Electrocardiographic Variations Research Articles

Effect of essential oil of Alpinia zerumbet on cardiovascular and autonomic function in rats with isoproterenol induced acute myocardial infarction.

Alpinia zerumbet is a plant popularly used to treat hypertension and anxiety. Studies with Alpinia zerumbet demonstrate antihypertensive and vasodilator effects, among others. The objective of this study was to analyze the effect of essential oil of Alpinia zerumbet (EOAz) on cardiovascular and autonomic function in rats with isoproterenol-induced myocardial infarction. Male Wistar rats (n=32) were equally allocated into four groups: Control, ISO (150mg/kg, subcutaneous), EOAz (100mg/kg by gavage), ISO+EOAz. The rats were evaluated for cardiovascular and, autonomic parameters, electrocardiogram, and infarct size. EOAz was not able to reduce the electrocardiographic variations induced by ISO. Heart rate variability showed a decrease in sympathetic modulation on the heart in the groups treated with EOAz. The cardiopulmonary reflex induced by serotonin invoked a superior blood pressure variation at the 2 µg/kg dose in the EOAz treated groups, while the heart rate variation was significantly higher at the 16 µg/kg dose, when compared to other doses, in all groups, except EOAz+ISO. The sympathetic vagal index was higher in ISO group than in control. EOAz did not reduce the infarct size. We conclude that pretreatment with EOAz does not reverse the hemodynamic and electrocardiographic damage caused by isoproterenol but does reduce sympathetic modulation.

486 ELECTROCARDIOGRAPHIC EVOLUTION IN ANDERSON-FABRY PATIENTS ON DISEASE SPECIFIC THERAPY

Abstract Background Anderson-Fabry disease (AFD) is an X-linked lysosomal storage disorder that have gained attention due to the availability of therapeutic options. Disease specific therapy (DST), either by enzyme replacement therapy or oral pharmacological chaperone, is the mainstay for AFD treatment. Although its widespread use, few data are available on the electrocardiographic variations associated with DST. Purpose To evaluate ECG findings and variations in AFD according to time duration of DST, comparing patients under long-term therapy with naïve patients starting therapy during follow-up. Methods One-hundred-seventy-nine AFD patients, ≥18 years old, with 2 readable ECGs, were recruited in the present multicentre study cohort. Two patients were excluded due to pacemaker (PM) implantation. Only patients on DST (n=107) were considered for final cohort and divided into 2 groups according to therapy duration: Group A (n=42) included patients treated for ≥12 months at the time of first evaluation, whereas Group B patients (n=65) started therapy during follow-up. Results Group A and Group B had not significant difference in terms of age at presentation (48[39-60] vs 48[36-56]years; p=0.856) and maximal wall thickness (13[11-15] vs 13[11-18]mm; p=0.090) whereas they differed for male prevalence (61% vs 38%; p=0.029) and classic phenotype (86% vs 29%; p<0.0001). At baseline, more than half of both groups had ECG abnormalities (61% vs 61%; p=1.000). The prevalence among Group A and Group B of atrial fibrillation (AF 5% vs 6%; p=1.000), first degree atrioventricular block (AVB, 7% vs 5%; p=0.677), right bundle branch block (RBBB, complete 7% vs 8%; p=1.000; incomplete RBBB 14% vs 12%; p=0.776), left anterior fascicular block (LAFB, 10% vs 9%;p=1.000) and repolarization abnormalities (48% vs 38%; p=0.423) was not significantly different. Conversely, left ventricular hypertrophy (LVH) was more prevalent in Group A (64% vs 37%; p=0.010). During the follow-up (57[60-28] months for Group A vs 70[37-85] months for Group B; p=0.152), both groups developed electrocardiographic alterations (38% vs 23%; p=0.127). Specifically, in GroupA, 4 (10%) patients presented AF, 1 (2%) AVB, 7 (17%) complete or incomplete RBBB, 4 (10%) LAFB, 1 (2%) LVH and 8 (19%) repolarization abnormalities. In Group B, 2 (3%) developed AF, 1 (2%) AVB, 7 (11%) complete or incomplete RBBB, 2(3%) LVH and 11(17%) repolarization abnormalities; none developed LAFB. Conclusions In this AFD cohort, both patients on chronic DST (Group A) and patients who started treatment during follow-up (Group B) developed ECG alterations. Treatment status didn't affect considerably the developing of ECG abnormalities and DST did not prevent ECG changes. ECG alterations during the follow-up were more frequent in Group A (38% vs 23%), mainly composed by classic phenotype and male patients, thus supporting a prompt start of therapy at an early stage.

