Journal of cardiovascular electrophysiology
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Mechanical and pharmacologic measures intended to increase blood flow to vital organs are the mainstay of therapy for patients in cardiac arrest. Several new cardiopulmonary resuscitation (CPR) techniques as well as novel devices and pharmacologic agents have been developed and tested since the first report of manual closed chested CPR over three decades ago. ⋯ Some of these new techniques, devices, and drug therapies are presently undergoing clinical evaluation in patients in cardiac arrest. While many of these new methods and techniques have shown promise in small clinical trials in humans, none have yet to be found to be conclusively superior to manual closed chested CPR and treatment with standard pharmacologic agents.
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J. Cardiovasc. Electrophysiol. · Apr 1997
Case ReportsTachycardia-induced cardiomyopathy secondary to right ventricular outflow tract ventricular tachycardia: improvement of left ventricular systolic function after radiofrequency catheter ablation of the arrhythmia.
Several reports describe development of cardiomyopathies secondary to supraventricular tachycardia. Few reports have described cardiomyopathies secondary to ventricular tachycardia. ⋯ This report suggests that right ventricular outflow tract ventricular tachycardia may cause reversible tachycardia-induced cardiomyopathy.
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J. Cardiovasc. Electrophysiol. · Dec 1996
Comparative StudyRight and left atrial radiofrequency catheter therapy of paroxysmal atrial fibrillation.
Atrial fibrillation (AF), the most common arrhythmia, is due to multiple simultaneous wavelets of reentry in the atria. The only available curative treatment is surgical, using atriotomies to compartmentalize the atria. Therefore, we investigated a staged anatomical approach using radiofrequency catheter ablation lines to prevent paroxysmal AF. ⋯ Successful radiofrequency catheter ablation of drug-refractory daily paroxysmal AF is feasible using linear atrial lesions complemented by focal ablation targeted at arrhythmogenic foci. Ablation only in the right atrium is a safe technique providing limited success, whereas linear lesions in the left atrium significantly increase the incidence of stable restoration of sinus rhythm, the inability to induce sustained AF, and the final success rate. The described technique is promising but must be considered preliminary because significant improvements are required to optimize lesion characteristics and shorten total procedure duration.
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J. Cardiovasc. Electrophysiol. · Dec 1996
Case ReportsRadiofrequency catheter ablation of idiopathic ventricular tachycardia originating in the anterior fascicle of the left bundle branch.
Idiopathic ventricular tachycardia (VT) originating in or close to the anterior fascicle of the left bundle is rare. A patient with no structural heart disease and VT with a right bundle branch block configuration and right-axis deviation underwent an electrophysiologic examination. ⋯ Idiopathic VT originating in or close to the anterior fascicle was cured by RF ablation. A Purkinje potential preceding the QRS during tachycardia and an optimal pacemap were used to guide RF ablation.
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J. Cardiovasc. Electrophysiol. · Jul 1996
Clinical TrialEffect of graded increases in parasympathetic tone on heart rate variability.
Time-and frequency-domain measurements of heart rate variability have been used as indices of parasympathetic tone. However, studies of the effect of parasympathetic stimulation on these indices in humans have yielded conflicting results. ⋯ These findings suggest that the respiratory variation in "parasympathetic effect" typically observed at the sinus node can be either increased or decreased by parasympathetic stimulation, depending on the initial level of parasympathetic tone and the intensity of stimulation. This resolves the previously conflicting data. Thus, evaluation of parasympathetic tone using heart rate variability techniques should be cautiously undertaken.