Study on the significant symptomatic and effect of treatment methods on 50 patients with 3 degree heart block (23 females and 27 males), were treated at Cardiovascular Hospital during 2002-2003. The results: 70% of total patients had Adams-stokes cyncope. 28% of them were made extent or temporary pacemaker with indications as slow heart rate making a severe Adams-stokes syncope or nearly making Adams-stokes syncope, A-V disorders, young patients with suspective inflammatory induced A-V block. All of patients were treated by Atropine, Theophylin, Ephedrin or Isoprenalin, but only 2 cases decreased of A-V block. 38 patients had successful with permanent pacemaker implantation
Diagnosis ; Therapeutics ; Heart Block

To study the significant symptoms and effect of treatment methods on complete heart block. Methods and results: 50 patients (23 female and 27 male) with complete A-V block were studied. 70% of total patients had Adams-stokes syncope. 28% of them were dazzled, dizzied, chest-pain... only one case was without symptom. Average heart rate was 39 beat per minute. 7 patients (14%) had heart failure. All of patients were treated by Atropine, Theophyline, Ephedrine or Isoprenalin, but only 2 cases decreased of A-V block. 38 patients had successful with permanent pacemaker implantation (PPI)
Diagnosis ; Therapeutics ; Heart Block ;

BACKGROUND AND OBJECTIVES: Atrioventricular block (AVB) is frequently seen following atrio-His (AH) interval lengthening after adenosine injection during sinus rhythm when both the fast and slow pathways are blocked in patients with dual atrioventricular nodal physiology (DAVNP). However, the condition also occurs in patients without DAVNP. Therefore, an AH jump may not indicate DAVNP if AVB is accompanied. The goal of this study was to use a low dose (6-9 mg) of adenosine to determine whether an AH jump truly represents DAVNP when the presence or absence of AVB following the AH jump is taken into consideration. SUBJECTS AND METHODS: This study included 78 patients (male:female=47:31, age 40.0+/-15.7 years, DAVNP group, n=46, control group, n=32). Adenosine (6-9 mg) was administered intravenously during sinus rhythm. The inclusion criteria of DAVNP were either induced AVNRT (n=37:common type, n=35, uncommon, n=2) or identification of AH jump (n=9) during elctrophysiology study (EPS). The control group consisted of patients without evidence of DAVNP and noninducible AVNRT on EPS. In all subjects, the electrophysiologic parameters of the AV nodal properties were tested. In the DAVNP group, intravenous adenosine during sinus rhythm resulted in an AH jump without AVB (8/46, 17.4%), an AH jump followed by AVB (9/46, 19.6%), an AH jump accompanied by induced AVNRT (1/46, 2.1%), or no significant changes in the AH interval (28/46, 60.9%). In the control group, none of the subjects showed an AH jump without AVB, however an AH jump with subsequent AVB was observed in 4 of 32 subjects (12.5%). If the finding of an AH jump without AVB alone was considered as a positive criteria of DAVNP, its specificity (87.5% to 100%) and positive predictive value (81.8% to 100%) increased compared to the criteria defined by an AH jump regardless of the presence or absence of AVB, however, its sensitivity decreased from 39.1% to 19.6%. CONCLUSION: AH jump induced by adenosine injection may not indicate DAVNP if AVB follows.
Adenosine* ; Atrioventricular Block ; Diagnosis* ; Heart Block ; Humans ; Physiology* ; Sensitivity and Specificity ; Tachycardia, Atrioventricular Nodal Reentry

Decreased cardiac output can present dizziness that is usually described as light-headed sensation of an impending faint. It is often associated with a feeling of unsteadiness or even of falling. Cardiogenic dizziness should always be included as a differential diagnosis especially when examining older patients with dizziness. It is obviously important to identify patients with heart related presyncope or syncope, because many of them have serious underlying cardiac diseases and are at risk for sudden death, if not appropriately treated. Four patients with dizziness were diagnosed at the University Hospital as having dizziness originated from decreased cardiac output. Two had the sick sinus syndrome, one had a complete AV block and one had a congestive heart failure with 2nd degree AV block. After evaluation and cardiac pacemaker implantation, they all became free of dizziness. We present these cases with some review of cardiogenic dizziness.
Atrioventricular Block ; Cardiac Output ; Death, Sudden ; Diagnosis, Differential ; Dizziness* ; Heart ; Heart Diseases ; Heart Failure ; Humans ; Sensation ; Sick Sinus Syndrome ; Syncope

Adult ; Cardiomyopathies ; diagnosis ; etiology ; Electrocardiography ; Heart Block ; diagnosis ; etiology ; Humans ; Male ; Sarcoidosis ; complications ; diagnosis ; pathology ; Skin Diseases ; diagnosis ; etiology ; pathology

Rate-dependent left bundle branch block during general anesthesia is rare, but its occurrence makes the electrocardiographic diagnosis of acute myocardial ischemia or infarction difficult. It can also be confused with slow rate ventricular tachycardia. Herein, a case of rate-dependent left bundle branch block, in a patient with no previous history of ischemic heart disease, is reported. The administration of esmolol resulted in a decrease in the heart rate, with reversion to normal sinus rhythm.
Anesthesia, General* ; Bundle-Branch Block* ; Diagnosis ; Electrocardiography ; Heart Rate ; Humans ; Infarction ; Myocardial Ischemia ; Tachycardia, Ventricular

Female ; Heart Block ; congenital ; Humans ; Infant, Newborn ; Lupus Erythematosus, Cutaneous ; diagnosis ; etiology ; therapy ; Male ; Prognosis ; Syndrome

