Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0018799 (heart disease)
 34,133 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Holter electrocardiographic monitoring in 55 symptomatic patients with syncope, palpitations or dizziness uncovered significant arrhythmias in 30 patients (55 percent). By providing an observation period of at least 24 hours including a period of sleep, the procedure aided detection and diagnosis in both symptomatic and asymptomatic patients of transient arrhythmias or conduction abnormalities not documented by routine electrocardiograms. Bradyarrhythmias accounted for the majority of arrhythmias recorded in 21 or 30 symptomatic patients (70 percent); 15 had sinus bradycardia (35 to 55 beats/min) alone and 6 also had long episodes of sinus arrest of up to 5 seconds. Two had sinus bradycardia with periods of atrioventricular block with Wenckebach phenomenon. Five patients had a tachycardia-bradycardia syndrome; three had other episodic arrhythmias and one had pacemaker failure. In 15 (60 percent) of the 25 patients without arrhythmias, monitoring did not document the cause of symptoms. Holter monitoring is of considerable value in assessing the efficacy and adequacy of drug treatment, especially in patients with known heart disease, and in detecting pacemaker malfunction. However, very long periods of monitoring may be needed to make a diagnosis in those with only sporadic symptoms.
 ...
PMID:Value of Holter monitoring in assessing cardiac arrhythmias in symptomatic patients. 124 26

To examine the clinical course of sinus node dysfunction that necessitates permanent pacing in the pediatric and young adult populations, we studied the records of the 39 patients 40 years of age or younger (mean age, 23 years) who underwent implantation of a permanent pacemaker for treatment of this disorder at our medical center between 1960 and 1983. The tachycardia-bradycardia syndrome was the most common rhythm disturbance, and syncope was the most frequent initial symptom. All symptomatic patients noted resolution of symptoms after pacemaker implantation. Twenty-five of the 39 patients (64%) had associated cardiovascular disease, most commonly transposition of the great arteries. In each of the 11 patients with this anomaly, sinus node dysfunction developed after a surgical procedure for correction of the defect. Of the total patient population, 20 patients (51%) had previously undergone a cardiac operation. The mean interval between pacemaker implantation and the previous operation was 105 months. After a mean follow-up of 50.5 months, the patients with no obvious underlying heart disease have done well. Each of the eight patients who have died had underlying cardiovascular disease. None of the deaths was thought to be pacemaker related. Sinus node dysfunction should be considered in the differential diagnosis of young patients with syncope or dizziness, especially if they have undergone a reparative cardiac surgical procedure. If symptomatic sinus node dysfunction is confirmed, permanent pacing is an effective therapeutic modality. In the absence of associated heart disease, the prognosis seems to be excellent.
 ...
PMID:Sinus node dysfunction in pediatric and young adult patients: treatment by implantation of a permanent pacemaker in 39 cases. 403 31

A 13-year-old male patient, who underwent Mustard operation for a very complex congenital heart disease (CHD), after palliation presented a decrease of the sinus node function, developing a tachy-brady syndrome and a mild dysfunction of atrioventricular (AV) conduction. He was successfully treated using a DDDRP pacemaker, which ensured a suitable atrial rhythm and was able to interrupt supraventricular tachycardia episodes. Until now, hospitalization related to episodes of heart failure or symptomatic arrhythmia, has not been necessary.
 ...
PMID:Use of DDDRP pacing device in prevention and treatment of tachy-brady syndrome after Mustard procedure. 1507 9

Persistent left superior vena cava (LSVC) is an asymptomatic congenital heart disease. It is usually found incidentally on imaging, during central line placements or while undergoing electrophysiological procedures. We present a case of a 91-year-old female who initially presented with seizures and was diagnosed with tachy-brady syndrome. She was planned to undergo dual-chamber permanent pacemaker placement. However, during the procedure, she was incidentally found to have an LSVC without a right superior vena cava. Due to challenging anatomy, her pacemaker was changed to a single-chamber atrial lead pacemaker. This case highlights the clinical implications of this unusual structural anomaly, technical difficulties that arise alongside and solutions on how to overcome these issues in the context of pacemaker implantation.
 ...
PMID:Pacemaker Implantation in Patient With Persistent Left Superior Vena Cava and Absent Right Superior Vena Cava. 3252 37