Attenuation of post-shock increases in brain natriuretic Peptide with post shock overdrive pacing.

Background: Predischarge defibrillation threshold testing is often performed a few days after ICD implantation in order to validate defibrillation thresholds obtained at the time of implant. Ventricular fibrillation is induced with such testing and causes an increase in serum Brain Natriuretic Peptide (BNP) levels. BNP is an indicator for cardiac stress.

The prediction of ICD therapy in multicenter automatic defibrillator implantation trial (MADIT) II like patients: a retrospective analysis.

Objectives: MADIT II like patients have not been compared to patients without an electrophysiological study, patients in whom ventricular tachycardia or fibrillation were induced in an electrophysiological study (EPS) and patients without an inducibility in EPS in one study.

Background: The multicenter automatic defibrillator implantation trial (MADIT) II showed a benefit of ICD implantation in patients with ischemic heart disease.

Methods: We performed a retrospective analysis in 93 patients with an ischemic heart disease and an ejection fraction View Article and Find Full Text PDF

Effect of induced ventricular fibrillation and shock delivery on brain natriuretic peptide measured serially following a predischarge ICD test.

Objectives: Brain natriuretic peptide (BNP) was a marker for heart failure and cardiac wall tension. We analysed the trend of BNP after predischarge testing in order to get non-invasive details about the cardiac stress during predischarge testing.

Methods: 4-5 days after ICD implant we measured BNP, myoglobin, cardiac troponin I and creatine kinase in 20 patients before and 1, 5, 10, 20, 40, 60, 80, 100, 120 minutes and at the next day after predischarge testing.

Prediction of atrial fibrillation with atrial late potentials and pathological chemoreflexsensitivity.

Background: Atrial fibrillation (AF) is a very common arrhythmia that often causes the serious complication of a stroke.

Object: The aim was to evaluate the utility of pathological chemoreflexsensitivity (PCHRS) and atrial late potentials (ALP) to predict AF in follow-up.

Methods: We investigated a prospective study on the basis of our observation about a PCHRS and ALP in paroxysmal AF.

Beta-blocker prophylaxis for atrial fibrillation after coronary artery bypass grafting in patients with sympathovagal imbalance.

Background: Atrial fibrillation (AF) is the most common arrhythmia after coronary bypass grafting (CABG) resulting in a prolonged hospital stay and higher costs. The withdrawal of beta-blocker and a sympathovagal imbalance were identified as risk factors for AF.

Methods: In our study we performed a measuring of standard deviation of all normal RR intervals (SDNN) among 142 consecutive patients with beta-blocker therapy before CABG in order to identify a collective who had an increased risk due to a withdrawal of beta-blocker medication.

Prediction of atrial fibrillation in patients with cardiac dysfunctions: P wave signal-averaged ECG and chemoreflexsensitivity in atrial fibrillation.

Aims: Atrial fibrillation (AF) is a common arrhythmia in advanced heart failure. The occurrence of AF increases the risk of death and hospitalization for patients with heart failure. The results of different studies indicated that patients with paroxysmal AF have a longer filtered P wave duration (FPD), a lower root mean square voltage of the last 20 ms of the P wave (RMS 20), and a lower chemoreflexsensitivity (CHRS).

Prediction of conversion from paroxysmal to permanent atrial fibrillation.

Background: Paroxysmal atrial fibrillation (PAF) transits to permanent atrial fibrillation (PEAF). The current study was to determine whether a P wave-triggered P wave signal averaged electrocardiogram (P-SAECG) and chemoreflexsensitivity (CHRS) are useful to predict a conversion to PEAF in patients with PAF.

Methods: The filtered P wave duration (FPD) and the root mean square voltage of the last 20 ms of the P wave (RMS 20) were measured by P-SAECG.

[Aortic valve stenosis: from valvuloplasty to percutaneous heart valve].

Calcified aortic stenosis is the predominant valve disease. Patients affected are most commonly elderly people, who often show associated comorbidities like reduced left ventricular function, impaired renal function, and pulmonary hypertension. The risk of open-heart surgery is elevated.

