Publications by authors named "Krivan L"

Article Synopsis
  • * Researchers analyzed data from 514 ACA patients, identifying 46 who met specific criteria for an advanced diagnostic work-up, which included various imaging and testing methods.
  • * Results showed that 37% of patients had a specific disease discovered, while true idiopathic VF was confirmed in only 15.2%, suggesting that even partial diagnostic efforts can lead to meaningful findings for targeted treatment.
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Introduction: Differences in conduction times from right ventricle to left ventricle and from left ventricle to right ventricle respectively were observed during biventricular devices implantation when changing pacing vector direction. In this article the phenomenon of interventricular conduction time differences is described and assessed in relationship to various clinical and electrophysiological parameters.

Methods: In 62 consecutive patients (9 females) interventricular conduction times between right and left ventricle in both directions were measured during cardiac resynchronization therapy device implantation procedure.

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Background: Observations from population-based studies demonstrated a strong genetic component of sudden cardiac death. The aim of this study was to test the hypothesis that ion channel genes mutations are more common in ventricular fibrillation (VF) survivors with coronary artery disease (CAD) compared to controls.

Methods: The entire coding sequence of KCNQ1, KCNH2, SCN5A, KCNE1, and KCNE2 genes was analyzed in 45 (five females) CAD individuals-survivors of documented VF and in 90 matched healthy controls.

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Background: The presence of a microvolt T wave alternans (MTWA) is linked with increased risk of malignant arrhythmias and overall mortality. The most common method used for MTWA detection is a bicycle exercise test (BET). Method has still several limitations.

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The aim of this study was a comparison of risk stratification for death in patients after myocardial infarction (MI) and of risk stratification for malignant arrhythmias in patients with implantable cardioverter-defibrillator (ICD). The individual risk factors and more complex approaches were used, which take into account that a borderline between a risky and non-risky value of each predictor is not clear-cut (fuzzification of a critical value) and that individual risk factors have different weight (area under receiver operating curve - AUC or Sommers' D - Dxy). The risk factors were baroreflex sensitivity, ejection fraction and the number of ventricular premature complexes/hour on Holter monitoring.

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Objective: The aim of this study was an analysis of patients with ICD implanted in primary prevention (PP) in long-term follow-up and comparison with data obtained in secondary prevention patients (SP).

Patients And Methods: We assessed 73 patients with PP ICD and 138 patients with SP ICD. Males were in majority with 88% in PP group and 78% in SP group.

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Unlabelled: The heart rate turbulence is promising marker of a sudden cardiac death. The aim of the study is to evaluate the influence of the ventricular premature beat (VPB) coupling interval on the values of turbulence onset (TO) and turbulence slope (TS) parameters in the three groups of patients--"healthy" with ventricular premature beats, pts post myocardial infarction (MI) and pts with chronic heart failure with the left ventricle ejection fraction (LVEF) < 0.35.

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62 years old patient was admitted to the hospital with weakness of lower extremities. Using laboratory examination, we found very severe hyponatrenaemia, hypochloraemia and hypotonia of blood plasma, because of SIADH. We searched for the cause of that syndrome and finally we found that the cause of that syndrome was small cell lung cancer with an expansion into the mediastinum and metastases into the skelet.

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Background: The number of patients with pacemakers is icreasing. The first reason is longer survival, the second reason is widening indications to cardiostimulation. Along with increasing numbers of performances, we have to recken larger number of complications and these complications solve so, that we avoid more serious damage of a patient.

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The authors present two cases of patients with perforation of the right ventricular wall by the implantable cardioverter defibrillator (ICD) lead. The complication was resolved by cardiosurgical revision and epicardial leads stitched onto the diaphragmatic wall of the heart. The perforation was identified by electrical parameter changes of the leads, echocardiography, and computed tomography.

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Some studies have demonstrated circadian incidence of sudden cardiac death (SCD), ventricular ectopies, acute coronary syndromes and heart rate variability. One of new parameters applied in non-invasive stratification of sudden cardiac death is heart rate turbulence (HRT). Detection of circadian oscillations in HRT and optimised measurement of HRT can increase the positive predictive value of HRT as a sign of SCD risk.

