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12. Nefarmakologická léčba srdečního selhání z pohledu nových evropských doporučení pro srdeční resynchronizační léčbu

Creator:
Heinc, Petr, Kováčik, František, Přeček, Jan, Smékal, Aleš, Šimková, Ivona, and Táborský, Miloš
Format:
print, text, and regular print
Type:
model:article, article, Text, and TEXT
Subject:
srdeční selhání--patofyziologie--terapie, elektrokardiografie, směrnice pro lékařskou praxi jako téma, randomizované kontrolované studie jako téma, pozorovací studie jako téma, srdeční resynchronizační terapie--metody, nemoci srdce--patofyziologie, objem srdce, fibrilace síní--patofyziologie, defibrilátory, kardiostimulace umělá--metody, elektrody, elektrická defibrilace, algoritmy, tachykardie, srdeční komory--patofyziologie, and lidé
Language:
Czech and English
Description:
Nová doporučení v oblasti srdeční resynchronizační léčby uvádějí klinické a EKG rysy pro největší přínos resynchronizační léčby, klíčové důkazy pro indikaci k resynchronizační léčbě, indikace resynchronizační léčby u pacientů se srdečním selháním a nízkou ejekční frakcí levé komory při sinusovém rytmu i při fibrilaci síní. Mimo to uvádějí doporučení pro „upgrade“ původní trvalé kardiostimulace i pro primoimplantace u pacientů indikovaných k trvalé kardiostimulaci z bradykardické příčiny a v závěru se zabývají klinickými faktory, které je vhodné zohlednit při volbě mezi biventrikulárním stimulátorem a biventrikulárním defibrilátorem v primární prevenci náhlého úmrtí., The new guidelines for cardiac resynchronization therapy state clinical and ECG features for the greatest benefit of resynchronization therapy, crucial evidence for the indication of cardiac resynchronization therapy, and indications for cardiac resynchronization therapy in patients with heart failure and low ejection fraction of the left ventricle in the presence of both sinus rhythm and atrial fibrillation. In addition, the guidelines provide recommendations for "upgrade" of original permanent cardiac pacing or primary implantation for persistent bradycardia patients and, finally, they define clinical factors that should be taken into account when choosing between a biventricular pacemaker and a biventricular defibrillator for primary prevention of sudden death., and Heinc P., Kováčik F., Přeček J., Smékal A., Šimková I., Táborský M.
Rights:
http://creativecommons.org/publicdomain/mark/1.0/ and policy:public

13. New insights into application of cardiac monophasic action potential

Creator:
Yang, S.-G. and Otomar Kittnar
Format:
print
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, elektrokardiografie, electrocardiography, monophasic action potential, 14, and 612
Language:
English
Description:
Monophasic action potential (MAP) recording plays an important role in a more direct view of human myocardial electrophysiology under both physiological and pathological conditions. The procedure of MAP measuring can be simply performed using the Seldinger technique, when MAP catheter is inserted through femoral vein into the right ventricle or through femoral artery to the left ventricle. The MAP method represents a very useful tool for electrophysiological research in cardiology. Its crucial importance is based upon the fact that it enables the study of the action potential (AP) of myocardial cell in vivo and, therefore, the study of the dynamic relation of this potential with all the organism variables. This can be particularly helpful in the case of arrhythmias. There are no doubts that physiological MAP recording accuracy is almost the same as transmembrane AP as was recently confirmed by anisotropic bidomain model of the cardiac tissue. MAP recording devices provide precise information not only on the local activation time but also on the entire local repolarization time course. Although the MAP does not reflect the absolute amplitude or upstroke velocity of transmembrane APs, it delivers highly accurate information on AP duration and configuration, including early afterdepolarizations as well as relative changes in transmembrane diastolic and systolic potential changes. Based on available data, the MAP probably reflects the transmembrane voltage of cells within a few millimeters of the exploring electrode. Thus MAP recordings offer the opportunity to study a variety of electrophysiological phenomena in the in situ heart (including effects of cycle length changes and antiarrhythmic drugs on AP duration)., S.-G. Yang, O. Kittnar., and Obsahuje bibliografii a bibliografické odkazy
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

