperative course was complicated by her first episodes of recurrent debilitating paroxysmal supraventricular tachycardia. Severe tricuspid insufficiency with low cardiac output necessitated a repeat intracardiac operation. At reoperation the patient underwent successful tricuspid valve replacement with concomitent cardiac mapping and division of the bundle of Kent. In patients with heart disease requiring intracardiac repair who also have Wolff-Parkinson-White syndrome, elective surgical division of the anomalous bundle is recommended whether or not preoperative attacks of tachycardia have occurred.
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PMID:Elective mapping and surgical division of the bundle of Kent in a patient with Ebstein's anomaly who required tricuspid valve replacement. 62 37

The ST length and T wave were investigated electrocardiographically and clinically in 200 patients with a short PQ interval in the electrocardiogram, independent of the length and shape of the QRS complex. In group A (Lown-Ganong-Syndrome LGL), we often found a narrow, pointed, positive P wave and a narrow QRS complex in the electrocardiogram in addition to the short PQ interval, and also a tendency to respiratory arrhythmia. Clinically this was frequently a matter of young women with a tendency to paroxysmal tachycardia and autonomic dystonia. A James bundle or even a short AV conduction pathway with a small heart might be considered as the origin of this LGL syndrome. A particular classification of patients with short PQ intervals and S-T deformation (Group B) in organic heart disease has not yet been described in the literature to our knowledge. The results of our investigations in group C (WPW syndrome) correspond in the main to those given in the literature.
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PMID:[Short PQ interval with particular reference to the Lown-Ganong-Levine syndrome (author's transl)]. 80 14

A fatal case of the pre-excitation syndrome in a 3 10/12 years old girl with no other heart disease is presented. Her death is thought to be the consequence of ventricular fibrillation. This observation is in contrast to the reported benign course in infants and children with the Wolff-Parkinson-White syndrome without other heart disease.
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PMID:Wolff-Parkinson-White syndrome. A fatal case in a girl with no other heart disease. 111 92

Verapamil was administered intravenously to 250 patients aged between 14 and 85, suffering from tachyarrhythmia of various type. The commonest heart conditions were hypertensive cardiopathy, acquired valvular defects, and ischaemic cardiopathy. The antiarrhythmia effectiveness of the treatment is shown by the excellent results obtained in sinus tachycardia, supraventricular paroxysmal tachycardia, high frequency atrial fibrillations and even in a patient with WPW syndrome and supraventricular paroxysmal tachycardia and in one of the 5 patients with ventricular tachycardia. Generally speaking, the treatment was continued orally in a dose of 240 mg per day, and it was possible to control the clinical situation with no side effects.
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PMID:[Clinical results with verapamil in intravenous administration in the emergency therapy of cardiac arrhythmias]. 112 30

The effects of intravenous verapamil on the electrocardiogram in 15 patients with heart disease in sinus rhythm and in 44 patients with supraventricular and ventricular tachyarrhythmias were evaluated. Verapamil prolonged the P-R interval without effect on the QRS duration or the Q-Tc interval. In patients with atrial flutter and fibrillation, A-V block was increased, with slowing of the ventricular rate, in almost all cases but sinus rhythm was restored in only 1 of 12 patients in atrial fibrillation and in 2 of the 11 patients with flutter. Verapamil had no effect in 3 patients with atrial fibrillation complicating WPW syndrome; in 1 of 5 patients with ventricular tachycardia it caused reversion to sinus rhythm. Sinus rhythm was restored promptly by verapamil in 13 of 17 patients with paroxysmal supraventricular tachycardias; in 2 others, sinus rhythm became established 1 to 2 hours after administration of the drug. Transient hypotension, not requiring treatment, was the only side effect noted but not in the patients with supraventricular tachycardias, in whom blood pressure generally increased after reversion to sinus rhythm by verapamil.
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PMID:Effects of intravenous verapamil on cardiac arrhythmias and on the electrocardiogram. 116 42

