American heart journal
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American heart journal · Dec 1998
Randomized Controlled Trial Clinical TrialSpinal cord stimulation in chronic intractable angina pectoris: a randomized, controlled efficacy study.
Spinal cord stimulation is known to be a successful treatment for chronic intractable angina pectoris. Its effect may be anti-ischemic. It is uncertain if the clinical effect is partly caused by a placebo effect of surgery for implantation of a stimulator. In this study, clinical efficacy is investigated, together with a possible placebo effect. ⋯ Spinal cord stimulation is effective in chronic intractable angina pectoris, and its effect is exerted through anti-ischemic action. Efficacy is unlikely to be explained as a placebo effect from surgery.
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American heart journal · Dec 1998
Clinical TrialDobutamine stress Doppler hemodynamics in patients with aortic stenosis: feasibility, safety, and surgical correlations.
This study was designed to describe the experience of our center with the safety and feasibility of dobutamine stress echocardiography (DSE) in aortic stenosis (AS), to characterize the hemodynamic response to dobutamine infusion, and to examine the hemodynamic response in relation to the anatomic evaluation of the valve among patients who underwent valve replacement. ⋯ Although more data are needed to fully establish the safety of the test in this indication, this study suggests that patients with AS can safely undergo DSE. Dobutamine results in an increase not only in the mean gradient, but also in the valve area. An increase in valve area with dobutamine was observed in some patients with anatomically confirmed severe AS and thus does not exclude fixed valve disease.
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American heart journal · Dec 1998
Comparative StudyElectrical cardioversion of atrial fibrillation or flutter with conscious sedation in the age of cost containment.
The purpose of this study was to compare the safety, efficacy, and cost of conscious sedation administered by electrophysiologists certified in the use of conscious sedation with sedation administered by anesthesiologists during cardioversion of atrial fibrillation or atrial flutter to sinus rhythm. ⋯ Sedation administered by electrophysiologists for cardioversion of atrial arrhythmias is safe and cost effective. Midazolam and morphine, the sedative agents administered by electrophysiologists, were effective and well tolerated by patients.
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American heart journal · Dec 1998
Clinical and echocardiographic findings in patients with suspected acute aortic dissection.
The objective of this study was to define the range of clinical presentations, echocardiographic findings, and underlying final diagnoses in patients with clinically suspected acute aortic dissection. ⋯ Symptoms in patients with acute aortic dissection are more variable than commonly recognized. Transesophageal echocardiography is an accurate primary diagnostic tool in patients with clinically suspected acute aortic dissection. It allows rapid diagnosis of dissection and can identify alternate cardiovascular pathology responsible for the symptoms in a significant number of patients without acute dissection.