[Inadequate, inappropriate sinus-node tachycardia: an old cardiac arrhythmia in a new perspective (II.): Our experiences with the pharmacological treatment].

Unlabelled: Összefoglaló. Bevezetés: Az inadekvát, aránytalan sinuscsomó-tachycardia a szív nomotop ingerképzési zavarával járó, nem ritka klinikai szindróma. A szívritmuszavar-entitást a nem paroxysmalis, magas nyugalmi sinusfrekvencia, a fizikai/pszichés stresszre adott aránytalan sinustachycardia, valamint főként palpitációs panaszok jellemzik.

[Inadequate, inappropriate sinus-node tachycardia. ].

The inadequate, inappropriate sinus-node tachycardia is not a rare clinical syndrome, defined as a non-paroxysmal, increased sinus-rate at rest, and/or inadequate response to physical and/or emotional stress, and palpitations. The aim of this study was to describe our experiences with the investigations of our inappropriate sinus-node tachycardia patients. In the last years, 104 patients (92 women, 12 men, mean age: 31 ± 10 years) were treated with this cardiac arrhythmia entity.

[The first use of iv. idarucizumab for dabigatran reversal in Hungary].

At present, the direct thrombin inhibitor dabigatran is the only one amongst the new direct anticoagulants which has an effective, specific reversal agent. The novel agent idarucizumab is a humanized, monoclonal antibody fragment binds to dabigatran within minutes thereby offers an opportunity to induce a safe, long-lasting reverse of the anticoagulant effects of dabigatran. The authors describe the first use of idarucizumab in Hungary (23.

[Catheter ablation for supraventricular tachycardia in children and congenital heart diseases].

Introduction: Recently catheter ablation has been accepted as standard therapy for symptomatic supraventricular tachycardia in children. Nature of childhood and the variability of congenital heart diseases and congenital heart surgery distinguishes pediatric catheter ablation from the adult practice.

Objectives: The aim of the present study was to summarize a single-center experience of the first 30 consecutive patients regarding the electrophysiological studies and catheter ablations, moreover to report on the national adoption of these interventions for pediatric patients in Hungary.

Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS).

Aims: Large randomized trials have shown that beta-blockers reduce mortality and hospital admissions in patients with heart failure. The effects of beta-blockers in elderly patients with a broad range of left ventricular ejection fraction are uncertain. The SENIORS study was performed to assess effects of the beta-blocker, nebivolol, in patients >/=70 years, regardless of ejection fraction.

Lack of a hypotensive effect with rapid administration of a new aqueous formulation of intravenous amiodarone.

Hypotension is the most frequent adverse event reported with intravenous amiodarone. Hypotension has been attributed to the vasoactive solvents of the standard formulation (Cordarone IV) and is not dose related, but related to the rate of infusion. Drug labeling calls for intravenous amiodarone to be administered over 10 minutes.

[Implantable pacemaker-cardioconverter-defibrillator].

The aim of this article is to introduce the automatic, implantable cardioverter-defibrillator (AICD) device in connection with the first two cases in Hungary. At present time, the indications of the AICD implantation in the European Community are as follows: recurrent sustained episodes of ventricular tachycardia ventricular fibrillation or aborted sudden cardiac (arrhythmic) death, when the treatment of the underlying heart disease and/or the application of antiarrhythmic drugs, antitachycardia surgery (or catheter ablation procedures) proved to be unsuccessful in the prevention of the ventricular tachyarrhythmias (guided by serial intracardiac electrophysiologic testing and exercise testing), Holter monitoring. On the one hand the implantation of an AICD is not a causative treatment, on the other hand the cost of an AICD is extremely expensive.

[The role of transesophageal echocardiography in the fibrinolytic treatment of thrombosis on the artificial mitral valve].

Unlabelled: Fibrinolytic treatment of mitral mechanical prosthetic valve thrombosis is still controversial. This treatment can only be justified if the incidence and severity of complications is relatively low compared to the expected success-rate. The purpose of this study was to assess the role of transesophageal echocardiography (TEE) in the selection of patients optimally suitable for fibrinolytic therapy.

