[Brugada syndrome].

Background: A high take-off descending ST segment associated with right bundle branch block is the typical ECG criterion of the Brugada-Brugada syndrome. It leads to ventricular fibrillation or syncopes in case of a familiar disposition.

Case Report: We describe a 56-year-old man in whom oral prajmalium bitartrate therapy previously prescribed for symptomatic ventricular extrasystoles unmasked an electrographic pattern characteristic of a Brugada syndrome.

Determinants of mortality after cardiac surgery: results of the registry of the Arbeitsgemeinschaft Leitender Kardiologischer Krankenhausärzte (ALKK) on 10 525 patients.

Background: Mortality from cardiac surgery is an essential indicator of quality and forms the basis of treatment strategy decisions in eligible patients. No contemporary complete data on unselected adult cardiac surgery patients are available in Germany.

Methods And Results: A registry was started in June 1997 of all patients referred to surgery from 85 cardiology centres in Germany.

[Basic diagnostic program in dizziness and syncope symptoms: value of electrophysiologic studies of the heart].

Syncopes and preceding signs and symptoms, particularly also in form of appearances of giddiness, are, including specialists of various branches, among others ENT, neurology, orthopaedics and ophthalmology, always to be classified according to the fact whether or not a cardiovascular disease is to be regarded as cause. If there is the suspicion, both special non-invasive investigations and such ones which possibly are to be performed invasively are indicated. The latter come after the non-invasive investigations partly on account of the expenditure (technique of heart catheterization) and the possibilities of complication.

[Diagnosis and therapy of ventricular tachycardia in heart failure].

In a survey diagnostic and therapeutic problems of the ventricular arrhythmias in cardiac insufficiency are described. It is expressed that prevalence and prognosis of the arrhythmia in cardiac insufficiency are not yet sufficiently investigated both in the acute and in the chronic phase. Furthermore, ascertained investigations concerning the effect of the individual antiarrhythmic drugs have not come to hand.

[Clinical aspects of reperfusion arrhythmia following intravenous thrombolysis in acute myocardial infarct].

In accordance with the majority of the reports in the literature reperfusion arrhythmias were observed in more than 30% of the patients with acute myocardial infarction (n = 25) under or immediately after a highly dosed short-term infusion with streptokinase. With reference to indirect signs the recanalisation rate was assumed with 75%. Only one third of the reperfusion arrhythmias had haemodynamically significant characteristics and required an influence.

[Effect of histamine H2 receptor blockers on hepatic elimination of drugs].

In an investigation is proved that already after a treatment with the histamine-H2-receptor blocker Cimetidine (Altramet) lasting 14 days the elimination of Antipyrine is significantly delayed. In 14 male patients suffering from peptic ulcer the half-life period of Antipyrine (t50) was 8.6 +/- 0.

[Prevention, clinical aspects and therapy of the side-effects of lidocaine].

In 134 patients with an acute myocardial infarction a prolonged lidocaine infusion was performed. In 6.7% of the patients severe side effects occurred.

[Lidocaine elimination and dose adjustment in acute heart infarct and heart insufficiency].

In 40 patients with an acute myocardial infarction a prolonged lidocaine infusion was indicated. The dosage of lidocain was done according to the body-weight. Patients suffering from a heart insufficiency received the anti-arrhythmic drug with a reduced dose referring to the degree of severity.

[Preoperative examinations by internists before reoperation].

Special attention should be focused upon the cardiopulmonary system and the liver function as well. The concomitant medical therapy in the pre-, intra- and postoperative phase has to be adapted to the patients actual requirements in order to avoid undesirable side-effects due to toxic plasma levels of the admitted drugs.

[Determination of hepatic metabolic capacity: antipyrine pharmacokinetics in circulatory liver damage due to cardiac insufficiency].

As it was demonstrated in a study, antipyrin halftime and clearance totalis are prolonged resp. reduced in patients with circulatory liver damage due to cardiac failure in myocardial infraction (group H) and in patients with chronic congested liver due to diseases of the heart valves (group V). group H: t50,2 +/- 11,7 h, Cltot 27 +/- 13,3 ml.

[Obesity--a surgical problem?].

This a a survey or morbid obesity in man, its causes and possibilities of conservative and surgical treatment. The different aetiological types of obesity are dealt with. Special attention is focused on the mitochondrial oxidation-process.

[Serum level determination in patients with acute myocardial infarction under diphenylhydantoin therapy].

For the therapy of disturbances of the cardiac rhythm with phenytoin 3 different dosage regimes are examined, in which cases an oral application of phenytoin proves as not suitable. Only by a stepped infusion with following oral treatment a rapid saturation and therapeutically effective serum levels are achieved which are decisive for the effectiveness of the therapeutic measures.

[Clinical experiences with the miniature-electrocardioscope MC-3 in cardiological emergencies].

Using the thoraxic putting up electrodes the cardioscope MC-3 (Medicor Budapest) principally satisfies the demands made on an emergency cardioscope. Usually derived with electrode cable, the derivation programme comprises 12 possibilities. The apparatus is distinguished by an easy service, slight susceptibility to disturbances and great security.