Abstract:
:This study was designed to evaluate the implantation of internal cardioverter/defibrillators under local anaesthesia by electrophysiologists and to compare this to our former experience of implants with general anaesthesia. Forty-seven internal cardioverter/defibrillators were implanted at our institution by electrophysiologists. Twenty-nine operations were performed under general anaesthesia (isoflurane 0.4-0.6%), and 18 under local anaesthesia (mepivacain 1%). The defibrillator leads were introduced by venotomy of the cephalic vein (n = 25), puncture of the subclavian vein (n = 17) or both (n = 5). All devices were implanted beneath the pectoral muscles. The mean operation time was 99 +/- 29 min. In the group with local anaesthesia the operation time was significantly shorter than with general anaesthesia (86 +/- 20 min vs 107 +/- 31 min; P = 0.027). The defibrillation threshold with biphasic shock application was below 24 J in all patients; thus, the implantation of an additional subcutaneous patch electrode was unnecessary. There were no major complications in either group. However, modifications were required in four patients: in one a set screw had to be re-tightened after delivery of an erroneous shock in the early postoperative phase; in another, device migration occurred several weeks after implantation, but no therapeutic intervention was required; in another, a rise in pacing threshold and partial sensing loss were noted ten days postoperatively; in the fourth, a minor pneumothorax occurred after subclavian puncture, but no further treatment was necessary. There was no intra-operative or postoperative mortality in either group. Implantation of internal cardioverter/defibrillators under local anaesthesia and mild sedation is feasible, and can be safely performed by electrophysiologists experienced in basic surgery. The newly developed smaller devices allow implantation in the subpectoral region, and with "active can' configuration and biphasic shock application, subcutaneous patch electrodes become unnecessary.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Schmitt C,Alt E,Plewan A,Schömig Adoi
10.1093/oxfordjournals.eurheartj.a014755subject
Has Abstractpub_date
1996-11-01 00:00:00pages
1710-6issue
11eissn
0195-668Xissn
1522-9645journal_volume
17pub_type
临床试验,杂志文章abstract:BACKGROUND:Electrocardiographic abnormalities and premature ventricular contractions are common in athletes and are generally benign. However, the specific outcome of high-level endurance athletes with frequent and complex ventricular arrhythmias is unclear. Also, information on the predictive accuracy of different inv...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1016/s0195-668x(03)00282-3
更新日期:2003-08-01 00:00:00
abstract:Aims:Fractional flow reserve (FFR) has proven to its prognostic and therapeutic value. However, the additive prognostic value of coronary flow reserve (CFR) remains unclear. This study sought to investigate the clinical utility of combined FFR and CFR measurements to predict outcomes. Methods and results:Using the pro...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehx139
更新日期:2017-07-01 00:00:00
abstract::Physical fitness of athletes affected by mitral valve prolapse (MVP) was examined, in order to evaluate the influence of sport activity on the natural history of the disease. Maximal workload, total workload, percentage efficiency (according to Hollmann's formula), double product of maximal cycloergometric stress test...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/8.suppl_d.33
更新日期:1987-08-01 00:00:00
abstract:AIMS:To assess the outcome and costs of patients with acute myocardial infarction (AMI) after initial admission to hospitals with or without catheterization facilities in Belgium. METHODS AND RESULTS:From a nationwide hospital register, we retrieved the data of 34 961 patients discharged during 1999-2001 with a princi...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究
doi:10.1093/eurheartj/ehl161
更新日期:2006-11-01 00:00:00
abstract:Aims:To elucidate the effects of intensive LDL-C lowering treatment with a standard dose of statin and ezetimibe in patients with dyslipidaemia and high risk of coronary events, targeting LDL-C less than 70 mg/dL (1.8 mmol/L), compared with standard LDL-C lowering lipid monotherapy targeting less than 100 mg/dL (2.6 mm...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehx162
更新日期:2017-08-01 00:00:00
abstract:AIMS:Morphological characteristics of non-significant coronary plaques (NSCPs) that develop rapid progression have not been fully elucidated. The aim of this study was to clarify the morphological characteristics of NSCPs in patients with coronary artery disease (CAD) using intravascular optical coherence tomography (O...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr284
更新日期:2012-01-01 00:00:00
abstract::As a rule, left ventricular relaxation is impaired in patients with coronary artery disease and congestive heart failure. In addition, the passive elastic properties in early and late diastole change when the ventricle dilates. Diastolic properties of the left ventricle were studied in 11 patients with congestive hear...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/13.suppl_e.52
更新日期:1992-11-01 00:00:00
