[Proceedings of the 124th Internal Medicine Seminar--19th Vanyska Seminar organized by the Czech and Slovak Internal Medicine Society and the Czech Medical Society of Brno. 21 March 2003, Brno. Cardiac electric potentials--100 years of ECG in internal medicine].

Vnitr Lek 2003, 49(9):699-784

[Failure of antiarrhythmia agents and understanding the phenomenon of proarrhythmia].

B Semrád

Vnitr Lek 2003, 49(9):700-706

The end of 80ies and the beginning of 90ies in arrhythmology was characterized by the demonstration of so called proarrhythmia, when drugs, particularly antiarrhythmic ones, induced serious, frequently fatal arrhythmias. The resulting pharmacotherapeutic skepsis in the treatment of, in particular, ventricular arrhythmias were accompanied at the same time by a powerful development of non-pharmacological modes of treatment of arrhythmias, especially by implantable defibrillators. The causes of proarrhythmia were identified with the evolution of knowledge in the genetic basis of hereditary syndrome of long QT interval. The first mutation was identified...

[Electrocardiography].

F Kölbel

Vnitr Lek 2003, 49(9):707-709

[New techniques in recording cardiac electric potentials].

J Siegelová

Vnitr Lek 2003, 49(9):710-712

New technologies of recording and processing of electrical cardiac potentials made significant advances in the course of recent years, contributing to the production of instrumentation the application of which enables a high level of diagnostics, therapy and rehabilitation to be reached in internal medicine. Modern technology of recording potentials by means of vacuum electrodes with surface finish and simultaneous application of new adaptable filters enable a more accurate digital processing of electrical pulses and a higher quality of their recording, indication, transmission, interpretation and archiving. The given requirements are complied with...

[Pitfalls in the interpretation of electrocardiographic signals].

J Vítovec, K Zeman

Vnitr Lek 2003, 49(9):713-717

[The ECG--a basic examination method in the cardiology laboratory].

M Soucek

Vnitr Lek 2003, 49(9):718-722

Electrocardiography entertains a centennial anniversary, but it still remains the basic and widely used examination method in heart diseases. Its important position remains even within the framework of basic clinical research, where it represents a starting parameter for the evaluation of other more sophisticated methods of examination. The strengthening of basic research and rapid application of the obtained knowledge in clinical practice were the main reasons for the foundation of the "Laboratory for Research of Blood Circulation Control". The laboratory is particularly engaged in investigating the influence of autonomous nervous system (ANS) in...

[Electrocardiography in acute myocardial infarct].

O Hlinomaz

Vnitr Lek 2003, 49(9):723-726

[Electrocardiography in cardiomyopathies].

P Gregor

Vnitr Lek 2003, 49(9):727-729

ECG plays a predominantly screening role in cardiomyopathies. It is particularly important in hypertrophic cardiomyopathies, where atrial abnormities may be present (25%), positive voltage criteria in hypertrophy of the left ventricle (63%), pathological Q or QS wave (24%), missing septal q in V5 and V6 (49%), missing increase in the R wave in V1-V3 (29%) and high R waves in V2-V3 (15%), changes in repolarization phase of the ST-T segment (87%). The left Tawar arm blockade is particularly typical for dilatation cardiomyopathies. In arrhythmogenic cardiomyopathies of the right ventricle the epsilon ware can be found as well as negative T waves in the...

[Changes in the ECG in chronic heart failure and after transplantation].

L Spinarová

Vnitr Lek 2003, 49(9):730-733

UNLABELLED: ECG examination belongs to basic procedures in the care of patients with heart failure. The Euroheart Survey study followed the data and therapy of hospitalized patients with chronic heart failure (CHF) with participation of 116 hospitals from 25 European countries and surveyed documentation of 45,993 patients dismissed from internal wards. A new atrial fibrillation or supraventricular tachycardia affected 25.3% of patients, chronic fibrillation was encountered in 23%. Bradyarrhythmia occurred in 10.8% and pacemaker was applied in 8.5% of patients. Ventricular arrhythmias were present in 8.4%, implantable cardiovertor-defibrillator in 1.5%....

[Biventricular cardiac pacing].

J Kautzner, L Riedlbauchová

Vnitr Lek 2003, 49(9):734-739

Chronic heart failure (CHF) is a very frequent condition. Its frequency increases with prolongation of median life expectancy and due to improvements in medical care. However, medical treatment does not allow adequate control of symptoms in many cases. Therefore, various nonpharmacological approaches are being developed. The so-called biventricular pacing is one of them. Its main goal is to restore impaired mechanical cardiac synchrony that is present in patients with prolonged QRS duration due to inter- or intraventricular conduction abnormality. At present, biventricular pacing can be achieved through positioning of a special pacing lead into a branch...