Electrocardiographic findings in Anderson-Fabry patients on disease specific therapy: can treatment prevent ECG changes?

Abstract Background Anderson-Fabry disease (AFD) is an X-linked lysosomal storage disorder that have gained attention due to the availability of therapeutic options. Disease specific therapy (DST), either by enzyme replacement therapy or oral pharmacological chaperone, is the mainstay for AFD treatment. Although its widespread use, few data are available on the electrocardiographic variations associated with DST. Purpose To evaluate ECG findings and variations in AFD according to time duration of DST, comparing patients under long-term therapy with naïve patients starting therapy during follow-up. Methods One-hundred-seventy-nine AFD patients, ≥18 years old, with 2 readable ECGs, were recruited in the present multicentre study cohort. Two patients were excluded due to pacemaker (PM) implantation. Only patients on DST (n=107) were considered for final cohort and divided into 2 groups according to therapy duration: Group A (n=42) included patients treated for ≥12 months at the time of first evaluation, whereas Group B patients (n=65) started therapy during follow-up. Results Group A and Group B had no significant difference in terms of age at presentation (48 [39–60] vs 48 [36–56] years; p=0.856) and maximal wall thickness (13 [11–15] vs 13 [11–18] mm; p=0.090) whereas they differed for male prevalence (61% vs 38%; p=0.029) and classic phenotype (86% vs 29%; p<0.0001). At baseline, more than half of both groups had ECG abnormalities (61% vs 61%; p=1.000). The prevalence among Group A and Group B of atrial fibrillation (AF, 5% vs 6%; p=1.000), first degree atrioventricular block (AVB, 7% vs 5%; p=0.677), right bundle branch block (RBBB, complete 7% vs 8%; p=1.000; incomplete RBBB 14% vs 12%; p=0.776), left anterior fascicular block (LAFB, 10% vs 9%; p=1.000) and repolarization abnormalities (48% vs 38%; p=0.423) was not significantly different. Conversely, left ventricular hypertrophy (LVH) was more prevalent in Group A (64% vs 37%; p=0.010). During the follow-up period (57 [60–28] months for Group A vs 70 (37–85) months for Group B; p=0.152), both groups developed electrocardiographic alterations (38% vs 23%; p=0.127). In particular, in Group A, 4 (10%) patients presented AF, 1 (2%) AVB, 7 (17%) complete or incomplete RBBB, 4 (10%) LAFB, 1 (2%) LVH and 8 (19%) repolarization abnormalities. In Group B, 2 (3%) developed AF, 1 (2%) AVB, 7 (11%) complete or incomplete RBBB, 2 (3%) LVH and 11 (17%) repolarization abnormalities; none developed LAFB. Conclusions In this AFD cohort, both patients on chronic DST (Group A) and patients who started treatment during follow-up (Group B) developed ECG alterations. ECG changes during the follow-up were more frequent in Group A (38% vs 23%), mainly composed by classic phenotype and male patients, suggesting a prompt start of therapy at an early stage. Funding Acknowledgement Type of funding sources: None.