14. P wave body surface isointegral maps in children and in young adults

Creator:
Katarína Kozlíková
Format:
print, bez média, and svazek
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, elektrokardiografie, electrocardiography, body surface mapping, heart atria, 14, and 612
Language:
English
Description:
Only limited data are available on body surface potential distribution during atrial activation. The aim of this study was to establish the distributions and to analyze chosen quantitative parameters of atrial isointegral maps recorded using a limited 24-lead system in a young healthy population. A total of 166 subjects underwent a procedure of body surface potential mapping. Isointegral maps during the P wave were constructed and qualitatively and quantitatively evaluated. Three types of atrial activation in individual maps were found according to the different shape of the zero isointegral line and to mutual positions of extrema. The most frequently occurring type resembled the group mean maps and was in good agreement with published data obtained from full lead systems. The highest extrema were found in the young men group, while, surprisingly, the lowest values in the young women group. All minima and the majority of maxima were recorded outside the ranges of standard chest leads. The usefulness of the limited lead system to record isointegral P wave maps was shown and new data were presented that can be useful in noninvasive evaluation of atrial pathologies., K. Kozlíková., and Obsahuje bibliografii
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

15. Periodicity of arrhythmias in healthy elderly men at the moderate altitude

Creator:
Štefan Kujaník, Marian Sninčák, Vokáľ, J., Juraj Podracký, and Juraj Kovaľ
Format:
print, bez média, and svazek
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, elektrokardiografie, srdeční arytmie, biorytmy, electrocardiography, cardiac arrhythmia, biological rhythms, holter ECG monitoring, altitude, 14, and 612
Language:
English
Description:
The 24-hour periodicity of supraventricular (SVPB) and ventricular (VEB) extrasystoles in healthy elderly men (age 49-69 years) was studied at two altitudes during 24 h Holter ECG monitoring. At the low altitude (200 m, n = 26), SVPB were more frequent than VEB. The highest occurrence of SVPB was at 17:00 h, the lowest at 01:00 and 02:00 h (P<0.001). The highest occurrence of VEB was at 09:00 h, the lowest one at 04:00 h (P<0.001). At 1350 m (n=9) the incidence of both SVPB and VEB was approximately twofold higher compared to that at the low altitude (P<0.001). The highest occurrence of SVPB was at 13:00 h, the lowest at 06:00 h (P<0.001). VEB were the most frequent at 10:00 h and 13:00 h, while the lowest frequency was observed at 06:00 h (P<0.001). Our results indicate that the incidence of SVPB and VEB in healthy persons at the moderate altitude is twofold and its periodicity is shifted compared to the low altitude. The cause of increased occurrence of extrasystoles is probably due to β-adrenergic activation of the heart at the higher altitude., Š. Kujaník, M. Sninčák, J.Vokáľ, J. Podracký, J. Koval., and Obsahuje bibliografii
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

16. Role of electrophysiological study and catheter ablation for recurrent ventricular tachycardia complicating myocarditis