PURPOSE: Patients with a suspected acute myocardial infarction (AMI) in the setting of a new or presumably new left bundle branch block (LBBB) present an important diagnostic and therapeutic challenge to clinicians. This study was conducted to identify the frequency of ST-segment elevation myocardial infarction (STEMI)-equivalent in this population, determine the diagnostic value of electrocardiographic and echocardiographic features and propose a new diagnostic algorithm. METHODS: From 793 patients who underwent emergent coronary angiography between January 1, 2012 and July 31, 2015, we examined data pertaining to 21 patients with new or presumably new LBBB. These patients were classified into three groups: 1) STEMI-equivalent, defined as an acute coronary occlusion on coronary angiogram (six patients), 2) non-STEMI (NSTEMI) (six patients), and 3) diagnosis other than myocardial infarction (non-MI) (nine patients). RESULTS: Six patients who met the ST-segment concordance criteria (score≥3) were STEMI-equivalent. On the other hand, seven patients with a discordant ST-elevation of ≥5 mm (score=2) were NSTEMI or non-MI. Therefore ST-segment concordance was highly sensitive and specific for the diagnosis of STEMI-equivalent. Compared with NSTEMI patients, nine non-MI patients with a normal angiogram had a low ejection fraction (35.6±19.0 vs. 56.0±12.9, p=0.04) and increased left ventricle end-diastolic dimension (63.9±8.8 vs. 51.7±6.4, p=0.012). CONCLUSION: Only a minority of patients with LBBB and suspected AMI have a STEMI-equivalent. Low ejection fraction and increased end-diastolic dimension of left ventricle indicate normal coronary angiogram in patients without ST-segment concordance of Sgarbossa criteria. We propose a new modified diagnostic algorithm in this population.
Bundle-Branch Block ; Coronary Angiography ; Coronary Occlusion ; Diagnosis ; Echocardiography ; Electrocardiography ; Hand ; Heart Ventricles ; Humans ; Myocardial Infarction

OBJECTIVE: To investigate the clinical manifestations and laboratory indicators of anti-Sjögren's-syndrome-related antigen A (SSA) antibody associated fetal cardiac disease. METHODS: Pregnant women hospitalized at Peking University People's Hospital from January 2013 to July 2023 were included. Eleven patients with anti-SSA antibody positive were eventually diagnosed with fetal cardiac di-sease. And patients with anti-SSA antibody positive without fetal cardiac disease were selected as controls. Clinical manifestations, laboratory indications and drug usage were compared between the two groups. RESULTS: Among these 11 patients, congenital heart block was confirmed in seven, which was the most common manifestations of fetal cardiac malformation. The proportion of the patients diagnosed with autoimmune disease before pregnancy in fetal cardiac malformation group was significantly lower than that in the control group (P=0.032), while most of the patients in the fetal cardiac malformation group received immune-related examinations for the first time because of this time's fetal cardiac diagnosis. While most of the patients in the control group received routine examinations because of autoimmune diseases diagnosed before pregnancy. During pregnancy, the white blood cell level [(9.29±2.58)×10⁹/L vs. (7.10±1.90×10⁹/L, t=3.052, P=0.004], erythrocyte sedimentation rate [(49.50 (48.00, 51.00) mm/h vs. 23.00 (15.00, 30.25) mm/h, Z=-2.251, P=0.024], IgA level [3.46 (2.30, 5.06) g/L vs. 2.13 (1.77, 2.77) g/L, Z=-2.181, P=0.029], and antinuclear antibody (ANA) titers [1∶320 (1∶160, 1∶320) vs. 1∶80 (1∶40, 1∶160), Z=-3.022, P=0.003] were significantly higher in fetal cardiac malformation group than in the control group. The proportion of positive anti-SSB antibody during pregnancy did not show a statistically significant difference between the two groups (37.5% vs. 7.7%, P=0.053). There was no significant difference in hydroxychloroquine dosage and initiation time between the two groups. The dosage of prednisone in the second and third trimesters was significantly higher in the cardiac malformation group than that in the control group, but there was no significant difference in the first trimester. CONCLUSION Fetal cardiac disease is rare in pregnant women with anti-SSA antibody. White blood cell, erythrocyte sedimentation rate, IgA, the titer of ANA positivity were higher in the fetal heart disease group during pregnancy. Since congenital heart block is difficult to reverse, its prevention and monitoring are more important than remedial treatment.
Humans ; Female ; Pregnancy ; Sjogren's Syndrome/complications* ; Autoimmune Diseases ; Heart Block/diagnosis* ; Autoantibodies ; Antibodies, Antinuclear ; Immunoglobulin A

A 2,800gm of full term male baby was born to a 30 year old Gr. 3 multipara by pitocin induction under the diagnosis of fetal distress. At birth the baby was cyanotic and grunting and the heart rate was 50/min. The baby had been done poorly and died of congestive heart failure at the age of 33 hours. ECG revealed second degree heart block. Postmortem examination was permitted for the heart only which revealed Coarctation of Aorta, Persistent Truncus Arteiosus with Pulmonary Artery Stenos is and Single Ventricle.
Adult ; Aortic Coarctation ; Autopsy ; Diagnosis ; Electrocardiography ; Fetal Distress ; Heart Block* ; Heart Defects, Congenital* ; Heart Failure ; Heart Rate ; Heart* ; Humans ; Male ; Oxytocin ; Parturition ; Pulmonary Artery