Single-chamber versus dual-chamber implantable cardioverter defibrillators: do we need physiologic pacing in the course?

Background: Many patients with ICD receive different antiarrhythmic drugs (e.g. sotalol, amiodarone, beta-blockers) because of ventricular or atrial tachycardias.

Amiodarone prophylaxis for atrial fibrillation of high-risk patients after coronary bypass grafting: a prospective, double-blinded, placebo-controlled, randomized study.

Aims: Atrial fibrillation (AF) occurs often in patients after coronary artery bypass grafting (CABG) and can result in increased morbidity and mortality. Previous studies using P-wave signal-averaged electrocardiogram (P-SAECG) have shown that patients with a longer filtered P-wave duration (FPD) have a high risk of AF after CABG. We have shown that patients with an FPD > or = 124 ms and a root-mean-square voltage of the last 20 ms of the P-wave 20 < or = 3.

Risk factors of ventricular tachyarrhythmias after coronary artery bypass grafting.

Background: Ventricular arrhythmias are rare and represent the most serious arrhythmic complication after coronary artery bypass grafting (CABG).

Methods: The present retrospective study was conducted for identifying patients at risk of ventricular arrhythmias with ventricular signal averaged ECG, standard deviation of all normal RR intervals (SDNN), angiographic and echocardiographic data. We defined ventricular arrhythmias as sustained ventricular fibrillation and ventricular tachycardia.

Prediction of atrial fibrillation after coronary artery bypass grafting: the role of chemoreflex-sensitivity and P wave signal averaged ECG.

Atrial fibrillation (AF) after coronary artery bypass grafting (CABG) results in a prolonged hospital stay associated with higher costs. In our study P wave triggered P wave signal averaged ECG and chemoreflex-sensitivity (CHRS) was performed on 101 consecutive patients with sinus rhythm before CABG in order to evaluate the utility of these methods to predict AF. A CHRS below 3.

Long-term outcome after cardioversion of atrial fibrillation: prediction of recurrence with P wave signal averaged ECG and chemoreflexsensitivity.

Aim: The recurrence of atrial fibrillation after cardioversion was a general problem in medical practice.

Methods: We wanted to test the hypothesis that the recurrence of atrial fibrillation could be predicted by measurements of P wave triggered P wave signal averaged ECG and chemoreflexsensitivity (CHRS) in 118 consecutive patients one day after successful electrical cardioversion. We measured the filtered P wave duration (FPD) and the root mean square voltage of the last 20 ms of the P wave (RMS 20) with P wave triggered P wave signal averaged ECG.

Prediction of the recurrence of atrial fibrillation after successful cardioversion with P wave signal-averaged ECG.

Background: The recurrence of atrial fibrillation (AF) was often observed after cardioversion.

Methods: In our study, a P wave triggered P wave signal-averaged ECG (P-SAECG) was performed on 118 consecutive patients 1 day after successful electrical cardioversion in order to evaluate the utility of this method to predict AF after cardioversion. We measured the filtered P wave duration (FPD) and the root mean square voltage of the last 20 ms of the P wave (RMS 20).

P wave signal averaged ECG and chemoreflexsensitivity in paroxysmal atrial fibrillation.

Detailed analysis of the QRS-complex and autonomic dysfunction can identify patients at risk to suffer from ventricular arrhythmias. To determine whether patients at risk for paroxysmal atrial fibrillation (PAF) could be identified while in sinus rhythm, a P wave triggered signal averaged ECG and an analysis of the autonomic function by chemoreflexsensitivity (CHRS) were examined. The ratio between the difference of RR intervals in the ECG and the venous partial pressure of oxygen before and after 5-min oxygen inhalation was measured for the determination of CHRS.

Effects of right coronary artery PTCA on variables of P-wave signal averaged electrocardiogram.

Background: P-wave signal averaged ECG has been used to detect atrial late potentials that were found in paroxysmal atrial fibrillation. Ischemia is supposed to trigger ventricular late potentials, which indicate an elevated risk for ventricular tachycardia. Preexistent ventricular late potentials measured by ventricular signal averaged ECG is supposed to be eliminated by successful PTCA.