Creator:
Cecchi, Emanuele, Fatucchi, Serena, Crudeli, Elena, and Giglioli, Cristina
Format:
braille, text, and regular print
Type:
model:article, article, Text, kazuistiky, and TEXT
Subject:
dospělí, katetrizační ablace, elektrická defibrilace, elektrokardiografie, elektrofyziologické techniky kardiologické, lidé, mužské pohlaví, myokarditida--komplikace, recidiva, and komorová tachykardie--diagnóza--chirurgie--komplikace--terapie
Language:
English
Description:
Here we report the case of a 31-year-old man admitted to our hospital with echocardiografic and Cardiac Magnetic Resonance signs of myocarditis complicated by ventricular tachycardia, initially resolved with direct current shock. After the recurrence of ventricular tachycardia the patient was submitted to electrophysiological study revealing a re-entrant circuit at the level of the medium segment of interventricular septum, successfully treated with transcatheter ablation. This case highlights how the presence of recurrent ventricular arrhythmias at the onset of acute myocarditis, suspected or proven, could be associated with a pre-existing arrhythmogenic substrate, therefore these patients should be submitted to electrophysiological study in order to rule out the presence of arrhythmogenic focuses that can be treated with transcatheter ablation., Emanuele Cecchi, Serena Fatucchi, Elena Crudeli, Cristina Giglioli, and Literatura 15
Rights:
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17. Ruptura aneuryzmatu nekoronárního Valsalvova sinu jako raritní příčina bolesti na hrudi – kazuistika

Creator:
Mikolášková, Monika, Ludka, Ondřej, Holická, Mária, Foukal, Jakub, Šebo, Marek, Ničovský, Jiří, and Špinar, Jindřich
Format:
print, text, and regular print
Type:
model:article, article, Text, kazuistiky, práce podpořená grantem, and TEXT
Subject:
dospělí, lidé, mužské pohlaví, Valsalvův sinus, ruptura aorty--diagnóza--chirurgie, troponin T--krev, elektrokardiografie, echokardiografie, tomografie rentgenová počítačová, angiografie, glukokortikoidy--škodlivé účinky, dyspnoe, vrozené srdeční vady, aortální aneurysma--diagnóza--etiologie--komplikace, aneuryzma Valsalvova sinu, and zkrat
Language:
Czech and English
Description:
Ruptura aneuryzmatu Valsalvova sinu je vzácné, ale závažné srdeční onemocnění, které může ohrozit pacienta na životě. Včasná diagnostika a správná léčba může výrazně ovlivnit prognózu pacienta. V naší kazuistice popisujeme případ 44letého muže přijatého na Interní kardiologickou kliniku FN Brno pro typické bolesti na hrudi s nespecifickými změnami při elektrokardiografickém vyšetření a s pozitivním troponinem T. Vstupní transthorakální echokardiografické vyšetření odhalilo aneuryzma nekoronárního sinu a komunikaci mezi aortou a pravou síní, která byla potvrzena i CT angiograficky. Pacient byl poté odeslán do kardiochirurgického centra, kde byla následně provedena resekce aneuryzmatu a uzavřena komunikace mezi aortou a pravou síní záplatou z perikardu. Při vzniku aneuryzmatu nelze vyloučit podíl metabolického účinku kortikoidů, které pacient dlouhodobě užíval. Z uvedené kazuistiky plyne, že pečlivé klinické vyšetření a neinvazivní vyšetřovací metody zůstávají stále základním diagnostickým postupem. Klíčová slova: aneuryzma Valsalvova sinu – vrozené srdeční onemocnění – ruptura – zkrat, Rupture of a sinus of Valsalva aneurysm is a rare and serious heart disease which can endanger the patient’s life. Early diagnosis and proper therapeutic treatment can significantly affect the patient’s prognosis. We describe the case of a 44‑year–old man admitted to the Cardiology Department of the University Hospital Brno with typical chest pain and non‑specific changes on electrocardiogram and positive troponin T. Transthoracic echocardiography revealed a non‑coronary sinus aneurysm and communication between the aorta and the right atrium, which was confirmed by computed tomography. The patient was referred to the cardiothoracic surgery centre and the aneurysm was resected. The communication between the aorta and the right atrium was closed via pericardial patch. The aneurysm formation can be caused by the metabolic effects of corticosteroids which the patient had been using for a long time. This case report suggests that careful clinical examination and noninvasive methods remain an essential diagnostic procedure. Keywords: aneurysm of sinus of Valsalva – congenital heart disease – rupture – shunt, and Mikolášková M., Ludka O., Holická M., Foukal J., Šebo M., Ničovský J., Špinar J.
Rights:
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18. Takotsubo kardiomyopatie, klinické zkušenosti s onemocněním a jednoletá prognóza pacientů