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Background: Some study reported circadian occurence of sudden cardiac death, ventricle ectopic activity, acute coronary syndromes and heart rate variability. Heart rate turbulence (HRT) is one of a new markers of noninvasive stratification of sudden cardiac death.

Methods And Results: We have evaluated HRT in 120 consecutive patiens post myocardial infarction in mean age 62.

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Background: Myocardial infarction survivors may develop a higher risk of sudden cardiac death. The risk markers: left ventricular ejection fraction, ventricular premature beats, late potentials on averaged ECG, baroreflex sensitivity and heart rate variability are used as non-invasive stratification markers.

Methods And Results: Occurrence of the autonomic and morphologic dysfunction risk markers in the myocardial infarction patients treated by thrombolysis and by primary percutaneous transluminal coronary angioplasty (PTCA) is compared.

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Background: A common ICD therapy-related complication is arrhythmic storm (AS). The objective of our study was to define the impact of AS on patients' prognoses in order to compare the total mortality of AS patients with the rest of the group.

Material/methods: We studied 138 patients who received ICDs between 1994 and 2001.

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The endothelins are peptides with vasoconstricting and growth-promoting properties. Endothelin-1 (ET-1) is known with its direct positive inotropic and chronotropic effects on isolated heart and with growth effects. The aim of this pilot study was to investigate the frequency distribution of the common polymorphism of the ET-1 gene and its possible relation with hemodynamic consequences of malignant ventricular arrhythmias in patients with structural heart disease.

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Background: Using implantable cardioverter-defibrillators in treatment of malignant ventricular arrhythmias revealed new complications specific to this therapy. Inappropriate therapy, arrhythmic storm and device related proarrhythmia belong to the most significant complications. The authors describe specific complications in a group of ICD patients, analyze their etiology and prognostic value.

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Implantable cardioverter defibrillators have become an integral part of treatment of patients with malignant chamber arrhythmias over last 10 years both in secondary and primary prevention of sudden deaths. Based on monitoring of a group of 182 patients and based on information in literature, authors present a survey of the most frequent situations, rules and complications related to therapy with implantable defibrillators. In the end they try to answer summary of the most frequent questions of internal medicine physicians and GPs concerning patients with this implanted device.

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A circadian distribution has been demonstrated in episodes of sudden cardiac death, acute myocardial infarction, ventricular premature complexes, heart rate variability, and ventricular tachyarrhythmias. The aim of this study was to evaluate the circadian distribution of ventricular tachyarrhythmia episodes in a population of ICD patients. Data were gathered from 72 patients (55 men, 17 women; mean age 62.

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Background: The endothelins are peptides with vasoconstricting and growth-promoting properties. Endothelin-1 (ET-1) is known for its direct positive inotropic and chronotropic effects on isolated heart, and for growth effects. The aim of this pilot study was to investigate the frequency distribution of a common polymorphism of the endothelin (ET-1) gene and its possible relation to the hemodynamic consequences of malignant ventricular arrhythmia in patients with structural heart disease.

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The aim of this work is to characterize and analyse the spectrum of therapies delivered from implantable cardioverter-defibrillators (ICD), to evaluate their effectivity and to mark the most effective types of antitachycardia stimulations (ATP), cardioversion (CV) and defibrillation (CD). To compare our results with references and give precautions of trouble-shootings. Our patients had implanted ICDs according to standard criteria for ICD implantations.

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Background: Syncope state performed by transient loss of consciousness connected with a postural tone decrease present still an important therapeutical problem. The authors use HUT testing for discovering of vasovagal etiology of a syncope. The aim of the study was to find out the optimal medication in treatment and prevention of VVS by repeated HUT drug testing in a group of positive patients.

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Syncope, a state performed by transient loss of consciousness connected with postural tone decrease present still an important therapeutical problem. It can vary from a benign physiological body reaction to a life-limiting situation. The authors of the article present HUT-testing to be a simple, useful and safe method for discovering vasovagal mechanism of the syncope.

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