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61.
R Ruffy P Smith M Laseter R Lal S S Kim 《Journal of the American College of Cardiology》1985,6(2):482-485
A 42 year old man who survived sudden cardiac death was treated with an automatic implantable cardioverter/defibrillator. After a 5 month symptom-free interval, the patient received two internal discharges in the conscious state while wearing an ambulatory electrocardiographic recorder. Analysis of the tape revealed that both discharges were activated by two bursts of polymorphous ventricular tachycardia, the first one occurring at the end and the second at the onset of episodes of slow, hemodynamically stable monomorphous ventricular tachycardia. This case illustrates the reliability of the automatic implantable cardioverter/defibrillator as an antiventricular tachycardia device and the problem posed by its exposure to nonsustained ventricular tachycardia. 相似文献
62.
目的:探讨分析应用稳心颗粒对心律失常患者进行治疗的临床效果以及安全性。方法选择该院2012年12月-2014年12月收治治疗的136例心律失常患者作为研究对象,采用随机数字法把其分成对照组和治疗组,其中治疗组患者采用稳心颗粒实施治疗,而对照组患者采用心律平实施治疗。结果两组患者经过临床治疗后,其中治疗组患者的临床治疗有效率为94.12豫;而对照组患者的临床治疗有效率为73.53豫,治疗组患者的临治疗效果明显的比对照组好,差异有统计学意义(P<0.05)。结论应用稳心颗粒对心律失常患者进行治疗,其具有较好的临床效果,是一种具备较强可靠性与合理性的治疗方法。 相似文献
63.
64.
Decreased ATP-sensitive K(+) current density during chronic human atrial fibrillation 总被引:3,自引:0,他引:3
Balana B Dobrev D Wettwer E Christ T Knaut M Ravens U 《Journal of molecular and cellular cardiology》2003,35(12):1399-1405
Chronic atrial fibrillation (AF) is associated with shortening of action potential duration (APD), which involves modified activity of atrial ion currents. However, little is known about the activity of ATP-sensitive K(+) channels (I(K,ATP)) during chronic AF. An AF-related increase in the activity of I(K,ATP) would reduce APD and could contribute to initiation and/or perpetuation of AF. Here, we studied the activity of I(K,ATP) in atrial myocytes from patients with sinus rhythm (SR) and chronic AF. Human atrial myocytes were isolated from atrial tissue obtained from patients undergoing open-heart surgery. Inward rectifier currents were measured with the whole-cell patch-clamp technique by applying a depolarizing ramp pulse (1245 ms) from -100 to +40 mV (0.5 Hz). I(K,ATP) was activated with the I(K,ATP) channel opener rilmakalim. The inward rectifier I(K1) and I(K,ATP) were identified by their sensitivity to 1 mM Ba(2+). Density of I(K1) did not differ between cells from patients with AF (at -100 mV: -14.8 +/- 1.3 pA/pF, n = 38/10 (cells/patients)) and SR (-13.8 +/- 1.5 pA/pF, n = 33/16). In both types of cells, rilmakalim stimulated I(K,ATP) (defined as rilmakalim-inducible current) in a concentration-dependent manner (0.3-10 microM). However, maximum activation of I(K,ATP) with 10 microM rilmakalim was smaller in AF than in SR cells (at -100 mV: -5.3 +/- 0.8 pA/pF, n = 22/7 vs. -11.2 +/- 2.9 pA/pF, n = 19/9; at +40 mV: +9.6 +/- 2.1 pA/pF, n = 22/7 vs. +23.7 +/- 3.4 pA/pF, n = 19/9 for AF and SR, respectively; P < 0.05). Only aortic valve disease and pulmonary hypertension were found to be independent contributors to I(K,ATP) current density. We provide evidence that chronic AF is associated with a downregulation of ATP-sensitive K(+) currents. These changes may provide an additional molecular mechanism for electrical remodeling in chronic AF. 相似文献
65.
66.
Wang SH Lin CY Huang TY Wu WS Chen CC Tsai SH 《International journal of cardiology》2001,80(2-3):179-183
Purpose: The clinical effect of cisapride on QT intervals was prospectively studied. Subjects: Consecutive adult patients were recruited in whom cisapride was indicated for gastroesophogeal reflux, gastric ulcer, duodenal ulcer, diabetic gastroparesis or chronic constipation refractory to laxatives. Exclusion criteria included disorders and medications affecting cardiac conduction, electrolyte homeostasis, drug clearance and membrane stability. Methods: Seventy-five patients were included and followed at 1 to 2 week intervals. Patients took cisapride 5 mg thrice daily for 1 to 4 weeks (lower dose stage), followed by 10 mg thrice daily for another 1 to 4 weeks (higher dose stage). Twelve-lead ECGs were performed before commencing cisapride (group B), at completion of the lower dose stage (group L) and at completion of the higher dose stage (group H). Results: No patients experienced presyncope or syncope. Seventeen patients failing to comply, and 7 complaining of abdominal discomfort or diarrhea were excluded, leaving 51 participants. Group H’s corrected QT interval (QTc) was longer than group B’s by 13±15 ms (P<0.001), and longer than group L’s by 7±11 ms (P<0.001). Group L’s QTc was longer than group B’s by 7±21 ms (P<0.05). QT dispersion did not differ significantly among groups. Neither torsade de pointe nor ventricular tachycardia were noted in Holter monitoring of 33 patients during the higher dose stage. Conclusion: cisapride dose-dependently prolongs the QT interval. Further study is needed to examine the arrhythmogenicity of cisapride in higher doses and for longer durations. 相似文献
67.