Creator:
Kubena, Petr, Bohatá, Šárka, Maňoušek, Jan, Špinar, Jindřich, and Pařenica, Jiří
Format:
print, text, and regular print
Type:
model:article, article, Text, práce podpořená grantem, and TEXT
Subject:
lidé, lidé středního věku, mužské pohlaví, staří, ženské pohlaví, prospektivní studie, takotsubo kardiomyopatie--diagnóza--mortalita--patofyziologie, magnetická rezonanční tomografie, elektrokardiografie, diferenciální diagnóza, přežívající - četnost, and prognóza
Language:
Czech and English
Description:
Úvod: Takotsubo kardiomyopatie (takotsubo cardiomyopathy – TCM) je vzácné srdeční onemocnění charakterizované v akutní fázi přechodnou dysfunkcí levé komory, které může být komplikováno fibrilací komor nebo srdečním selháním. V diferenciální diagnostice musí být vždy vyloučen akutní infarkt myokardu. Cílem práce je prezentovat charakteristiku pacientů s TCM, jejich jednoletou prognózu a přínos magnetické rezonance k diagnostice těchto pacientů v klinické praxi. Metodika: Vyhodnoceno bylo celkem 47 pacientů s prokázanou TCM. U všech pacientů byla vyloučena významná ateroskleróza koronárních tepen pomocí selektivní koronární angiografie. Celkem u 10 pacientů (21,3 %) bylo provedeno vyšetření magnetickou rezonancí (MRI) srdce. Pacienti byli prospektivně sledováni minimálně 12 měsíců. Výsledky: Soubor pacientů s TCM tvořily z 89,4 % ženy, průměrný věk pacientů byl 62,3 ? 11,1 let. Třicet devět pacientů (83,0 %) mělo apikální a 8 midventrikulární formu TCM. Zjevný provokující stresový faktor jsme identifikovali u 18 pacientů (38,3 %). Časté byly další komorbidity, zejména onemocnění štítnice, psychiatrická, plicní nebo alergická onemocnění. U 42 pacientů (89,4 %) byla přítomna dysfunkce levé komory, 4 pacienti (8,5 %) byli v kardiogenním šoku. Čtyři pacienti (8,5 %) prodělali během hospitalizace fibrilaci komor. Roční mortalita v našem souboru činila 14,9 %, jedna pacientka (2,1 %) prodělala v průběhu sledování recidivu ataky TCM. Závěr: Přestože u pacientů s TCM dochází k úpravě funkce levé komory, akutní fáze může být komplikována rozvojem kardiogenního šoku nebo fibrilací komor. U části pacientů je indikováno vyšetření MRI k vyloučení ischemické nebo zánětlivé etiologie., Introduction: Takotsubo cardiomyopathy (TCM) is a rare cardiac disease. In the acute phase it may imitate acute myocardial infarction of the anterior wall with ST elevations. This can be complicated by ventricular fibrilation or heart failure. The aim of this study is to show the characteristics of patients with takotsubo cardiomyopathy, the one year outcome and the application of magnetic resonance imaging of the heart in the diagnosis of this disease. Methods: Forty seven patients with takotsubo cardiomyopathy were enrolled in this study. Severe stenosis of coronary arteries was excluded by selective coronarography. In twelve patients the magnetic resonance imaging of the myocardium was performed. The patients were observed for at least 12 months. Results: 89.4 % of takotsubo patients were women. Average of age was 62.3 ? 11.1 years. We found obvious stress factors in 18 patients (38.3 %). Many patients suffered from thyroid disorders, psychiatric, lung or allergic diseases. Thirty nine patients (83.0 %) had the apical and eight the midventricular type of takotsubo cardiomyopathy. In 42 patients (89.4 %) developed systolic left ventricular dysfunction and four patients (8.5 %) were in cardiogenic shock. Four patients (8.5 %) manifested ventricle fibrilation. One patient (2.1 %) had recurring takotsubo cardiomyopathy. Conclusion: Left ventricle function is mostly recovered in patients with takotsubo cardiomyopathy, but the acute phase can be complicated by cardiogenic shock or ventricular fibrilation. Magnetic resonance imaging of the heart is indicated in some patients to differentiate this cardiomyopathy from ischemic or inflammatory etiology., and Petr Kubena, Šárka Bohatá, Jan Maňoušek, Jindřich Špinar, Jiří Pařenica
Rights:
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19. The electrocardiographic holter monitoring in experimental veterinary practice

