Cardiac Complexes, Premature/*physiopathology ; Electrocardiography

Among 1227 cardiovascular patients at Thanh Nhan Hospital (Hanoi) in the year 2001, there were 33 with ventricular extrasystole (2.69%), a common pathology, third rank of causes of arrhythmia usually, left ventricular extrasystole, aparse occurrence, type of compensative rest, uniform, monofocus. The most common causes are high blood pressure, diseases of, heart ischemia, occuring in female more than in male, the incidence increases with the age. Most common complication is ventricular tachycardia; ventricular fibrillation and apical twisting are less common but the more dangerous leading to death
Cardiac Complexes, Premature ; Cardiology ; Diseases ; complications ; etiology

The effect of oral mexiletin was evaluated by a 10-day double-blind cross-over protocol on 10 subjects with chronic stable high-frequency ventricular premature beats referred to our cardiology clinic from February through July, 1982. Total daily doses were either 450mg or 600mg in three divided portions depending on body weight. The frequency of the premature ventricular beats was measured by 3 separate 24-hour ambulatory EKG recordings by dual-channel Holter monitor on each patient. Mexiletine was judged to be effective in suppressing the ventricular arrhythmias when the 24-hour PVC-counts during the study-drug period showed a decrease by 80% and the hourly average PVC-counts by 70% compared with those of the equivalent intervals of both the baseline and the placebo periods. Mexiletine was effective in 5 of the 10 subjects. Mild tremor and anorexia were noted in 2 patients, but they were able to comply with the study protocol in spite of these minor side effects. Blood level measurements were not done in this study for lack of such facility, the utilization of which would undoubtedly enhance the therapeutic effectiveness of the antiarrhythmic agent in the individualization of treatment.
Anorexia ; Arrhythmias, Cardiac ; Body Weight ; Cardiac Complexes, Premature* ; Cardiology ; Electrocardiography ; Humans ; Mexiletine* ; Tremor ; Ventricular Premature Complexes

BACKGROUND AND OBJECTIVES: Frequent ventricular premature complex (VPC) is one of the most common arrhythmia syndromes. Symptoms observed frequently with this arrhythmia syndrome remain limited. We sought to identify predictors of VPC-related symptoms by analyzing demographic information, VPC burden, and VPC surface electrocardiogram characteristics. SUBJECTS AND METHODS: We prospectively enrolled 109 patients with idiopathic outflow tract VPCs (63 males, 49+/-16 years old). They were divided into Group A (n=30, without VPC-related symptoms of palpitations or "dropped beats") and Group B (n=79, with VPC-related symptoms). Measured parameters were sinus and VPC QRS width, coupling interval (CI) between the previous sinus beat and VPC, CI ratio (%, CI/sinus cycle length), post-VPC CI and CI ratio, and VPC amplitude. RESULTS: Both groups had similar age (p=0.22), daily VPC burden (p=0.15), and VPC site of origin (p=0.36). The VPC CI ratio was higher in Group B (60+/-15%) than in Group A (49+/-22%) (p=0.01). CONCLUSION: VPC-related symptoms are associated with a higher VPC CI ratio (>50%). The physiologic basis for these results deserves further study.
Arrhythmias, Cardiac ; Electrocardiography ; Humans ; Male ; Prospective Studies ; Ventricular Premature Complexes

Centrifuge high +Gz training has been reported to provoke cardiac arrhythmias in ostensibly healthy individuals, and ECG monitoring of aircrew undergoing such training is recommended for their safety. However, there are few reports about ECG responses during actual high +Gz flight. Therefore, we start this study to determine the ECG responses during actual high +Gzz flight of F-5. In our study, twenty-four pilots, ages 25-37 and one Flight Surgeon were monitored by Holter ECG monitor for four hours, which included periods before, during, and after either a high +Gz or low +Gz flight in a F-5, Actual flight times ranged from 28-78 minutes. Sixteen(16) pilots were monitored in both high +Gz (>5Gz) and low +Gz (<3Gz) flight, the flight surgeon and seven(7) pilots were monitored only in high +Gz flight, one pilot was monitored only in low +Gz flight. Heart rate(HR) and cardiac rhythm were evaluated during a total of 41 flights. During the high +Gz flight, there was one episode of visual black out and dyspnea, three episodes of gray out, and one episode of fatigue. During the low +Gz flight, there were two episodes of coughing. The frequency of occurrence of Ventricular Ectopic Beats (VEs) (Premature Ventricular Contractions (PVCs), especially in-flight VEs(PVCs), was significantly higher in pilots who hart symptoms during the flight as compared to pilots who had no symptoms in one pilot, we recorded 16 VEs (PVCs) over the four houris wlth 10 VEs occurring during the flight. Another pilot experienced 254 Supraventricular ectopic beats (SVEs)(Premature Atrial Contractions (PVCs) or Premature Junctional Contractions (PVCs)) with a total of 87 SVEs recorded during the flight. In high +Gz flight, there were, overall, twelve (12) cases of VEs and fifteen (15) cases of SVEs. In low +Gz flight, there were four (4) cases of VEs anti ten (10) cases of SVEs. In addition, We correlated the HR 30 minutes before flight (range of 52-117 bpm) with maximum in-flight HR (range of 92-178 bpm). We found that the maximum HR during the flight was lower with increased pilot's experience (i.e., age and total flight time). There was no significant difference noted in HR and cardiac arrhythmias when comparing high +Gz and low +Gz flight. During the high +Gz flight, stress may cause symptoms with minor cardiac arrhythmias. Further studies shou1d be done to better correlate the exact relationship and timing between onset of +Gz forces, arrhythmias, and occurrence of adverse clinical symptoms.
Arrhythmias, Cardiac ; Cough ; Dyspnea ; Electrocardiography* ; Fatigue ; Heart ; Ventricular Premature Complexes

