Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Aug 1996
Randomized Controlled Trial Multicenter Study Clinical TrialPrognostic significance of precordial ST segment depression on admission electrocardiogram in patients with inferior wall myocardial infarction.
This study assessed retrospectively the correlation between the pattern of precordial ST segment depression on the admission electrocardiogram (ECG) and hospital mortality in patients with an inferior myocardial infarction treated with intravenous thrombolytic therapy. ⋯ The risk of mortality is higher in patients with an inferior myocardial infarction and maximal ST segment depression in precordial leads V4 to V6 versus precordial leads V1 to V3 on the admission ECG.
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J. Am. Coll. Cardiol. · Aug 1996
Randomized Controlled Trial Comparative Study Clinical TrialDiuretic efficacy of high dose furosemide in severe heart failure: bolus injection versus continuous infusion.
The efficacy of high dose furosemide as a continuous infusion was compared with a bolus injection of equal dose in patients with severe heart failure. ⋯ We conclude that in patients with severe heart failure, high dose furosemide administered as a continuous infusion is more efficacious than bolus injection and causes less ototoxic side effects.
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J. Am. Coll. Cardiol. · Aug 1996
Distinction between arrhythmic and nonarrhythmic death after acute myocardial infarction based on heart rate variability, signal-averaged electrocardiogram, ventricular arrhythmias and left ventricular ejection fraction.
We investigated whether heart rate variability, the signal-averaged electrocardiogram (ECG), ventricular arrhythmias and left ventricular ejection fraction predict the mechanism of cardiac death after myocardial infarction. ⋯ Arrhythmic death was associated predominantly with depressed heart rate variability and ventricular tachycardia runs, and nonarrhythmic death with low ejection fraction, ventricular ectopic beats and depressed heart rate variability. A combination of risk factors identified patient groups in which a majority of deaths were either arrhythmic or nonarrhythmic.
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J. Am. Coll. Cardiol. · Aug 1996
Electromagnetic interference from welding and motors on implantable cardioverter-defibrillators as tested in the electrically hostile work site.
This study was designed to determine the susceptibility of an implanted cardioverter-defibrillator to electromagnetic interference in an electrically hostile work site environment, with the ultimate goal of allowing the patient to return to work. ⋯ None of the implanted defibrillators tested were affected by oversensing of the electric field as verified by telemetry from the detection circuits. The magnetic field from 225-A welding current produced a flux density of 1.2 G; this density was not adequate to close the reed switch, which requires approximately 10 G. Our testing at the work site revealed no electrical interference with this type of defibrillator. Patients were allowed to return to work. The following precautions should be observed by the patient: 1) maintain a minimal distance of 2 ft (61 cm) from the welding arc and cables or large motors, 2) do not exceed tested currents with the welding equipment, 3) wear insulated gloves while operating electrical equipment, 4) verify that electrical equipment is properly grounded, and 5) stop welding and leave the work area immediately if a therapy is delivered or a feeling of lightheadedness is experienced.
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This analysis was performed to quantitatively assess the relative risks, associated with underlying cardiovascular disease, incurred in the course of intense competitive sports. ⋯ Although highly trained athletes such as marathon runners may harbor underlying and potentially lethal cardiovascular disease, the risk for sudden cardiac death associated with such intense physical effort was exceedingly small (1 in 50,000) and as little as 1/100th of the annual overall risk associated with living, either with or without heart disease. The low risk for sudden death identified in long-distance runners from the general population suggests that routine screening for cardiovascular disease in such athletic populations may not be justifiable.