[Intracardiac electrocardiography in the diagnosis and therapy of arrhythmia].

M Kozák

Vnitr Lek 2003, 49(9):740-747

The recording of intracardial electrocardiograms (IECG) has made good progress in the arrhythmology during last 15 years. First the aim was to describe the characteristics of the conduction system of the heart (Hisogram recording), followed by the evaluation of pathologies of the conduction system (meaning bradyarrhythmias), electrical activation of the myocardium when tachyarrhythmia is ongoing for diagnosis and punctual localization of accessory pathways during endocardial mapping. The next logical step as a reaction to the knowledge of endocardial mapping was the evaluation of new therapeutic methods--DC followed by radiofrequency ablations--nonpharmacological...

[Atrial fibrillation].

J Spinar, J Vítovec

Vnitr Lek 2003, 49(9):748-753

Atrial fibrilation is the most frequent arrhythmia, the occurrence increasing with age and associated diseases. The incidence at the age below 60 years is markedly lower than one per cent, whereas in persons above 80 years of age it exceeds six per cent. The occurrence in patients with heart failure is from 10% (NYHA II) up to 50% (NYHA IV). Atrial fibrillation is classified into that observed for the first time and permanent, respectively, while transient forms include paroxyzmal and persistent atrial fibrillation. The diagnosis is based on ECG recording, while echocardiography is most significant. The therapy includes two basic questions--anticoagulant...

[Treatment of ventricular arrhythmias].

J Bytesník

Vnitr Lek 2003, 49(9):754-762

The term ventricular arrhythmia denotes various disorder in the cardiac rhythm--from isolated monomorphic ventricular extrasystoles to ventricular flutter and fibrillation. The choice of therapy of ventricular arrhythmias is primarily based on prognostic aspects. Ventricular tachycardias represent the main cause of sudden cardiac death, which is responsible for more than 60% of all deaths for cardial causes. In the industrially advanced countries the ventricular tachyarrhythmias represent more than 90% of cases based on coronary disease. The prevention of sudden death is directed particularly to prevention and therapy of ischaemic heart disease. The...

[Cardiac bradyarrhythmia ].

M Táborský, P Neuzil, P Niederle

Vnitr Lek 2003, 49(9):763-767

Permanent cardiac pacing was introduced in 1958 and till the end of 70s this method saved lives in particular of the patients with advanced atrioventricular block. The implantation technique has changed from complicated thoracotomy to endovasal approaches. The introduction of physiological AV sequenced atrioventricular pacing marked a significant progress in this field. Acute haemodynamic studies documented positive effect of the atrial contribution. Numerous studies subsequently analyzed the influence of different pacing regimes on total and specific cardiovascular mortality and morbidity. It can be concluded that on the basis of present evidence-based...

[Molecular genetic aspects of arrhythmias].

T Novotný

Vnitr Lek 2003, 49(9):768-772

The sequencing of human genome was completed in 2001. The position of particular DNA base is established-i.e. we know all "letters" in the "book" but we understand only limited number of "words" i. e. only limited number of genes was identified. And the human genome consists of about 30,000 genes from which through the mechanism of alternative RNA splicing more than 100,000 genes can be derived. All the genes of one individual form the genotype. The expression of genotype in particular environment forms the phenotype. What is not present in genotype can neither be present in phenotype. In the last decade a substantial progress was achieved in understanding...

[Methods in stress ECG].

Z Mikes

Vnitr Lek 2003, 49(9):773-778

In spite of the continuous development of methods of examination, the exercise ECG still retains its position in the palette of examination methods for ischaemic heart disease. The examination mostly employs a mechanical load on bicycle ergometer or a treadmill. In the changes in the ST segment (horizontal or descending regression of ST surpassing 1 mm, i.e. 0.1 mV, measured 60-80 ms from junction) is still considered as the most indicative ECG index. The detection rate of ischaemic changes is proportional to the number of used leads. Sensitivity of visually evaluated exercise ECG is in the rang of 54 to 66%, specificity is around 82%. The elevation...

[The ECG in acute non-cardiac states].

C Cíhalík, M Fiala, A Martínek

Vnitr Lek 2003, 49(9):779-784