Relationship between left ventricular ejection fractions and electrocardiographic variations in chronic chagasic patients

The sistodiastolic dysfunction of the heart measured through global ejection of the left ventricle as systolic parameter and the ventricular rapid filling plus the time of ventricular total filling as parameters of function diastólica are informational facts of complementary examinations of high sensibility and specificity for this type of study. It was established a relationship between the fraction of left ventricular ejection global and segment, measured for ventriculografía radioisotópica of balance, with the disorders electrocardiográficos in chronic chagásic patients. It is possible to conclude that while major alteration exists in the fraction of ventricular ejection, major abnormal variations exist in the electrocardiography of the chronical chagasic patients. Those who presented complete block of right branch show the possible existence of association in the deterioration of the fraction of ejection apicoseptal, aspect that would allow to conclude that the complete blockade of right branch can be a variable predisposed. The statistical analysis of the fraction of ejection apical that was found shows that the decrease of this region has a statistical force with the electrocardiografic deterioration complete blockade of right branch more front left hemibloqueo, This scientific evidence is confirmed across the statistical and epidemiological evidence which indicators allow to observe a major prevalency in 66 % and a major association of 1.51 times of complete Blockade of Right Branch more front left hemibloqueo in relation to other segments.

Electrocardiographic variations in cases with pulmonary tuberculosis related to anti-tuberculosis therapy

Tuberculosis is the major public health concern globally. Cardiovascular involvement was observed in 1-2% of cases with pulmonary tuberculosis. The present study was designed to assess the ECG changes in pulmonary tuberculosis before and after anti-tuberculosis therapy. A total of 90 clinically diagnosed with sputum positive pulmonary tuberculosis cases above 21 years of age were included. Cases with abnormal findings on ECG were advised to echocardiography to detect the exact abnormality / cardiac complication due to pulmonary tuberculosis. Collected data were analysed to compare the ECG changes in pulmonary tuberculosis at the initial diagnosis and follow up for six months. In 60% of cases, the duration of symptoms was less than 6 months and in 40% cases, it was more than 6 months. ECG abnormalities was observed in 65.5% pulmonary tuberculosis cases before commencing anti-tuberculosis therapy, whereas ECG abnormalities were noted in 34.4% of cases after completion of anti-tuberculosis therapy. Sinus tachycardia was observed in pulmonary tuberculosis cases before anti tuberculosis therapy was 42.2% and after 6 months follow up with ATT it was reduced to 11.1%. Sinus tachycardia, QRS axia+900, p wave axis +900, Right side axis deviation and p-pulmonale was the main abnormalities noticed in ECG before the commencement of anti-tuberculosis therapy. The values were reverted back to normal after anti tuberculosis therapy. PT cases with atypical features should be a monitor with echocardiography for early detection of cardiac complications.

A correlative study of electrocardiographic, echocardiographic and hematological findings in chronic obstructive lung disease

A correlative study of electrocardiographic, echocardiographic and hematological findings in chronic obstructive lung disease - IJIRM- Print ISSN No: - 2581-4214 Online ISSN No:- 2581-4222 Article DOI No:- 10.18231/2581-4222.2019.0009, IP Indian Journal of Immunology and Respiratory Medicine-IP Indian J Immunol Respir

Pathophysiological links, echocardiographic characteristics, and clinical implications of QRS morphology in patients with dilated cardiomyopathy.

Heart failure is an important clinical problem worldwide. There is great interest in evaluating the relationship between electrocardiographic variations and dilated cardiomyopathy (DCM) since it has been used as a predictor of increased morbidity and mortality. The presence of fragmentation in the QRS complexes on 12-lead electrocardiogram (ECG) was reported as a marker of depolarization abnormality in patients with DCM. Previous studies have investigated the relation between QRS morphology and DCM. QRS morphology and duration are associated with clinical deterioration and increased mortality in patients with DCM. Although surface ECG provides valuable information on prognosis of these patients, echocardiographic methods have been used for further investigation of patients with DCM. The aim of the present review is to provide an overview of the pathophysiological links, echocardiographic characteristics and clinical implications of QRS morphology in patients with DCM.

