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排序方式: 共有3237条查询结果,搜索用时 296 毫秒
1.
MOHAMED B. EL-HARARI PHILIP C. ADAMS 《Pacing and clinical electrophysiology : PACE》1998,21(10):1999-2001
We describe a case of 1:1 atrial flutter in a patient with coronary disease taking propafenone. In atrial flutter, the atrial rate is usually about 300 beciis/min with 2:1 AV conduction and a ventricular rate of 150 beats/min. Class IA antiarrhythmic drugs, especially quinidine and disopyramide, may cause 1:1 AV response because they reduce atrial rate and are vagolytic. However, propafenone is a Class IC agent and has no anticholinergic properties, and the occurrence of 1:1 AV conduction at a rate of about 250 beats/min is an important side, effect that, although uncommon, should be recognized. 相似文献
2.
Pleomorphic Ventricular Tachycardia: Demonstration of Conduction Reversal Within the Reentry Circuit
KARL-HEINZ KUCK MICHAEL SCHLÜTER KLAUS-PETER KUNZE MANFRED GEIGER 《Pacing and clinical electrophysiology : PACE》1989,12(7):1055-1064
A case is presented of a patient with incessant venfricular tacbycardia of left bundle branch block morphology. Endocardial mapping revealed the site of earliest activation during tachycardia to be the proximal right ventricular septum. Pacing at this site elicited the clinical tachycardia, whereas pacing at the proximal left ventricular septum induced a right bundle branch block morphology identical to that of a previously recorded spontaneous ventricuiar tachycardia. Electrophysiological evidence is given that both types of tachycardia originate from a single reentry circuit located in the proximal ventricular septum in which the reentrant wavefront may travel either orthodromically (during spontaneous tachycardia and right ventricular pacing) or antidromically (during left ventricular pacing). 相似文献
3.
Nuray
. Kanbur Eudice Goldberg Leora Pinhas Robert M. Hamilton Robin Clegg Debra K. Katzman 《The International journal of eating disorders》2009,42(6):575-578
Anorexia nervosa (AN) can cause both functional and structural cardiac complications, including a variety of different conduction abnormalities. This is the first case report of symptomatic diurnal second‐degree atrioventricular (AV) block (Mobitz Type I) in an adolescent with AN. We present a 12‐year‐old girl with AN, restrictor sub‐type who reported cardiac symptoms during weight gain, at the time of the initial diagnosis of AV block. Second‐degree AV block (Mobitz Type I) is discussed as a possible complication of the AN, as well as being an intrinsic conduction system disease. © 2009 by Wiley Periodicals, Inc. Int J Eat Disord 2009 相似文献
4.
应用食管调搏,检测64例旁道参与的房室折返性心速患者Ⅰ、Ⅱ、Ⅴ1和食管导联的室房时距、P'v,Pet时距。发现左侧AP者RP'1较RP'V1短(P<0.01),而右侧AP时较RP'v1长(P<0.01)。 相似文献
5.
Skip mediastinal nodal metastases in non-small cell lung cancer 总被引:1,自引:0,他引:1
Fumihiro Tanaka Kazumasa Takenaka Hiroki Oyanagi Takuji Fujinaga Yosuke Otake Kazuhiro Yanagihara Harumi Ito Hiromi Wada 《European journal of cardio-thoracic surgery》2004,25(6):744-1120
Objective: To reveal the incidence and clinical significance of mediastinal nodal metastases without N1-station nodal metastases (‘skip-N2 metastases’) in non-small cell lung cancer (NSCLC). Methods: A total of 450 NSCLC patients who underwent tumor resection with a systemic mediastinal nodal dissection were retrospectively reviewed. p53 status and proliferative activity represented as proliferative index (PI) were also examined immunohistochemically. Results: Skip-N2 metastases were documented in 49 (13%) patients of all 450 patients; among 334 patients without N1-nodal involvement, 18% patients had skip-N2 metastases. The postoperative survival of skip-N2 patients was almost same as that for patients with metastases to both N1 and N2 nodes. Skip-N2 metastases were significantly more frequent in male patients and squamous cell carcinoma patients. In addition, the mean PI for tumor with skip-N2 metastases was significantly higher than that for any other pathologic nodal (pN)-status diseases. Combined with histologic type and PI, the incidences of skip-N2 metastases for adenocarcinoma showing lower PI were only 5% (7/137) of all patients and 7% (7/94) of patients without N1-nodal involvement. Conclusions: N1 nodal status is not a useful predictor of N2 nodal status in NSCLC, because skip-N2 metastases were documented in 18% patients showing no N1-nodal involvement. However, N1 node-guided dissection might be performed in patients with adenocarcinoma showing lower PI, because the incidence of skip-N2 metastases was extremely low. 相似文献
6.
