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NICOLAS SADOUL M.D. BERNARD DODINOT M.D. DANIEL BEURRIER M.D. CHRISTIAN DE. CHILLOU M.D. ETIENNE ALIOT M.D. 《Journal of interventional cardiology》1996,9(4):347-353
Dual chamber pacing is a new indication for the treatment of drug resistant hypertrophic obstructive cardiontyopathy (HOCM) in patients with normal atrioventricular (AV) conduction. In sinus rhythm, the efficacy of the treatment is mainly related to the ability to bypass the normal AV conduction system in order to obtain a complete and permanent right ventricular (RV) capture. This is achieved by programming short AV delays. On the other hand, patients with HOCM frequently have co-existing left ventricular diastolic dysfunction, and the atrial contribution to left ventricular filling is critical. The lack of improvement, rarely encountered, is probably due to incomplete RV capture andlor to the deleterious effect of short AV delay. Instrumental AV node prolongation may he indicated in this situation. This procedure should be undertaken when previous drug-induced AV prolongation has failed. In theory, AV node modulation (i.e., creating a I ± AV block) seems ideal. However, this technique remains difficult, with disappointing chronic results. Most authors hence perform "conventional" AV node ablation. Particular attention is taken in order to perform a proximal node ablation, resulting in a complete AV block with narrow QRS escape rhythm. The reported incidence of AV node prolongation ranges from 7.5%-37.5%. The efficacy of the procedure on symptoms is explained by improved left ventricular filling and/or a further reduction in the systolic gradient evoked by complete RV capture. Another indication for AV node ablation in HOCM is the occurrence of atrial fibrillation, in order to restore adequate and permanent RV capture . 相似文献
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Chelyabinsk Medical Institute. (Presented by Academician of the Academy of Medical Sciences of the USSR A. D. Ado.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 113, No. 3, pp. 299–301, March, 1992. 相似文献
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A case is presented of a 16-year-old girl with ectodermal dysplasia for whom dental surgery under general anaesthesia was planned. Following a priming dose of vecuronium, and immediately after injection of sodium thiopentone (5 mg·kg−1 ) pulmonary aspiration of gastric contents occurred. It is hypothesized that, because of the rapid speed of onset of neuromuscular blocking agents on the laryngeal muscles, that partial laryngeal paralysis was present at the time of induction of anaesthesia and that this was responsible in part for the episode of pulmonary aspiration. 相似文献
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E. A. Érenpreisa R. A. Zirne N. D. Zaleskaya T. G. Sjakste 《Bulletin of experimental biology and medicine》1988,106(5):1605-1608
Laboratory of Chemistry of the Cancer Cell, Latvian Research Institute of Experimental and Clinical Medicine, Ministry of Health of the Latvian SSR, Riga. (Presented by Academician of the Academy of Medical Sciences of the USSR I. B. Zbarskii.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 106, No. 11, pp. 591–593, November, 1988. 相似文献