Outcomes among Athletes with Arrhythmias and Electrocardiographic Abnormalities: Implications for ECG Interpretation

Electrocardiographic (ECG) aberrations and arrhythmias occur frequently among athletes due to normal variants, subclinical cardiac disease or structural and electrical remodeling in response to training. It is unclear whether these changes are associated with adverse clinical outcomes over time among otherwise asymptomatic, healthy athletes. Consensus guidelines have been developed to guide the clinician regarding further management of these arrhythmias. The purpose of this review is to summarize prospective data regarding cardiovascular outcomes related to ECG changes among athletes and compare these findings with current guidelines. A review of the literature was conducted using the PubMed database (1966--present). Outcomes of interest included documented cardiac symptoms or events, such as episodes of cardiac or cerebral hypoperfusion, sudden death or prophylactic procedural interventions. Studies were included for analysis if they involved (1) athletes with documented, baseline arrhythmias and/or abnormal ECG variations; (2) a study design with longitudinal follow-up (designated as >1 month, to exclude short-term Holter studies); and (3) outcomes that include documented cardiac symptoms or events. A total of 33 studies met the above criteria, encompassing over 4,200 athletes, with follow-up ranging from 2 months to 14.6 years. There were few adverse outcomes among cases of sinus bradycardia >30 bpm, sinus pauses <3 s, first-degree atrioventricular (AV) block, second-degree type I AV block and incomplete right bundle branch block. Results among these studies are concordant with guidelines that recommend work-up in the setting of cardiac symptoms, history or physical examination indicative of cardiac disease, severe sinus bradycardia or AV block that does not resolve with exercise or hyperventilation. Outcomes among prospective studies also support guidelines that recommend further evaluation for repolarization abnormalities and supraventricular tachycardias, including atrial fibrillation, atrial flutter and Wolff-Parkinson-White syndrome. Ventricular arrhythmias in the setting of structural cardiac disease are associated with an increased risk of adverse events, including sudden cardiac death, and warrant special consideration with regards to sports eligibility. Findings in this review are limited by a lack of control groups, limited assessment of confounding factors (such as performance-enhancing drugs), and under-representation of women and certain ethnicities. Further prospective studies are needed to better characterize the long-term outcome of ECG abnormalities among athletes and provide evidence for ECG interpretation guidelines.

Novel Bayesian Vectorcardiographic Loop Alignment for Improved Monitoring of ECG and Fetal Movement

The continuous analysis of electrocardiographic (ECG) signals is complicated by morphological variability in the ECG due to movement of the heart. By aligning vectorcardiographic loops, movement-induced ECG variations can be partly corrected for. Existing methods for loop alignment can account for loop rotation, scaling, and time delays, but they lack the possibility to include a priori information on any of these transformations, and they are unreliable in case of low-quality signals, such as fetal ECG signals. The inclusion of a priori information might aid in the robustness of loop alignment and is, hence, proposed in this paper. We provide a generic Bayesian framework to derive our loop alignment method. In this framework, existing methods can be readily derived as well, as a simplification of our method. The loop alignment is evaluated by comparing its performance in loop alignment to two existing methods, for both adult and fetal ECG recordings. For the adult ECG recordings, a quantitative performance assessment shows that the developed method outperforms the existing method in terms of robustness. For the fetal ECG recordings, it is demonstrated that the developed method can be used to correct ECG signals for movement-induced morphology changes (enabling diagnostics) and that the method is capable of classifying recorded ECG signals to periods of fetal movement or rest ( 0.01). This information on fetal movement can also serve as a valuable diagnostic tool.

Kounis syndrome associated with benzathine penicillin G use: A case report

Kounis syndrome is a life-threatening medical condition that causes severe allergic reaction and acute coronary syndrome. Benzathine penicillin G is one of the most widely used antibiotics in clinical practice, but it can enhance both allergic and hypersensitivity complications. In this report, we describe the case of a 42-year-old man admitted to our hospital who presented with cryptic tonsillitis accompanied by angioneurotic edema, chest pain, and electrocardiographic variations. The patient was diagnosed with Kounis syndrome and treated with oral antihistamines and prednisolone. He was discharged following a complete recovery and regression of electrocardiographic abnormalities within 72 hours.