目的研究房室结逆向传导的电生理特点。方法分析在我院行电生理检查和/或射频消融的成年患者中电生理资料比较完整的300例患者的房室结逆传电生理特点。结果射频消融术后有161例(54%)有房室结逆传。有逆传患者的前传功能要好于无逆传的患者,对于术后存在室房逆传的患者,逆传功能均明显差于前传功能。射频消融术后有28例(17%)经房室结逆传最早激动冠状静脉窦口,其逆传功能较最早激动希氏束电图的病例相比要差,而两者的前传功能差异无统计学意义。结论射频消融术后54%的患者存在房室结逆传,可能是正常人群中室房逆传的真实反映。有室房逆传患者的房室结前传功能优于无室房逆传者,也优于其本身的逆传功能。房室结逆传冲动进入心房可能存在两条不同的通路。 相似文献
7.
HANS KOTTKAMP M.D. GERHARD HINDRICKS M.D. MARTIN BORGGREFE M.D. GÜNTER BREITHARDT M.D. 《Journal of cardiovascular electrophysiology》1997,8(4):451-468
Catheter Ablation Techniques in AVNRT. Radiofrequency catheter ablation has been established as a first-line curative treatment modality in patients with symptomatic AV nodal reentrant tachycardia (AVNRT). The successful sites of stepwise catheter ablation approaches of the so-called fast and slow pathways strongly suggest that AVNRT involves the atrial approaches to the AV node. The typical fast pathway ablation sites are located anterosuperior toward the apex of the triangle of Koch, which also contains the compact AV node, whereas the usual slow pathway ablation sites are located posteroinferior toward the base of the triangle of Koch at a greater distance to the compact AV node and bundle of His. Accordingly, ablation studies with large patient cohorts have demonstrated that fast pathway ablation carries a higher risk of inadvertent complete AV block. Thus, the slow pathway is clearly the primary target site, and fast pathway ablation is rarely necessary. Different approaches for slow pathway ablation have been elaborated: anatomically oriented stepwise techniques, ablation guided by double potentials recorded within the area of the slow pathway insertion, and combined techniques. The modern concept of AVNRT suggests that this arrhythmia involves the highly complex three-dimensional nonuniform anisotropic AV junctional area. Accordingly, mapping and ablation studies demonstrated that the anterior approach is not identical with fast pathway ablation, and the posterior approach is not identical with slow pathway ablation. Therefore, it is essential for interventional electrophysiologists to familiarize themsdves with the anatomic and electrophysiologic details of this complex and variable specialized AV junctional region. In this review, the anatomic and pathophysiologic aspects of the AV junctional area as they relate to interventional therapy are summarized briefly, and the catheter techniques for ablation of the so-called fast and slow AV nodal pathways for the treatment of AVNRT are described. 相似文献
8.
