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

In order to evaluate the incidence and significance of inducible supra-ventricular (SVTA) in patients with chronic myocardial infarction (MI), the results of systematic programmed atrial stimulation were compared in two groups of patients: 150 patients (group I) without MI or underlying heart disease, studied for syncope or conduction disturbances, 296 patients (group II) studied after an acute Mi (greater than 1 month). None of them had spontaneous SVTA, and 24-h Holter monitoring showed no SVTA. The atrial stimulation programme used one and two extra stimuli delivered during sinus rhythm and atrial pacing (600 ms and 10% less than the sinus cycle length). A sustained (S) (greater than 30 s) supraventricular tachycardia (SVT) (atrial flutter, fibrillation, tachycardia) was induced in 17 patients in group I (11%) and in 120 patients in group II (40.5%). In group II inducible SVTA could not be correlated with the occurrence of a SVT during acute MI, the location of MI, the value of LV ejection fraction (EF), the incidence of inducible sustained ventricular tachycardia (VT), or fibrillation (VF). However, inducible SVTA could be correlated with a significantly shorter effective atrial refractory period (197 +/- 23 ms vs 220 +/- 35 ms, P less than 0.001) and a shorter retrograde block cycle length (518 +/- 215 vs 585 +/- 215 ms, P less than 0.03). The patients in group II were followed-up for at least 6 months; 12 of them developed sustained episodes of supraventricular tachycardia; 11 of them had inducible SVTA (P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Incidence and significance of inducible supraventricular tachyarrhythmias in patients with chronic myocardial infarction. 204 Mar 23

Electrophysiologic studies were performed in 134 patients (87 males, mean age 59 years) with unexplained syncope. Seventy-one patients had organic heart disease (ischaemic in 50). Electrophysiologic studies revealed conduction abnormalities and tachyarrhythmias that could account for syncope in 40 patients (30%). Thirty-seven (93%) of these patients received pacing or antiarrhythmic therapy compared with 23 (24%) of the remaining 94 patients who had a negative study and received empiric therapy (P less than 0.0001). Risk of having an abnormal electrophysiologic study was greater in patients with underlying heart disease (P less than 0.05). During a mean follow-up of 22 +/- 17 months, 26 patients (19%) either had recurrent syncope (22 patients) or died (four patients) suddenly. Men had a higher incidence of recurrent syncope than women (26% vs 6%, P less than 0.005). Other clinical characteristics, electrophysiologic findings, final diagnosis and therapy at discharge were not predictive of outcome. We conclude that (1) 19% of patients investigated for syncope will have a recurrent event, (2) female gender may be an independent predictor of favourable outcome.
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PMID:Electrophysiologic evaluation and outcome of patients with syncope of unknown origin. 204 46

Ventricular fibrillation (VF) is a well-known but rare complication of the Wolff-Parkinson-White syndrome (WPW). Clinical and electrophysiological data of 23 patients with spontaneous VF were compared with data from 100 consecutive patients with WPW without VF but with symptomatic supraventricular tachycardia. The 23 patients were collected in a multicentre retrospective study in seven European centres. VF occurred in only one patient who was receiving antiarrhythmic drugs, and was the first manifestation of the syndrome in six. No significant differences were found between those with VF and without VF in age, complaints of palpitations, syncope, and presence of structural heart disease. The retrograde effective refractory period of the accessory pathway, the atrial refractory period and the fastest atrial pacing rate with 1:1 anterograde conduction over the accessory pathway were similar in both groups. Significant differences were found for sex, permanent pre-excitation on the electrocardiogram, type of documented supraventricular tachyarrhythmias, shortest RR interval less than or equal to 220 ms during spontaneous atrial fibrillation (AF), inducibility of supraventricular tachycardias, ventricular effective refractory period less than or equal to 190 ms, mean shortest RR interval during induced AF less than or equal to 180 ms and presence of multiple accessory pathways.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ventricular fibrillation in the Wolff-Parkinson-White syndrome. 204 47

In patients with syncope, ventricular tachyarrhythmias, and sudden death, in the absence of coronary artery disease or dilative and hypertrophic cardiomyopathy, arrhythmogenic right ventricular disease is a common underlying heart disease. It is marked by ventricular tachyarrhythmias of left bundle branch block pattern, often induced by exercise; negative T-waves in the right precordial leads of the surface-ECG, and localized or diffuse right ventricular contraction abnormalities detected by various imaging techniques in a young, apparently healthy population. Congenital disposition with progressive fibrous and lipomatous tissue infiltration of the right ventricular myocardium with hypertrophy and degeneration of surviving myocytes is the pathogenetic factor leading to modification of conduction and resulting in the development of arrhythmogenic zones. This review contains the current knowledge about arrhythmogenic right ventricular disease on the basis of our own experience, and also a review of the literature. Controversial hypotheses concerning etiology and prognosis are discussed. Variant forms and stages of the disease are described, taking differential diagnostic aspects into consideration. Non-invasive and invasive diagnostic methods are evaluated with regard to their diagnostic accuracy, feasibility, and limitations. Pharmacological and alternative therapeutic concepts are presented, including catheter ablation and surgical intervention.
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PMID:[Arrhythmogenic right ventricular disease]. 205 43