Spontaneous left side pneumothorax and myocardial infarction: rare but potentially lethal coexistence that can frustrate clinicians

Spontaneous pneumothorax is a common surgical disease that is a surgical emergency. It can be divided into primary (caused by microscopic blebs <1 cm in diameter) and secondary (asthmatic, catamenial, neonatal, caused by emphysematic bullae or chronic respiratory obstruction) varieties. This surgical entity has been closely associated to a variety of electrocardiographic (ECG) changes, which are pathophysiologically explained by spatial changes in the anatomical structure of the mediastinum caused by increased hemithoracic pressure. Several reports on ECG variations due to pneumothorax that masquerades as myocardial ischemia have been previously recorded. However, when the underlying disease involves two pathological entities, in this case pneumothorax and myocardial infarction, time limits can be pressing. Herein, we describe an interesting case of a patient who presented with left secondary spontaneous pneumothorax associated with acute myocardial infarction. It is an intriguing and rarely encountered case in which the patient's anamnesis can easily mislead the clinician and valuable time can be wasted.

Clinical Predictors of Conduction Disease Progression in Type I Myotonic Muscular Dystrophy

Patients with type I myotonic muscular dystrophy (DM1) are at risk for sudden death due to atrioventricular conduction block. We sought to characterize the trends and predictors of time-dependent electrocardiographic (ECG) variations in patients with DM1. Seventy patients with DM1 underwent standard electrocardiography at first evaluation and routine and symptom prompted follow-up. Individual variations in ECG conduction intervals were assessed using spaghetti plots. Clinical predictors of conduction disease progression were assessed using multivariate random effects regression models of panel data clustered by patient and adjusted for heart rate. Substantial individual variability was noted in time-dependent changes in PR, QRS, and QTc intervals of patients with DM1. Changes in the QTc interval were closely associated with prolongation of the QRS interval. Age, the presence of paroxysmal atrial flutter or fibrillation, and the number of cytosine-thymine-guanine (CTG) repeats were independent positive predictors of time-dependent PR and QRS prolongation during long-term follow-up. Female sex was negatively associated with PR prolongation but positively associated with QTc prolongation. Lower left ventricular ejection fraction was associated with greater QRS interval progression during long-term follow-up but was not predictive of PR interval progression. Patients with DM1 can develop rapid changes in cardiac conduction intervals. Paroxysmal atrial flutter or fibrillation, older age, and larger CTG expansions predict greater time-dependent PR and QRS interval prolongation and warrant particular attention in the arrhythmic evaluation of this high risk patient subset.

Modified electrode placement must be recorded when performing 12-lead electrocardiograms

Background: Local observation has suggested that placing limb leads on the torso when recording the standard 12-lead resting electrocardiogram (ECG) has become commonplace. This non-standard modification has the important advantages...

Differential electrocardiographic study on Iberica and Duroc breeds of pig during physical maturation.

Sequential electrocardiograms were taken of 50 pigs (25 Iberica and 25 Duroc), from the ages of 5 days to 205 days. The records were analysed to establish the normal values of the different electrocardiographic intervals (RR, QRS, QT, TQ and ST intervals), the diastole/systole quotient and heart score in the first 7 months of life, as well as age-related electrocardiographic variations. In addition, it was intended to determine which of these two breeds showed the greater heart recovery capacity. Finally, positive or negative correlations between the RR interval and the electrocardiographic incidents studied were analysed. The mean values obtained for the electrocardiographic parameters were similar in the two breeds and increased with their physical maturity. Analysis of the correlation between the duration of the heart cycle and the different electrocardiographic incidents showed a positive and significant correlation, the r-values being higher for the RR interval-TQ interval correlation. There was very little correlation between RR interval and heart score in Duroc pigs and practically no correlation between the RR interval and the QRS interval in either breed.

The novacode criteria for classification of ECG abnormalities and their clinically significant progression and regression

Electrocardiographic (ECG) manifestations of clinical and subclinical cardiovascular disease are used as an important component in the evaluation of clinical trials, and there is an increasing demand for well-defined criteria for clinically significant evolution of ECG abnormalities. The Novacode ECG classification system provides a comprehensive hierarchical set of criteria for prevalent ECG abnormalities and for clinically significant serial ECG changes, both adverse and favorable, as a response to pharmacologic, surgical, and other interventions. These criteria are used to grade Q wave and ischemic abnormalities in order to achieve stable classification of both prevalent and incident myocardial infarctions by minimizing false classifications due to clinically insignificant ECG variations. This approach differs from the traditional Minnesota Code classification system, in which incident events are determined by changes in classification categories, with the application of additional elaborate validation rules to exclude frequent false classifications. Novacode hierarchy is so structured that for each abnormality, a general class is first determined with the simplest possible classification criteria and more specific abnormality subgroups are then classified with more elaborate criteria. This approach will satisfy differing needs of clinical trials for detail in classification. Explicit definition of ECG variables and condition statements for the classification criteria facilitate implementation of the Novacode with computer ECG programs.