Creator:
Peter Scheer, Petr Svoboda, Milan Sepši, Katarína Janečková, and Jaroslav Doubek
Format:
print
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, elektrokardiografie, králíci, kočky, psi, ovce, electrocardiography, rabbits, cats, dogs, sheep, ECG holter recording, rat, ferret, minipig, 14, and 612
Language:
English
Description:
The long-term electrocardiographic recording with retrospective evaluation (Holter system) has been widely used not only in cardiology, but also in other disciplines of internal medicine and in pharmaceutical research. The Holter system can be used in mini-pig, sheep, dog, cat, rabbit, ferret, and rat. In this paper hardware, software, and anesthesia requirements are summarized with respect to the experimental work with various species. As the Holter systems work in bipolar mode, the use of bipolar leads in sagittal and transversal planes has been proved to be the most appropriate because of large amplitude of QRS complex and uncomplicated consequent automatic analysis of the record. In conclusion, Holter electrocardiography represents a simple and applicable method for monitoring the electrical activity of the heart in small animals’ experimental studies., P. Scheer ... [et al.]., and Obsahuje bibliografii a bibliografické odkazy
Rights:
http://creativecommons.org/licenses/by-nc-sa/4.0/ and policy:public

20. Ventricular electrical heterogeneity in experimental diabetes mellitus: effect of myocardial ischemia

Creator:
Sedova, K. A., Vaykshnorayte, M. A., Ovechkin, A. O., Peter Kneppo, Bernikova. O. G., Vityazev, V. A., and Azarov, J. E.
Format:
print, bez média, and svazek
Type:
article, články, model:article, and TEXT
Subject:
Fyziologie člověka a srovnávací fyziologie, diabetes mellitus, myokard, elektrokardiografie, myocardium, electrocardiography, cardiac electrophysiology, regional ischemia, 14, and 612
Language:
English
Description:
Aims of the study were to compare the development of electrocardiographic responses of the ischemia-induced heterogeneities of activation and repolarization in the ventricular myocardium of normal and diabetic animals. Body surface ECGs and unipolar electrograms in 64 epicardial leads were recorded before and during 20 min after the ligation of the left anterior descending artery in diabetic (alloxan model, 4 weeks, n=8) and control (n=8) rabbits. Activation times (ATs), end of repolarization times (RTs) and repolarization durations (activation-recovery intervals, ARIs) were determined in ischemic and periischemic zones. In contrast to the controls, the diabetic rabbits demonstrated the significant prolongation of ATs and shortening of ARIs (P<0.05) during ischemia in the affected region resulting in the development and progressive increase of the ARI and RT gradients across the ischemic zone boundary. The alterations of global and local dispersions of the RTs in diabetics correlated with the Tpeak-Tend interval changes in the limb leads ECGs. In the ischemic conditions, the diabetic animals differed from the controls by the activation delay, significant repolarization duration shortening, and the increase of local repolarization dispersion; the latter could be assessed by the Tpeak-Tend interval measurements in the body surface ECGs., K. A. Sedova, M. A. Vaykshnorayte, A. O. Ovechkin, P. Kneppo, O. G. Bernikova, V. A. Vityazev, J. E. Azarov., and Obsahuje bibliografii
Rights:
http://creativecommons.org/publicdomain/mark/1.0/ and policy:public