Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Nov 1994
Risk stratification for arrhythmic events in patients with nonischemic dilated cardiomyopathy and nonsustained ventricular tachycardia: role of programmed ventricular stimulation and the signal-averaged electrocardiogram.
This study investigated prediction of arrhythmic events by the signal-averaged electrocardiogram (ECG) and programmed stimulation in patients with nonischemic dilated cardiomyopathy. ⋯ In patients with nonischemic dilated cardiomyopathy, 1) there is a strong correlation between abnormal findings on the time-domain signal-averaged ECG and induced ventricular tachycardia, but both findings are uncommon; and 2) normal findings on the signal-averaged ECG, as well as failure to induce ventricular tachycardia, do not imply a benign outcome.
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J. Am. Coll. Cardiol. · Nov 1994
Comparative Study Clinical TrialTransesophageal dobutamine stress echocardiography for evaluation of patients with coronary artery disease.
The present study was undertaken to determine the safety, feasibility and diagnostic accuracy of transesophageal dobutamine stress echocardiography for the evaluation of patients with known or suspected coronary artery disease. ⋯ Transesophageal dobutamine stress echocardiography is a safe, feasible and accurate method for assessing coronary artery disease. Its use should be considered in patients who have a suboptimal ultrasound window, and it provides an excellent tool for clinical investigations based on ultrasound imaging of the myocardium.
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J. Am. Coll. Cardiol. · Nov 1994
Clinical TrialIncreased left ventricular diastolic chamber stiffness immediately after coronary artery bypass surgery.
The aim of this study was to assess the incidence and severity of left ventricular diastolic dysfunction immediately after coronary artery bypass surgery by utilizing simultaneous transesophageal echocardiographic and hemodynamic monitoring. ⋯ Left ventricular diastolic chamber stiffness frequently increases immediately after coronary artery bypass surgery. Simultaneous hemodynamic and transesophageal echocardiographic monitoring, through the construction of end-diastolic pressure-area curves, is a useful method to evaluate diastolic function and guide management after cardiac surgery.
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J. Am. Coll. Cardiol. · Nov 1994
Multicenter Study Comparative StudyManagement outcome and follow-up of fetal tachycardia.
The aim of this study was to evaluate fetal tachycardia and the efficacy of maternally administered antiarrhythmic agents and the effect of this therapy on delivery and postpartum management. ⋯ Fetal tachycardia can be treated adequately in the majority of patients, even in the presence of hydrops, and therefore emergency delivery might not be indicated. Digoxin and flecainide were drugs of first choice and produced no serious adverse effects in this series of patients. The majority of patients do not require prolonged therapy.
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J. Am. Coll. Cardiol. · Nov 1994
Balancing the circulation: theoretic optimization of pulmonary/systemic flow ratio in hypoplastic left heart syndrome.
This study examined the effects of the pulmonary (QP)/systemic (QS) blood flow ratio (QP/QS) on systemic oxygen availability in neonates with hypoplastic left heart syndrome. ⋯ This analysis provides a theoretic basis for balancing both the pulmonary and systemic circulation and suggests that evaluating both systemic arterial and venous oxygen saturation may be a useful way to determine the relative pulmonary and systemic flows. When high systemic arterial and low systemic venous oxygen saturation are present, pulmonary blood flow should be decreased; conversely, when both low systemic arterial and venous oxygen saturation are present, more flow should be directed to the pulmonary circulation.