Antihypertensive Effects of Tertatolol: A Comparative Study Versus Atenolol

The purpose of this study was to compare the antihypertensive efficacy and tolerance of tertatolol and atenolol. Sixty-one ambulatory patients with uncomplicated mild to moderate hypertension (diastolic blood pressure (DBP) between 95 and 120 mm Hg) received, following a randomized allocation, either 5 mg tertatolol (T) (n = 30) or 100 mg atenolol (A) (n = 31) in single daily dose. After a one-month single-blind placebo run-in period, the two drugs were administered double-blind over a 3 month period. Blood pressure (BP) and heart rate were measured before, and after the first and third months. Electrocardiographic and biological data were collected respectively before and at the third month. At each consultation, patients were asked to report any side effects. Atenolol and tertatolol were similar in controlling BP: the decrease in supine systolic blood pressure (SBP) reached 24.2 mm Hg (P less than .001) in group T and 21.7 mm Hg in group A (P less than .001), and the decrease in DBP reached 16.6 mm Hg in group T (P less than .001) and 16.8 mm Hg in group A (P less than .001). Supine heart rate (HR) fell by 15.5 beats/min and 14.8 beats/min in the T and A groups, respectively (P less than .001). At the end of the trial, blood pressure control (DBP less than or equal to 90 mm Hg) was obtained in 80% and 70% of the patients in the T and A groups, respectively. The clinical tolerance of both drugs was satisfactory with 8 slight and transient complaints in T group, and 14 complaints with one treatment-related withdrawal at the second month in A group. Electrocardiographic and biochemical variations were not significantly different in the two groups. We conclude that the antihypertensive efficacy of 5 mg tertatolol is comparable to that of 100 mg atenolol, with a similar clinical and biochemical tolerance.

Basis of static and dynamic electrocardiographic variations in Wolff-Parkinson-White syndrome: Anatomic and electrophysiologic observations in right and left ventricular preexcitation

A squirrel monkey with naturally occurring Wolff-Parkinson-White syndrome was studied electrophysiologically and anatomically. Two sites of preexcitation were found, one in the right ventricle, the other in the left ventricle. Induced premature atrial beats revealed functional dissociation of preexcitation; at one point block occurred in one pathway and not in the other. The anatomic features were studied from 7μ serial sections. Each section contained a plane through the entire heart, allowing visualization of the interrelations between the normal atrioventricular (A-V) node, His-Purkinje system, A-V ring and valves and 2 accessory connections that corresponded in location to the 2 areas of preexcitation. Atrial and ventricular activation were studied in 7 subjects with Wolff-Parkinson-White syndrome and various static forms of either right or left ventricular preexcitation. Whereas patients with right ventricular preexcitation demonstrated predominantly anomalous excitation and long QRS duration, those with left ventricular preexcitation demonstrated a greater component of normal depolarization and less QRS duration. This finding appeared to be related to variation in the distance and activation times between the atrial pacemaker and the location of the right or left accessory tracts. Other findings demonstrated that dynamic changes in QRS configuration, varying between more and less preexcitation, occurred as a result of changes in atrial activation and the relative input times to the normal and accessory A-V connections. The data indicate several probable mechanisms for the static and dynamic variability of the electrocardiogram that is characteristic of the Wolff-Parkinson-White syndrome.

