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  • 1
    Digitale Medien
    Digitale Medien
    Excessive Increase in QT Interval and Dispersion of Repolarization Predict Recurrent Ventricular Tachyarrhythmia after Amiodarone (2004)
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Pacing and clinical electrophysiology 27 (2004), S. 0 
    Details
    ISSN: 1540-8159
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Although chronic amiodarone has been proven to be effective to suppress ventricular tachycardia (VT) and ventricular fibrillation (VF), how we predict the recurrence of VT/VF after chronic amiodarone remains unknown. This study evaluated the predictive value of the QT interval, spatial, and transmural dispersions of repolarization (SDR and TDR) for further arrhythmic events after chronic amiodarone. Eighty-seven leads body surface ECGs were recorded before (pre) and one month after (post) chronic oral amiodarone in 50 patients with sustained monomorphic VT associated with organic heart disease. The Q-Tend (QTe), the Q-Tpeak (QTp), and the interval between Tpeak and Tend (Tp-e) as an index of TDR were measured automatically from 87-lead ECG, corrected Bazett's method (QTce, QTcp, Tcp-e), and averaged among all 87 leads. As an index of SDR, the maximum (max) minus minimum (min) QTce (max-min QTce) and standard deviation of QTce (SD-QTce) was obtained among 87 leads. All patients were prospectively followed (15 ± 10 months) after starting amiodarone, and 20 patients had arrhythmic events. The univariate analysis revealed that post max QTce, post SD-QTce, post max-min QTce, and post mean Tcp-e from 87-lead but not from 12-lead ECG were the significant predictors for further arrhythmic events. ROC analysis indicated the post max-min QTce ≥106 ms as the best predictor of events (hazard ratio = 10.4, 95%, CI 2.7 to 40.5, P = 0.0008). Excessive QT prolongation associated with increased spatial and transmural dispersions of repolarization predict the recurrence of VT/VF after amiodarone treatment. (PACE 2004; 27:901–909)
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1540-8159.2004.00557.x
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 2
    Digitale Medien
    Digitale Medien
    Dynamic Changes of 12-Lead Electrocardiograms in a Patient with Brugada Syndrome (1998)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 9 (1998), S. 0 
    Details
    ISSN: 1540-8167
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Dynamic ECG Changes in Brugada Syndrome. We present a patient with Brugada syndrome in whom 12-lead ECXis were recorded just before and after an episode of ventricular fibrillation (VF). A progressive elevation of both the RS-T segment and J waves just preceding and following the VF, and a close relationship between the amplitude of the RS-T segment and the preceding R-R intervals during atrial fibrillation, were documented. These findings support the hypothesis that RS-T elevation and a subsequent VF are related to a transient outward current-mediated spike-and-dome morphology of the epicardial action potential.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1540-8167.1998.tb01843.x
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 3
    Digitale Medien
    Digitale Medien
    Electroporation in a Model of Cardiac Defibrillation (2001)
    Oxford, UK : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 12 (2001), S. 0 
    Details
    ISSN: 1540-8167
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Electroporation in a Model of Cardiac Defibrillation. Introduction: It is known that highstrength shock disrupts the lipid matrix of the myocardial cell membrane and forms reversible aqueous pores across the membrane. This process is known as “electroporation.” However, it remains unclear whether electroporation contributes to the mechanism of ventricular defibrillation. The aim of this computer simulation study was to examine the possible role of electroporation in the success of defibrillation shock. Methods and Results: Using a modified Luo-Rudy-1 model, we simulated two-dimensional myocardial tissue with a homogeneous bidomain nature and unequal anisotropy ratios. Spiral waves were induced by the S1-S2 method. Next, monophasic defibrillation shocks were delivered externally via two line electrodes. For nonelectroporating tissue, termination of ongoing fibrillation succeeded; however, new spiral waves were initiated, even with high-strength shock (24 V/cm). For electroporating tissue, high-strength shock (24 V/cm) was sufficient to extinguish ongoing fibrillation and did not initiate any new spiral waves. Weak shock (16 to 20 V/cm) also extinguished ongoing fibrillation; however, in contrast to the highstrength shock, new spiral waves were initiated. Success in defibrillation depended on the occurrence of electroporation-mediated anodal-break excitation from the physical anode and the virtual anode. Some excitation wavefronts following electrical shock used a deexcited area with recovered excitability as a pass-through point; therefore, electroporation-mediated anodal-break excitation is necessary to block out the pass-through point, resulting in successful defibrillation. Conclusion: The electroporation-mediated anodal-break excitation mechanism may play an important role in electrical defibrillation.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1046/j.1540-8167.2001.01393.x