On the basis of Poincare scatter plot and first order difference scatter plot, a novel heart rate variability (HRV) analysis method based on scatter plots of RR intervals and first order difference of RR intervals (namely, RdR) was proposed. The abscissa of the RdR scatter plot, the x-axis, is RR intervals and the ordinate, y-axis, is the difference between successive RR intervals. The RdR scatter plot includes the information of RR intervals and the difference between successive RR intervals, which captures more HRV information. By RdR scatter plot analysis of some records of MIT-BIH arrhythmias database, we found that the scatter plot of uncoupled premature ventricular contraction (PVC), coupled ventricular bigeminy and ventricular trigeminy PVC had specific graphic characteristics. The RdR scatter plot method has higher detecting performance than the Poincare scatter plot method, and simpler and more intuitive than the first order difference method.
Arrhythmias, Cardiac ; Databases, Factual ; Heart Rate ; Humans ; Ventricular Premature Complexes

Cardiac arrhythmias are a common problem in the neurological intensive care unit and represent a major cause of ischemic stroke. Significant arrhythmias are most likely to occur in elderly patients. In this review, we focus on three arrhythmias: premature beats, atrial fibrillation, and QT prolongation. The goal of this review is to provide a current concept of diagnosis and acute management of arrhythmias in the neurological intensive care unit.
Aged ; Arrhythmias, Cardiac ; Atrial Fibrillation ; Atrial Premature Complexes ; Cardiac Complexes, Premature ; Critical Care ; Diagnosis ; Humans ; Intensive Care Units ; Stroke ; Ventricular Premature Complexes

BACKGROUND AND OBJECTIVES: We undertook this study to assess the initiation and maintenance mechanisms of atrial fibrillation (AF) and their relationships with the anatomical structures of the left atrium (LA) and pulmonary veins (PVs). SUBJECTS AND METHODS: Thirty-seven patients (33 men, mean age 50, range 25-68 years) with paroxysmal AF (n=29) and persistent AF (n=8) who underwent mapping of the LA and PV using 3D non-contact endocardial mapping system (EnSite 3000) were enrolled. The multielectrode array and ablation catheter were positioned in the LA via the double transseptal approach. Atrial premature beats (APBs) which triggered initiation of AF that lasted longer than 1 min were mapped and the activation sequence was analyzed on isopotential color maps. Wave front dynamics and the relationship with the underlying structures were assessed. RESULTS: More than half, 56.4%, of APBs from PV were related to the initiation of AF, but not related to the maintenance of AF. A quarter, 25.6%, of APBs from PV not only initiated AF, but also maintained AF without continuous triggering. Mixed type and indeterminate type of AF was 5.0% and 12.8%, respectively. During AF, the mean number of wavelets was 1.45 (maximum 3 in 76.5%). Anatomical structures showing slow conduction and wavebreaks were mostly located at the septopulmonary bundle (86.5%) and the posterior roof of the LA between the left superior PV and right superior PV (54.1%). CONCLUSION: Focal repetitive activity from PV played an important role in both the initiation and maintenance of AF. Specific anatomical structures such as septopulmonary bundle or posterior roof of the LA were related to the heterogeneous conduction delay and spontaneous wavebreak, which was also important in the maintenance of AF.
Atrial Fibrillation* ; Atrial Premature Complexes ; Cardiac Complexes, Premature ; Catheters ; Heart Atria ; Humans ; Male ; Pulmonary Veins ; Structure-Activity Relationship

Lipomatous hypertrophy of interartiral septum (LHIS) is a rare entity that is characterized by the excessive deposition of fat in the interatrial septum. The appearance of LHIS on echocardiogram is a bilobed or dumbbell-shaped in interatrial septum. We report a case of 56-years man with frequent premature ventricular contraction on holter monitoring which may related to his sudden cardiac death diagnosed lipomatous hypertrophy of interatrial septum by echocardiography.
Arrhythmias, Cardiac ; Death, Sudden, Cardiac ; Echocardiography ; Electrocardiography, Ambulatory ; Heart Septum ; Hypertrophy* ; Ventricular Premature Complexes

In order to observe the arrhythmia which occured in early convalescent phase of acute myocardial infarction, a 24 hour ambulartory ECG monitiring was performed in 15 patients who is admitted at dept of Int Medicine, Ewha Womans University hospital from Aug. 1985 to Sept. 1986. during 7.5+/-3.4 days after admission. In all cases one or more of the following arrhythmias were observed;atrial premature beat, ventricular premature beat(VPB), transient paroxysmal ventricular thchycardia, atrial fibrillation, sinus arrest and junctional beat. Of 15 cases, 11(77.3%) had VPB's:Simple VPB's in 4 cases(26.7%) and complex VPB's(6.52+/-2.52)(P<0.05). But there were no difference of premature and abberancy index between complex VPB's and simple VPB's(P>0.1). In addition, we compaired the arrhythmias in CCU with those of early convalescent phase of acute myocardial infarction. But there was no correlation between them.
Arrhythmias, Cardiac* ; Atrial Fibrillation ; Cardiac Complexes, Premature ; Electrocardiography* ; Female ; Humans ; Myocardial Infarction*