騒音の心電図におよぼす影響に関する研究 : 第1報 騒音による心電図の変化について

The purpose of this paper is to report the effects of noise upon electrocardiographic tracings of the workers. The studies were done in a textile fabric, where noises of 95 phon, 600 to 4000 c.p.s., were recorded. 20 female workers of 3 to 8 year's experience and 22 female workers of less than 6 months' experience were chosen for this study. The latter group was studied in the second week, the third month and the sixth month from the beginning of their work. In the former group of longer working experience, no significant variations of PQ, QRS, QT and RR intervals and R height were observed, while augmented T wave after 8 hours' exposure was noted, which declined down to the control level within 12 hours after the cessation of the work. In the latter group of 6 months' experience, again no significant variations of PQ, QRS, QT intervals and R height were observed, while increased voltage in T wave after 8 hours' labor was noted, in the group of more than 3 months' experience which declined down to the control level within 12 hours after the cessation of the work. Tendency toward prolongation of RR interval after 8 hours' work was noted in the group of more than 6 months' experience. These electrocardiographic variations were not observed in the group working in the place where noise level of less than 60 phon was recorded. These findings suggest that the electrocardiographic variations are presumably due to the effects of noise. In order to clarify the effects of noise immediately after the onset and discontinuance of the exposure to the noise, 12 unexperienced subjects were put under the noise of 103 phon, 600 to 8000 c.p.s., for 60 minutes. Before, during and after the procedure, continuous electrocardiograms were taken. Fluctuation of T height, with less marked variations of RR interval and R voltage were observed during 10 minutes after the onset and discontinuance. In summary, the effects of noise on electrocardiographic tracings were almost invariably seen as an augmentation of T wave immediately after the cessation of work.

Electrocardiocramme Dyskaliemique Et Acidose Diabetique

SummaryAlthough the electrocardiographic variations during diabetic acidosis mostly reflect the perturbations of K metabolism, it seems hardly possible to find an absolute correlation between ECG and blood potassium alterations.Certain experimental and modern electrophysiologic data would permit to consider another interpretation : a dyskalicmic ECG would reflect the variations of the gradient Ki/Ke.To prop up this theory, we report 7 cases of diabetic acidosis, with a series of biological investigations, studies of neuro-muscular excitability, and electrocardiograms. The gradient theory takes account of the initially stated facts. However, one must take care not to consider the potassic desequilibrium alone : pH variations (intracellular as well as extracellular), the alterations of other ionic elements (Ca, Na, K/Na...), may of course play also their part.Anyhow it would seem that one must consider the « metabolic » ECG not as a reflect of extracellular disbalance, but as a witness of the variations of ...

肺手術に関する心電図の臨床的研究(第2報) : 胸成術後心電図各棘の変化

The author made periodic observations of electrocardiographic variations resulting from thoracoplasty. Results obtained are given below.Methods : Methods used were just the same as those described in Report I.Results and Conclusions : Selection of cases was done as described in Report I ; that is, from 93 cases who had undergone thoracoplasty those were selected who gave abnormal electrocardiographic findings at rest or after exercise. The selected cases were electrocardiographically examined from the 2nd month after operation to the 12th.1) P-Wave : Cases with heightened PII III-waves gradually increased in number from the 2nd postoperative month, and in the 12 th month had increased by about 300 per cent. This is a peculiar phenomenon observed only after thoracoplasty.2) ST-Segment : Cases with lowered STII III-and STV5 V6-segments gradually decreased in number from the 2nd postoperative month, and in the 12th month had decreased by about 50 per cent. But those cases who had preperatively shown abnormal variations in this segment at rest or after exercise gave the same abnormal findings even 12 months after operation. That is, the number of cases with abnormalities of this kind was nearly the same before and 12 months after operation.3) T-Wave : Cases with abnormal TI-waves were rapidly reduced in number from the 2nd month after operation. But those cases who had preperatively shown abnormal TI-waves at rest remained all the same unimproved on this point even 12 months after operation. Abnormal TII III-, TV2- and TV5 V6-waves were normalized in nearly the same way as abnormal ST-segments.4) Comparison between Abnormal ST-Segments and T-Waves in Standard Limb Lead and Those in Precordial Lead : Abnormal ST-segments and T-waves in standard limb lead were compared with those in precordial lead. Results thus obtained indicated not only that myocardial damage existed in the right ventricle, as reported by various investigators, but also its presence in the left ventricle.