Without treatment, about 60% of atrial arrhythmia patients suffer a relapse within 3 months and 70% within one year. Antiarrhythmic treatment intended to reduce this percentage is therefore justified, on condition that it is well tolerated. Several preliminary questions have to be settled before this medical prophylaxis: 1) Justification of antiarrhythmic treatment (sometimes pointless to deal with very occasional episodes); 2) Treatment of the underlying heart disease (valve disease, cardiothyrotoxicosis, etc.) or promoting factors (potassium depletion etc.); 3) Accurate assessment of any associated conduction abnormalities, which may constitute a contraindication to antiarrhythmic treatment (WPW syndrome in the case of verapamil and the digitalis-like drugs) or require additional treatment (pacemaker); 4) Definition of the mechanism (vagal or sympathotonic) inducing arrhythmia; 5) Evaluation of the hemodynamic parameters of the underlying heart disease (size of the atria, ventricular function, coronary or valvular lesions) which may limit the efficacy of the treatment. Once these parameters have been identified, the primary treatment should be type la or lb antiarrhythmics, which have been shown to be effective, despite the fact that they are not without arrhythmic risks (the Ib antiarrhythmics are less effective and have a poor safety profile). The beta-blockers have preferential indications (hypersympatheticotonia, hyperthyroidism, hypertrophic myocardiopathy, mitral prolapse, angina etc.) and can be replaced by verapamil or bepridil if there are non-cardiac contraindications (ulcers, asthma, diabetes). Amiodarone is extremely effective, but its poor extracardiac safety restricts its long-term use. Complementary treatments (digitalis-like, anticoagulants or anti-PAF and cardiostimulant drugs) should be added if necessary. Recurrences (to be confirmed by ECG or Holter) should lead to rigorous confirmation of therapeutic compliance and observance of simple hygienic and dietary measures (no excessive exertion, elimination of stimulants etc.). With strict clinical and ECG monitoring, it would then be possible either to increase the dose levels (accompanied by plasma determinations if possible) or to switch to a treatment with more effective, but more aggressive drugs (amiodarone, flecainide) or to use drug associations (la and lb, la and II etc.). Repeated failure of such attempts should lead to a non-medical approach to treatment.
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PMID:[Preventive drug therapy of recurrence of atrial fibrillation]. 129 92

Ninety five patients with a mean age of 39 +/- 19 years, 82 of whom were symptomatic, having an accessory atrioventricular bidirectional conduction pathway (WPW syndrome: 77; "concealed": 18) were followed up for an average of 7.3 +/- 2.6 years. The objectives were to analyse: the incidence and causes of death and the possible predictive factors of death due to the WPW syndrome--the influence of medical treatment and type of medication on survival and symptoms. Of the 8 cardiac deaths, 6 seemed to be related to the WPW syndrome, a prevalence of 7.8% and an annual incidence of 1.1/1000. The main risk factors which were identified were: age 62 +/- 8 years versus 37 +/- 15 years in survivors; p < 0.02--associated organic heart disease, especially ischaemic heart disease (5/6)--the description of severe symptoms, in particular recurrent syncope--documented malignant spontaneous or induced arrhythmias (5/6)--anterograde AV conduction with an effective refractory period < or = 230 msec in 4, though it was only 270 msec in the other 2 patients, indicating that this parameter is not specific--amiodarone (6/6) did not prevent the fatal outcome in this particular group of patients. In the "benign" forms, only betablocker drugs could significantly reduce the frequency and severity of symptoms, especially when compared with Class I or IC antiarrhythmics. These results suggest that the indications of radical treatment should be widened in high risk patients, especially when elderly and with associated coronary artery disease. They also suggest that the role of betablocker drugs should be reevaluated in the so-called "benign" symptomatic forms.
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PMID:[Long-term outcome of a hospital series of patients with atrio-ventricular accessory pathway]. 136 71

Interventional treatment is necessary for fatal drug-refractory tachyarrhythmias. Thirty-three, 33 and 16 patients (pts) with intractable ventricular tachycardia (VT) and/or fibrillation (VF) were managed with cryosurgery (CS), electrical catheter ablation (EA) and implantable pacer-cardioverter-defibrillator (PCD), respectively. Seventy-six and 43 pts with sudden death risk in the Wolff-Parkinson-White syndrome (WPW) also underwent CS and EA, respectively. CS success rates were 85% in VT/VF and 95% in WPW. Those of EA were 48% and 81%, respectively. EA success rates were 100% (6/6) in idiopathic verapamil-sensitive VT originated from LV, 0% (0/2) in VT following TOF repair and 0% (0/2) in idiopathic VT originated from right ventricular outflow tract. A new VT developed in 5 of 11 pts with arrhythmogenic right ventricular dysplasia (ARVD) following EA. PCD was effective for prevention from sudden death in idiopathic VF and pleomorphic VT. All of pharmacologic, EA and CS therapies were relatively effective in ischemic heart disease without low EF. In conclusion, the decision of VT-VF therapy may be affected by the underlying heart disease and EA may be established as an initial intervention for high risk WPW.
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PMID:[Surgical versus nonsurgical therapy of fatal tachyarrhythmias]. 147 Jan 8


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