abstract::Pulmonary arterial hypertension (PAH) can be a rapidly progressive disorder and is associated with high rate of mortality, despite medical intervention. With the availability of effective therapy, early disease detection is an important strategic objective to improve treatment outcomes. Resting echocardiography is cur...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/ehr160
更新日期:2011-10-01 00:00:00
abstract:AIMS:Patients with chronic kidney disease (CKD) pose a worldwide growing burden to health care systems due to accelerated atherosclerosis and subsequent high cardiovascular (CV) morbidity. Atherogenesis is prominently driven by monocytes and monocyte-derived macrophages. The expression of CD14 and CD16 characterizes th...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehq371
更新日期:2011-01-01 00:00:00
abstract:AIMS:Magnetic resonance imaging (MRI) is well established as an important diagnostic tool in medicine. However, the presence of a cardiac pacemaker is usually regarded as a contraindication for MRI due to safety reasons. In this study, heating effects at the myocardium-pacemaker lead tip interface have been investigate...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi009
更新日期:2005-02-01 00:00:00
abstract::Among 369 patients with native valve infective endocarditis observed during a 14-year period, 17 were related to S: pneumoniae. Fourteen of them were observed in the last 7 years. At the time of admission 13 exhibited purulent meningitis, 6 of them being comatose. An apparent portal of entry was present in 13 patients...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/5.suppl_c.77
更新日期:1984-10-01 00:00:00
abstract:AIMS:To evaluate the predictive value of high sensitivity (hs) C-reactive protein levels on long-term survival in patients with ST-elevation myocardial infarction (STEMI) treated with primary PCI. METHODS AND RESULTS:We conducted a retrospective analysis of 758 STEMI patients (from January 2003 to December 2005), with...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm338
更新日期:2008-05-01 00:00:00
abstract::The present study was carried out to evaluate systolic and diastolic parameters in overweight and moderately obese, but otherwise healthy subjects, and in a lean control group, to determine whether degree and duration of obesity can influence left ventricular function. A total of 27 subjects, 17 overweight or with mod...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060249
更新日期:1992-06-01 00:00:00
abstract:AIMS:We aimed to assess the contemporary outcome of Eisenmenger syndrome (ES), delineate the use of disease targeting therapies (DTT) in these patients and to investigate the effect of treatment on outcome in the community. METHODS AND RESULTS:Patients with ES were systematically identified from the German National Re...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehv743
更新日期:2016-05-07 00:00:00
abstract::A previously described nitroglycerin-induced heparin resistance could not be verified by in-vitro experiments or in a randomized, double-blind, crossover trial in healthy volunteers. A clinically relevant attenuation of the anticoagulant effect of a heparin bolus (40 U.kg-1) by a concomitant infusion of nitroglycerin ...
journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1093/oxfordjournals.eurheartj.a060182
更新日期:1992-03-01 00:00:00
abstract::Although indicated by several experimental studies, the presence of a renin-angiotensin system has not been demonstrated in the human heart. The influence of a local renin-angiotensin system on the coronary vessels may be difficult to establish after oral or intravenous administration of an angiotensin converting-enzy...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/10.suppl_f.97
更新日期:1989-11-01 00:00:00
abstract::The effects of dexamethasone on cultured rat beating heart cells experimentally infected with coxsackievirus B2 were investigated at an early stage (1-3 days) post challenge. Changes in the release of the cardiac enzyme, aspartate amino-transferase (AST), beating %, cytopathic effect (CPE), virus titre, ultrastructure...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/12.suppl_d.39
更新日期:1991-08-01 00:00:00
abstract::Promising approaches towards new therapeutic strategies in coronary heart disease might emerge from an improved pathophysiological understanding of the role of certain peptides, which require a localizing event for their accumulation or expression in the coronary vasculature. Temporal myocardial ischaemia or hypoperfu...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/12.suppl_f.112
更新日期:1991-12-01 00:00:00
abstract::The aim of the present investigation was to evaluate the type and the incidence of cardiac arrhythmias and ischaemic events in patients suffering from testicular cancer and submitted to combination chemotherapy with cisplatin, bleomycin and vinblastine (PVB) or etoposide (PEB). Forty-seven patients took part in the st...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060426
更新日期:1994-11-01 00:00:00
abstract:AIMS:High-density lipoproteins (HDLs) are considered as anti-atherogenic. Recent experimental findings suggest that their biological properties can be modified in certain clinical conditions by accumulation of serum amyloid A (SAA). The effect of SAA on the association between HDL-cholesterol (HDL-C) and cardiovascular...
journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehv352
更新日期:2015-11-14 00:00:00
abstract::To assess the clinical significance of monitoring during physical training in post-myocardial infarction (MI) patients with asymptomatic exercise-induced ischaemia, we studied 232 patients who were survivors of first recent acute MI and consecutively admitted to the same CCU, who underwent an exercise test (ET) and co...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/9.suppl_n.176
更新日期:1988-12-01 00:00:00
abstract:Aims:To analyse reasons, timing and predictors of hospital readmissions after transcatheter aortic valve implantation (TAVI). Methods and results:Patients included in the Bern TAVI Registry between August 2007 and June 2014 were analysed. Fine and Gray competing risk regression was used to identify factors predictive ...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehx182
更新日期:2017-07-21 00:00:00
abstract::Patients who have experienced a myocardial infarction (MI) are at increased risk of sudden cardiac death (SCD). With the advent of implantable cardioverter-defibrillators (ICDs), accurate risk stratification has become very relevant. Numerous investigations have proven that a reduced left ventricular ejection fraction...
journal_title:European heart journal
pub_type: 杂志文章,评审
doi:10.1093/eurheartj/eht109
更新日期:2013-07-01 00:00:00
abstract:AIM:To investigate fatalities from myocardial infarction at 28 days and one-year among patients aged 35-64 years in the Nordic and Lithuanian centres participating in the World Health Organization MONICA (Monitoring of Trends and Determinants of Cardiovascular Disease) Project. METHODS AND RESULTS:Altogether 9100 myoc...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015124
更新日期:1997-01-01 00:00:00
abstract:AIMS:Vascular endothelial growth factor-A (VEGF-A) is an angiogenic and vasoprotective molecule whose expression is modulated by hypoxia and inflammatory mediators. Here we have tested the hypothesis that plasma levels of VEGF-A are influenced by pre-existing coronary artery disease and by changes in circulating interl...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.3034
更新日期:2002-06-01 00:00:00
abstract:AIMS:Nuclear receptors and their cofactors regulate key pathophysiological processes in atherosclerosis development. The transcriptional activity of these nuclear receptors is controlled by the nuclear receptor corepressors (NCOR), scaffolding proteins that form the basis of large corepressor complexes. Studies with pr...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehz667
更新日期:2020-03-01 00:00:00
abstract:AIMS:The ESC/ACC redefined myocardial infarction as any amount of necrosis caused by ischaemia. The aim of this study was to describe the management and outcomes using 'real-world' data taking the new definition of acute myocardial infarction into account. METHODS AND RESULTS:A total of 2,151 consecutive patients (76....
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehm031
更新日期:2007-06-01 00:00:00
abstract::The effect of diuretic dose on the haemodynamic response to captopril was assessed in nine patients with chronic cardiac failure. Each patient was given an intravenous dose of captopril while maintained on (a) a low dose diuretic regime, and (b) a high dose diuretic regime. Activity of the renin angiotensin aldosteron...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a060302
更新日期:1992-07-01 00:00:00
abstract:AIMS:To investigate the efficacy and outcome of emergency percutaneous coronary interventions (PCI) in patients with stent thrombosis. METHODS AND RESULTS:Between 1995 and 2003, 6058 patients underwent bare-metal stent implantation, of which 95 (1.6%) patients suffered from stent thrombosis. The timing of stent thromb...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehi135
更新日期:2005-06-01 00:00:00
abstract::The purpose of the study was to determine the sensitivity and specificity of two-dimensional echocardiography (2dE) in the detection of impaired left ventricular function, compared with cineventriculography (CVG). Apical two-dimensional echocardiograms were performed in 110 patients undergoing heart catheterization fo...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a061694
更新日期:1984-06-01 00:00:00