Clinical findings of 52 patients with sustained ventricular tachycardia (VT) were analyzed to assess the importance of the underlying etiology. Among patients with organic heart diseases, no differences were found in the VT rate, the incidence of syncope, and the number of patients who required DC shock, regardless of the difference of the underlying organic heart diseases. Patients without organic heart disease had usually more benign clinical presentations. The electrophysiologic findings of VT such as inducibility, a mode of induction and incidence of pleomorphism were similar in patients who had organic heart disease of various causes. Neither the incidence of pleomorphism nor occurrence of acceleration of VT rate was found in patients with idiopathic VT, and the incidence of VT induction was low in patients with idiopathic VT of RV origin. Patients with organic heart diseases often died suddenly, and patients when their VT rate was 200/min or higher, developed syncope, even who had normal LV function.
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PMID:Clinical features of sustained ventricular tachycardia among various underlying heart diseases. 207 76

The long-term follow-up of 52 pts (36 M, 16 F, mean age: 62 years) with sustained ventricular tachyarrhythmias (SVT) was analyzed to assess the efficacy and feasibility of empiric amiodarone treatment. Forty-five pts had organic heart disease (mean EF: 38.3%) and 7 pts no overt heart disease. Twenty pts suffered from syncope or cardiac arrest secondary to sustained ventricular tachyarrhythmias (mean: 2.35 episodes) and 32 did not. All pts were given amiodarone empirically (mean dose: 390 mg) and followed-up for a mean period of 29.5 months (range 1-137). Two pts (3.8%) died of non cardiac causes, 5 (9.6%) of non sudden cardiac death and 7 (13.4%) of sudden death. Fifteen pts (28.8%) experienced non fatal arrhythmic recurrences. Four out of 7 pts who died suddenly experienced non fatal arrhythmic recurrence before death. The actuarial incidence of cardiac death was 10.8, 22.7, 31.5, 31.5% at 1, 2, 3 and 5 years; the actuarial incidence of sudden death was 8.9, 12, 22.1, 22.1% at 1, 2, 3 and 5 years; the actuarial incidence of non fatal arrhythmic recurrences was 17.4, 26.3, 26.3, 26.3, 44.7% at 1, 2, 3, 4 and 5 years. Univariate analysis identified recent myocardial infarction, NYHA functional class, detection of frequent and/or repetitive premature ventricular contractions on Holter monitoring and non fatal arrhythmic recurrences as predictors of cardiac death (p less than 0.05), while only non fatal arrhythmic recurrences were associated with sudden death (p less than 0.05). Twenty-two pts (42.3%) developed side effects. Nine (17.3%) discontinued amiodarone: 6 pts (11.5%) because of side effects and 3 inadvertently.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Empiric treatment with amiodarone in patients with sustained ventricular tachyarrhythmia. Results of a long-term follow-up]. 207 83

Right ventricular arrhythmogenic dysplasia (RVAD) is a typical asymptomatic arrhythmogenic cardiopathy in athletes, which is occasionally concurrent with normal ventricular function and life-threatening arrhythmias. A total of 32 athletes (28 males and 4 females, mean age, 23 years, mean follow-up, 6.7 years) were examined for severe cardiac arrhythmias with left bundle branch block. The conclusive diagnosis of RVAD was established from clinical, echocardio-, and angiographic evidence. The protocol of the examination involved Holter monitoring, loading tests, electrophysiological study, two-dimensional echocardiography, cardiac angiography of the right and left ventricles, coronary angiography. The most severe arrhythmias were observed in athletes whose mean age was 23.4 years, 20 patients had sustained ventricular tachycardia (it occurred only in 19 who were indulging in sports), 6 presented with transient ventricular tachycardia, and 1 had ventricular fibrillation. They all had been considered fit for sports. The disease proceeded severely in 16 of 32 athletes (in 13 of 16 while indulging in sports), the conditions close to syncope were seen in 9 patients (8 had sustained ventricular tachycardias and 1 had transient ventricular tachycardias), syncopes were observed in 5 patients (sustained ventricular tachycardias).
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PMID:[Stable ventricular tachycardia in arrhythmogenic dysplasia of the right ventricle in sportsmen]. 208 39

