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  • Blackwell Publishing Ltd  (3)
Document type
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  • 1
    Electronic Resource
    Electronic Resource
    Normal Dispersion of Ventricular Repolarization in Patients with Kawasaki Disease Who Develop Coronary Artery Abnormalities (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of noninvasive electrocardiology 3 (1998), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Kawasaki disease (KD) is complicated by coronary artery abnormalities (CAA) in 3%-25% of patients, depending on acute therapy. ECG markers of ventricular vulnerability such as QT and JT dispersion, SAECG, and ambulatory monitoring have been shown to have predictive value in disparate diseases such as long QT syndrome, postmyocardial infarction, and atherosclerotic coronary artery disease. The aim of this study was to evaluate the association between QT and JT dispersion and the occurrence of CAA in KD.〈section xml:id="abs1-2"〉〈title type="main"〉MethodsOver the past 15 years, we evaluated 814 children with acute KD, of which 24 (3%) developed significant CAA (aneurysms, stenoses). An additional 40 children (5%) developed milder CAA (4–5 mm dilation). Multivariate analysis was used to compare QTc, JTc, and dispersion in the 24 patients who developed significant CAA with three other groups: 40 patients with mild CAA, 750 KD patients without evidence of CAA, and 1000 normal control children. A small prospective study included additional noninvasive ECG markers using ambulatory (Holter) monitoring and SAECG.〈section xml:id="abs1-3"〉〈title type="main"〉ResultsThere were no significant differences in any ECG measures of ventricular repolarization among any of the three KD groups and the normal control pediatric ECGs.〈section xml:id="abs1-4"〉〈title type="main"〉ConclusionsIncreased dispersion of ventricular repolarization is not associated with coronary-artery abnormalities in KD.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.1998.tb00042.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Provocative Testing in Children with Suspect Congenital Long QT Syndrome (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Annals of noninvasive electrocardiology 3 (1998), S. 0 
    Details
    ISSN: 1542-474X
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: This study was designed to evaluate several alternative ECG measurements and provocative tests in order to identify markers for children with suspect congenital long QT syndrome (LQTS).〈section xml:id="abs1-2"〉〈title type="main"〉BackgroundA single QTc measurement on a resting ECG does not identify all children with LQTS. Alternative ECG measurements have been established for identification of LQTS patients, with varied degrees of accuracy. Additionally, findings of QT prolongation during exercise or catecholaminergic stimulation have been suggested as indicators for the presence of LQTS and associated arrhythmias.〈section xml:id="abs1-3"〉〈title type="main"〉MethodsThe ECGs from 40 children with suspect congenital LQTS were compared with 1000 gender and age matched control patients. Complete exercise ECG studies were performed on 32 of the 40 suspect LQTS patients and compared with 29 controls. ECGs recorded during isoproterenol infusion were obtained in 9 suspect LQTS patients and compared with 44 matched control subjects.〈section xml:id="abs1-4"〉〈title type="main"〉ResultsDuring exercise, the QTc was mildly prolonged in both groups, without a similar increase in JTc, suggesting prolongation of depolarization time. QT and JT dispersion shortened with exercise in control subjects, but not in the suspect LQTS patients. During isoproterenol infusion, the QTc and JTc are prolonged in the suspect LQTS group, without an increase in the control patients.〈section xml:id="abs1-5"〉〈title type="main"〉ConclusionsWe describe the ECG findings with provocative testing in patients in whom there is a clinical suspicion of LQTS, yet have a normal or borderline QTc. Exercise or isoproterenol may aid in identification of patients with congenital long QT syndrome.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1542-474X.1998.tb00023.x
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  • 3
    Electronic Resource
    Electronic Resource
    Electrocardiographic Markers of Late Sudden Death Risk in Postoperative Tetralogy of Fallot Children (1997)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 8 (1997), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Late Sudden Death Risk in Postoperative TOF. Following surgery for tetralogy of Fallot (TOP), children may develop late onset ventricular arrhythmias. Many patients have both depolarization and repolarization abnormalities, including right bundle branch block (RBBB) and QT prolongation. The goal of this study was to improve prospective risk-assessment screening for late onset sudden death. Resting ECG markers including QRS duration, QTc, JTc, and interlead QT and JT dispersion were statistically analyzed to identify those patients at risk for ventricular arrhythmias and sudden cardiac death. To determine predictive markers for future development of arrhythmia, we examined 101 resting ECGs in patients (age 12 ± 6 years) with postoperative TOF and RBBB, 14 of whom developed late ventricular tachycardia (VT) or sudden death. These ECGs were also compared with an additional control group of 1000 age- and gender-matched normal ECGs. The mean QRS (± SD) in the VT group was 0.18 ± 0.02 seconds versus 0.14 ± 0.02 seconds in the non-VT group (P 〈 0.01). QTc and JTc in the VT group was 0.53 ± 0.05 seconds and 0.33 ± 0.03 seconds compared with 0.50 ± 0.03 seconds and 0.32 ± 0.03 seconds in the non-VT group (P = NS). There was no increase in QT dispersion among TOF patients with VT or sudden death compared with control patients or TOF patients without VT, although JT dispersion was more common in the TOF groups. A prolonged QRS duration in postoperative TOF with RBBB is more predictive than QTc, JTc, or dispersion indexes for identifying vulnerability to ventricular arrhythmias in this population, while retaining high specificity. The combination of both QRS prolongation and increased JT dispersion had very good positive and negative predictive values. These results suggest that arrhythmogenesis in children following TOF surgery might involve depolarization in addition to repolarization abnormalities. Prospective identification of high-risk children may be accomplished using these ECG criteria.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8167.1997.tb01031.x
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