Clinical predictors of electrophysiologic findings in patients with syncope of unknown origin.

Unexplained syncope is a common medical problem. Intracardiac electrophysiologic studies (EPS) have been used to uncover the underlying arrhythmic mechanisms. Electrophysiologic studies are especially helpful in the management of patients with inducible tachyarrhythmias, but is of limited usefulness in those with normal EPS findings.

Oral amiodarone loading therapy. I. The effect on serial signal-averaged electrocardiographic recordings and the QTc in patients with ventricular tachyarrhythmias.

The effect of amiodarone loading (1400 mg/day for 7 days) and maintenance therapy (400 mg/day) on the signal-averaged electrocardiogram (SAECG) and the QTc were evaluated in 14 patients. Daily recordings were taken for the first 7 days of loading and on the ninth, twelfth, fourteenth, and twenty-first day of maintenance therapy. All patients had inducible sustained ventricular tachycardia (VT), 10 of them had late potential (LP) positive recording, and four were LP negative during control measurements.

Short-term effect of coronary artery bypass grafting on the signal-averaged electrocardiogram.

Ventricular late potentials at the end of the QRS can be detected on the body surface during sinus rhythm by recording a signal-averaged electrocardiogram (SAECG). In patients with coronary artery disease, these late potentials have been shown to be markers for spontaneous or inducible ventricular tachycardia, or both. The short-term (before and 10 +/- 4 days after coronary revascularization) influence of coronary artery bypass grafting (CABG) on the quantitative SAECG variables was studied in 40 patients with chronic coronary artery disease.

Correlation between the signal-averaged electrocardiogram and electrophysiologic study findings in patients with coronary artery disease and sustained ventricular tachycardia.

Ventricular late potentials at the end of the surface QRS, detected on the signal-averaged electrocardiogram (SAECG) have been shown to be markers for spontaneous and/or inducible ventricular tachycardia (VT) in patients with coronary artery disease (CAD). We examined the correlations between electrophysiologic study (EPS) findings and SAECG indexes in 50 patients with chronic CAD with documented spontaneous VT/ventricular fibrillation (VF), who had either syncope (24 patients) or aborted sudden cardiac death (SCD). The prevalence of late potentials was significantly higher in the syncope patients (75%) compared with the SCD group (46%) (p less than 0.

The automatic implantable cardioverter-defibrillator. Clinical experience, complications, and follow-up in 25 patients.

Twenty-five patients with recurrent ventricular tachyarrhythmias underwent implantation of an automatic implantable cardioverter-defibrillator. The mean length of follow-up was 11.9 +/- 10.

The clinical value of the His-bundle electrogram in intraventricular conduction defects.

A study concerned with the clinical significance of the His-bundle ECG was carried out in association with upper atrial stimulation in 20 patients with intraventricular conduction defect. On the ground of the results the His-bundle ECG is regarded as a procedure of diagnostic value in intraventricular conduction defects by contributing to the accuracy of information on the severity and extent of the lesion. In the framework of published observations, including the present findings, questions relating to prognosis and to the necessity for pacing in bifascicular block are discussed.

The secondary poststimulative phase after rapid atrial pacing: its importance in the diagnosis of sinus node dysfunction.

The effect of atropine and the beta-blocker Tobanum was studied on intrinsic heart rate (IHR) and on rapid atrial pacing carried out before and after administration of the drugs. The primary and secondary postpacing parameters were examined in both circumstances. In patients with normal IHR, return to the basic heart frequency after the drugs showed an exponential characteristic while in patients with abnormal IHR, the cycles of PPC 2-10 have lost this characteristic feature.

Application of His bundle recording in different rhythm disturbances of the heart.

The new intracardiac electrophysiological method: His bundle electrocardiography, combined with the electrophysiological examination used in routine clinical practice, has considerably improved our knowledge of the cardiac dysrhythmias. It helps to localize the focus of the atypical junctional and other supraventricular premature beats complicated with either organic or functional intraventricular conduction disturbance. The various forms of paroxysmal tachycardias can be differentiated more exactly from each other.