Nabil El-Sherif 《The International Journal of Cardiac Imaging》1991,7(3-4):141-150
In this work the electrophysiologic mechanisms of ventricular arrhythmias have been briefly summarized. Ventricular arrhytmias can be caused either by pacemaker activity or by reentrant excitation. Enhancement of normal automaticy can generate a parasystolic rhythm in normal fibers. Abnormal automaticity may arise fom fibers in which maximum diastolic potential has been reduced by a variety of interventions. Triggered activity is caused by either an early (EAD) or delayed (DAD) afterdepolarization and requires a prior normal action potential for initiation. While there is growing evidence that EAD-induced triggered activity plays a significant role in the Long QTU syndrome and Torsade de Pointes, no clinical arrhythmias has definitely been ascribed to DADs, although DADs have been recorded in man after acute digoxin intoxication.Ventricular arrhytmias can be also caused by reentrant excitation, which can be subdivided into reflection or circus movement reentry (CMR). In the reflection model impulses in both directions are transmitted over the same pathway. In the CMR three models can be differentiated: the ring model, which requires a fixed anatomical obstacle; the figure-eight model and the leading circle model, where functional rather than fixed anatomical obstacles are involved.Abbreviations AV
atrio-ventricular
- CMR
circus movement reentry
- DAD
delayed afterdepolarization
- EAD
early afterdepolarization
- ECG
electrocardiogram
- LV
left ventricle
- MAP
monophasic action potential
- MF
muscle fiber
- PF
Purkinje fiber
- RV
right ventricle
- TdP
Torsade de Pointes 相似文献
9.
Rate-Related and Autonomic Effects on Atrioventricular Conduction Assessed Through Beat-to-Beat PR Interval and Cycle Length Variability 总被引:1,自引:0,他引:1
CHRISTOPHER T. LEFFLER M.D. J. PHILIP SAUL M.D. RICHARD J. COHEN M.D. Ph .D. 《Journal of cardiovascular electrophysiology》1994,5(1):2-15
Atrioventricular Conduction Variability. Introduction: Atrioventricular AV) conduction time varies on a beat-by-beat basis in response to the influences of cardiac efferent autonomic activity and rate-dependent electrical recovery processes. The goals of this study were to distinguish these effects on AV conduction time and to compare the variability in sinoatrial and AV nodal function. Methods and Results: The PR interval on the surface ECG served as an index of AV conduction time in this study of 14 adult human subjects undergoing a random interval breathing protocol. P and R waves were located by a template-matching algorithm. Spectral analysis allowed frequency-domain comparisons between PR and RR interval variability. Spectra of PR and RR intervals had similar power distributions, although the power of the RR interval spectra was much greater. Autonomic blockade with atropine plus propranolol reduced the power of both spectra. Standing significantly decreased the spectral power from 0.15 to 0.5 Hz for PR and RR spectra, and introduced a peak near 0.1 Hz in the mean PR and RR spectra, although the latter finding was significant only for the RR interval spectra. Propranolol had no significant effects on the PR and RR interval spectra. Linear regression analysis allowed quantification of the autonomic and recovery effects on AV conduction and showed which effect predominated. Simple linear regression confirmed in adults a previous finding in children that conduction time may be either positively or negatively correlated with cycle length. By multiple regression and transfer function analysis, the inverse relation seen in some subjects was attributed to the effect of recovery from the preceding cycle. With the preceding recovery period accounted for, the conduction time and cycle length of the current beat were positively correlated, presumably due to the parallel autonomic effects on the sinoatrial and AV nodes. The magnitude of the recovery effect predicted by the regression analysis was similar to published values. Conclusion: A noninvasive evaluation of the surface ECG can be used to compare variability in AV conduction time and cycle length and characterize the effects of autonomic efferent activity and rate-related recovery on AV nodal function. 相似文献
10.
本文通过食道心房程序调搏检测出典型房室结双径路23例,其中12例诱发室上性心动过速(占52%);占17例有心动过速发作史者的70.6%。本文着重分析了房室结双径路与室上性心动过速的关系。 相似文献