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 4
    Digitale Medien
    Digitale Medien
    Recovery Time Dispersion Measured from 87-Lead Body Surface Potential Mapping as a Predictor of Sustained Ventricular Tachycardia in Patients with Idiopathic Dilated Cardiomyopathy (2000)
    Oxford, UK : Blackwell Publishing Ltd
    Journal of cardiovascular electrophysiology 11 (2000), S. 0 
    Details
    ISSN: 1540-8167
    Quelle: Blackwell Publishing Journal Backfiles 1879-2005
    Thema: Medizin
    Notizen: Recovery Time Dispersion in DCM. Introduction: The clinical usefulness of QT dispersion in 12-lead ECG has been controversial in identifying subjects at risk for sustained ventricular tachycardia (VT) in patients with idiopathic dilated cardiomyopathy (DCM). We hypothesized that increasing the spatial resolution of the ECG improves the accuracy of risk stratification. The purpose of this study was to test the ability of recovery time dispersion measured from 87-lead body surface potential mapping (BSPM) to identify patients at risk for sustained VT in idiopathic DCM. Methods and Results: We obtained 87-lead BSPM and 12-lead ECG in 33 patients with idiopathic DCM (15 patients with a history of sustained VT [VT(+) group] and 18 patients without a history of sustained VT [VT(-) group]) and in 20 normal control subjects. We measured the corrected QT dispersion and corrected recovery time dispersion from 12-lead ECG (QTc-12 dispersion and RTc-12 dispersion, respectively) and 87-lead BSPM (QTc-87 dispersion and RTc-87 dispersion, respectively). Signal-averaged ECG also was recorded in 25 patients. Neither the QTc-12 nor Qrc-87 dispersion discriminated between the VT(+) and VT(-) groups patients. The VT(+) group patients had a larger but insignificant RTc-12 dispersion than the VT(-) group patients. In contrast, the RTc-87 dispersion was significantly larger in the VT(+) group patients than in the VT(-) group patients (236 ± 39 msec vs 184 ± 28 msec, P 〈 0.001). Receiver operating curve analysis indicated that the RTc-87 dispersion was as good as late potentials in predicting susceptibility to sustained VT; its sensitivity, specificity, and negative predictive value were 73%, 76%, and 76%, respectively (cutoff value 200 msec). RTc-87 dispersion 〉200 msec combined with positive late potentials provide high sensitivity (92%) and high negative predictive value (88%) for sustained VT. Conclusion: The RTc-87 dispersion is a useful tool to identify subjects at risk for sustained VT in patients with idiopathic DCM.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1111/j.1540-8167.2000.tb00168.x
    Standort Signatur Einschränkungen Verfügbarkeit
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  • 5
    Digitale Medien
    Digitale Medien
    Absorption of various drugs through the rabbit's respiratory mucosa in vitro (1983)
    Springer
    European archives of oto-rhino-laryngology and head & neck 238 (1983), S. 87-96 
    Details
    ISSN: 1434-4726
    Schlagwort(e): Trachea ; Schleimhautabsorption ; Antibiotika ; menschliches IgG ; Absorptionsmodus ; Trachea ; Mucosal absorption ; Antibiotics ; Human IgG ; Absorption pathway
    Quelle: Springer Online Journal Archives 1860-2000
    Thema: Medizin
    Beschreibung / Inhaltsverzeichnis: Summary The absorption of doxycycline (DOTC), bekanamycin (AKM), cefazolin (CEZ), penicillin G (PC-G), predonisolone, and human IgG through the rabbit's tracheal mucosa was examined using the double-chamber method. The results indicate that the tracheal mucosa can absorb both small molecules and macromolecules. Passing through the intercellular space, DOTC, a small molecule, was absorbed through the tracheal epithelium by diffusion. Human IgG, a macromolecule, was absorbed by the mechanism of an energy-consuming transport process. This study of the absorption of drugs through the respiratory mucosa could open up new areas in the utilization of intrarespiratory administration of drugs and lead to a better understanding of the mechanisms involved in respiratory allergies.
    Notizen: Zusammenfassung Die Aufnahme von DOTC, AKM, CEZ, PC-G, Predonisolon und menschlichem IgG durch die Trachealmucosa des Kaninchens wurde mit der Doppelkammermethode geprüft. Als Resultat zeigte sich, daß die Trachealmucosa sowohl kleine Moleküle als auch Makromoleküle resorbieren konnte. Durch die Interzeüularspalten wurde DOTC, ein kleines Molekül von dem Trachealepithelium durch Diffusion resorbiert. Das menschliche IgG, ein Makromolekül, wurde durch den Mechanismus des Energie verbrauchenden Transportprozesses resorbiert. Die vorliegende Studie läßt neue Wege für die Verwendung einer intrarespiratorischen Verabreichung von Arzneien erkennen und kann wichtigen Erkenntnissen über den Mechanismus der respiratorischen Allergie führen.
    Materialart: Digitale Medien
    URL: http://dx.doi.org/10.1007/BF00453745
    Standort Signatur Einschränkungen Verfügbarkeit
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