Autopsy studies of arrhythmogenic right ventricular dysplasia (ARVD) have rarely been reported, and its etiology remains unknown. The present report describes a detailed histopathological study of two autopsied cases of ARVD. Case 1: This 21-year-old man experienced palpitation accompanied by syncope. He died after ventricular tachycardia of right ventricular origin. The heart weighed 365 g and the right ventricular cavity was markedly dilated. The distribution of fatty tissue was roughly limited to the middle layer of the free wall, replacing the myocardium with fatty degeneration. Medial hyperplasia of the small arteries within the fatty tissue was also observed. Fibroelastosis was observed in the left ventricular endocardium. In the conduction system, fatty tissue was found in the sinus node. In addition, medial hypoplasia was observed in the pulmonary arteries. Case 2: This 32-year-old man who had had an arrhythmia for 10 years died of ventricular tachycardia of right ventricular origin. His older brother also died of heart disease. His heart weighed 515 g and both the right and left ventricles were dilated. Fatty tissue, unlike that in Case 1, was shown to markedly infiltrate from the epicardium into both the right and left ventricular walls. In the right ventricular wall, muscle layers disappeared in some portions. In the conduction system, fatty tissue was observed in the sinus node. Although ARVD may be considered a syndromic entity, individual cases are different in terms of pathological morphology, with possible variations in the etiology and pathogenesis.
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PMID:[Two autopsied cases of arrhythmogenic right ventricular dysplasia]. 213 13

The usefulness of pacemaker treatment appears doubtful in patients suffering from syncope of unknown origin after a complete diagnostic evaluation, which includes electrophysiological study. To better assess the effectiveness of this therapy, 24 patients with syncope of unknown origin and negative electrophysiological study were prospectively and alternatively assigned to treatment with pacemaker (group A) vs treatment without pacemaker (group B). Group A included 12 patients (7 males, 5 females) with a mean age of 64 +/- 10 years. No heart disease was present in 7 cases (58%); 3 cases had chronic ischaemic heart disease (25%) and 2 had hypertensive heart disease (17%). The standard ECG was normal in 7 patients, while various conduction abnormalities were observed in the other 5. The mean number of syncopal episodes was 4.8 +/- 3.9 per patient, and the mean between the onset of symptoms and the beginning of this study was 32 +/- 42 months. In these 12 cases a VVI-M pacemaker was implanted, at a programmed rate of 50 or 60 bpm; in three subjects, the pacemaker was of the diagnostic type ("bradycardia event counter"). Group B included 12 patients (8 females, 4 males) with a mean age of 56 +/- 11 years. Organic heart disease was absent in 7 cases (58%); 4 patients showed hypertensive heart disease (33%) and 1 had mitral prolapse (9%). The ECG was normal in 9 subjects. The mean number of syncopes was 3.2 +/- 1.5 per patient; the mean interval since the onset of symptoms was 18 +/- 19 months.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Syncope of unknown origin after electrophysiologic study: is the treatment with pacemaker useful?]. 218 56

The purpose of this study was to clarify the difference of clinical and electrophysiologic characteristics between sustained ventricular tachycardia (SVT) and nonsustained ventricular tachycardia (NSVT). 40 patients consisting of 24 males and 16 females with an average age of 50.0 years (range from 19 to 83), who had shown ventricular tachycardia (VT) on electrocardiogram, were studied consecutively. The patients were divided into SVT group (19 cases) and NSVT group (21 cases). Ventricular stimulation was performed up to triple extrastimuli, and ventricular burst pacing was used when required. After VT was induced, R-R interval during VT was measured and an antiarrhythmic agent was given by bolus injection. Echocardiography was used for measurement of left ventricular ejection fraction (EF) and for evaluation of mitral valve prolapse (MVP). Palpitation and oppressive sensation were dominant in SVT (84.2%), while dizziness and syncope were prominent in NSVT (57.1%). Organic heart disease (OHD) was observed in only 42.1% of SVT, and in none of NSVT. MVP was observed in 6 patients of SVT and in 5 patients of NSVT. EF was significantly higher in NSVT (67.1%) than in SVT (56.9%) (p less than 0.02), while it was not significantly different in cases of NSVT and SVT where OHD was not present (64.4%). VT was induced and sustained in 17 out of 19 patients (89.5%) in SVT by ventricular stimulation. In NSVT, VT was induced in 6 of 21 patients (38.6%), but it was not sustained in any of them. The induction of VT in NSVT appeared to require more extrastimuli than in SVT. The R-R interval in SVT was longer than in NSVT (345.9 +/- 84.6 msec and 245.0 +/- 40.7 msec, p less than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[A study on clinical and electrophysiologic characteristics of ventricular tachycardia: comparison of differences on its sustenance]. 221 86


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