法乐氏四联症根治术后运动功能和运动风险的研究 总被引:3,自引:0,他引:3
目的 研究法乐氏四联症 (TOF)根治术后运动功能和运动风险 ,并探讨相关因素对远期预后的影响。方法 5 4例TOF根治术后患儿依次进行心电图、2 4小时动态心电图、超声心动图和运动试验。结果 除 13~ 14岁年龄组外 ,其余各组TOF根治术后患儿静息心率和收缩压与正常同龄儿童差异无显著性 ,但其极量心率和最大收缩压均明显低于正常对照组。TOF术后患儿运动耐量平均为正常同龄标准的 ( 81 7± 13 8) %。运动耐量与肺动脉瓣返流程度、体外循环时间、手术年龄、右室流出道梗阻程度呈负相关。 18例存在室性心律失常的患儿平均运动耐量为 ( 6 9 4± 2 0 1) % ,35例无室性心律失常的患儿平均运动耐量为 ( 85 5± 7 8) % ,两者差异有显著性 (t=3 2 2 8,P <0 0 1)。2例患儿运动诱发频发多源室性早搏。结论 TOF术后运动功能较正常同龄降低约 2 0 % ,影响运动功能的主要因素包括右室收缩压增高、中 重度肺动脉瓣返流、手术年龄、体外循环时间和心律失常。运动诱发频发多源室早提示存在严重的血流动力学异常 ,发生室性心动过速的风险增高。早期进行手术 ,术后血流动力学正常或接近正常的TOF患儿远期预后良好 相似文献
68.
22例急性心肌梗死患者接受经皮冠状动脉内血栓溶解治疗,经即刻冠状动脉造影证实14例冠状动脉再通。9例(64.3%)发生再灌注性心律失常(RA)。14例中7例(50.0%)为室性RA,3例(21.4%)发生加速性室性自主节律,后者为提示再灌注的特异性较高的指标。一过性缓慢性心律失常的5例(35.8%)均发生在下壁及(或)后壁梗死。RA的发生与再灌注前心肌缺血时间和缺血性心律失常存在与否无关,心肌功能严重受损患者可能更易发生RA。本文并就如何预防和治疗RA进行了探讨。 相似文献
69.
原发性高血压左心室不同构型民律失常的比较 总被引:5,自引:0,他引:5
目的 研究原发性高血压患者左心室重构不同构型间心律失常的差异。方法 179例原发性高血压患者均进行了24h动态心电图,动态血压监测,超声心动图等检查,根据检查结果划分左心室构型,判定心律失常,比较左心室重构组与正常构型组心律失常的发生率;通过多元逐步回归分析,甄选出对心律失常有独立影响的因素。并在校正这些影响因素后,比较左心室不同构型间心律失常严重程度的差异。结果 左心室重构组的房性心律失常,室性心律失常,复杂室性心律失常的发生率均显著高于正常构型组,而影响原发性高血压心律失常的相对独立因素很多,其中部分左心室解剖结构指标,高血压分级,左心房内径,E/A值,夜间舒张压负荷值以及日平均心率等占重要地位;校正上述影响因素后,不同构型两两比较时,部分构型之间心律失常分级级别仍存在差异,且差异为构型本知差异所致。结论 原发性高血压心律失常的影响因素很多(例如高血压分级、左心室重量指数,左心房内径,左心室后壁厚度等),不同构型间心律失常的严重程度存在差异。 相似文献
70.
The present report describes a 40-year-old woman with a long history of monomorphic ventricular tachycardia and left bundle branch block. She was treated with various antiarrhythmic agents; ventricular tachycardia ablation was attempted and an automatic implantable cardioverter defibrillator was implanted. Three-dimensional echocardiography clearly demonstrated features of arrhythmogenic right ventricular cardiomyopathy, including marked right ventricular (RV) dilation, decreased RV systolic function and thinning of the RV free wall. Other RV morphological abnormalities included excessive trabeculations and a localized apical aneurysm. Two years later, the patient developed symptoms of congestive heart failure. Despite maximal medical therapy, her clinical condition continued to deteriorate and she was referred for heart transplantation. Results of the pathology of her explanted heart confirmed this rare diagnosis. She presented with an unusual clinical course for arrhythmogenic right ventricular cardiomyopathy, which was complicated by progressive congestive heart failure and ultimately required heart transplantation. Three-dimensional echocardiography identified the structural abnormalities related to this rare disease. 相似文献