[The supplement on 100 years' of ECG--genesis of its inception].

P Svacina

Vnitr Lek 2002, 48(Supplement 1):4

[One hundred years' of the electrocardiogram--a look at the past and view of the future ].

F Kölbel

Vnitr Lek 2002, 48(Supplement 1):5-6

[Pathways in the development of electrocardiography].

M Stejfa

Vnitr Lek 2002, 48(Supplement 1):7-14

Electrocardiography celebrates hundred years of its existence. The historical article on the cornerstones of its development was written on request of the editorial board of Vnitrní lékarství (Internal Medicine) and the Czech Society of Internal Medicine. After summarizing the beginnings of the discovery of bioelectric current and attempts of its registration the author describes the construction of the string galvanometer by Willem Einthoven. In 1901 and 1903 he published the first findings on the application of electrocardiography in man. Therefore that years are considered the years when clinical electrocardiography was born. Next we deal with the...

[The beginnings of electrocardiography at the Prague Medical School].

J Kolár, M Aschermann, F Boudík, K Horký

Vnitr Lek 2002, 48(Supplement 1):15-19

The authors describe the beginnings of development of electrocardiography at the Prague Medical Faculty of Charles-Ferdinand and Charles University resp. The first results of the new method came from the physiological laboratory of Ewald Karl Konstantin Hering (1834-1918), who contributed to electrocardiography by explaining the mechanism of atrial fibrillation and to Richard Hans Kahn (1876-1941) who was the first to publish electrocardiographic changes after temporary block of coronary artery blood flow in the dog. Clinical application and the promotion of electrocardiography in this country is among others in particular from Václav Libenský (1877-1938),...

Willem Einthoven--inventor of electrocardiography.

P Schweitzer, S Keller

Vnitr Lek 2002, 48(Supplement 1):20-23

Willem Einthoven, the inventor of the string galvanometer electrocardiograph, was born in the Dutch East Indies, studied medicine in Utrecht Holland, and became chairman of the Department of Physiology at the University of Leiden. In 1924 he was awarded the Nobel Price for physiology and medicine. Einthoven became interested in electrophysiology after Waller's demonstration of the human electrogram using Lippmann's capillary electrometer. Because of important limitations of this device, Einthoven decided to construct the string galvanometer to be used for physiological research and in clinical medicine. Einthoven's main achievements in electrophysiology...

A history of atrial fibrillation.

P Schweitzer, S Keller

Vnitr Lek 2002, 48(Supplement 1):24-26

Vulpian in France and Hoff and Ludwing in Germany first studied atrial fibrillation in experimental animals. In clinical medicine, de Senac and others, first observed irregular and fast pulse. Hering in 1903 described "pulsus irregularis perpetuus" as a distinct arrhythmia. Hering believed, that this was an extrasystolic rhythm disturbance, while Cushny and Edmunds suggested atrial fibrillation as its cause. Mackenzie was another British author who played an important role in the clarification of atrial fibrillation, particularly after Cushny convinced him, that the so-called nodal rhythm was atrial fibrillation. Einthoven reported the first ECG of...

[100 years' of ECG or 100 years' of excellence in recording the electrical activity of the human heart].

J Kvasnicka, J Herzová

Vnitr Lek 2002, 48(Supplement 1):27-34

The authors present a brief history of high-standard records of the electric activity of the human heart. Its beginnings date back to 1892 when Willem Einthoven recorded the first electrocardiogram.

[Perspectives in electrocardiography 100 years after Einthoven's discovery. Personal views].

Z Rosol

Vnitr Lek 2002, 48(Supplement 1):35

[The electrocardiogram and thrombolytic therapy in patients with acute myocardial infarct].

S Cagán, Z Moťovská, S Wimmerová, I Besedová, T Trnovec

Vnitr Lek 2002, 48(Supplement 1):36-44

The objective of the submitted work is to analyze in patients with acute myocardial infarction (AIM) local priority data on ECG markers after admission to hospital, data on some associations of ECG and thrombolytic treatment and to assess in patients with the first AMI data on hospital mortality in connection with some ECG markers. The project was implemented as a prospective multicentre study. An independent audit and collection of data was done in 3123 patients with AIM in 66 departments between Sept. 16 1997 and Sept. 15 1998. The group included patients admitted within 96 hours after development of complaints with the diagnosis or suspicion of...

[The ECG in prediction of the infarcted artery and left ventricular dysfunction].

D Vorác, P Widimský

Vnitr Lek 2002, 48(Supplement 1):45-50

OBJECTIVE: To assess the possibilities of ECG in prediction of an infarcted artery in patients with acute myocardial infarction (AIM) and evaluate the relationship of left ventricular function to the number of pathological Qs.METHOD: The trial comprises 216 patients with acute myocardial infarction (AMI) treated by primary PTCA. The diagnosis of AIM was confirmed in addition to ECG also by coronarography and elevation of cardiospecific enzymes. On the baseline 12-lead ECG denivelization of the ST segment > 1 mm was considered significant. The number of pathological Q waves on the ECG tracing on discharge was compared with left ventricular function...

[Risk stratification in unstable angina pectoris and non-Q myocardial infarct: anamnesis, physical examination, electrocardiography, specific cardiac markers].

J Veselka

Vnitr Lek 2002, 48(Supplement 1):51-55

Patients with unstable angina pectoris or non Q-infarction of the myocardium are a very heterogeneous group. It comprises patients with angina pectoris which developed for the first time in their life and had only an episodic character, as well as patients with a severe clinical course and prognostically serious coronary finding. In this connection risk stratification of patients is useful as a provision from which the further diagnostic and therapeutic procedure develops. Based on an analysis of anamnestic data, physical examination, electrocardiogram and examination of cardiospecific, biochemical markers we can divide the patients into groups with...

[Role of electrocardiography in the diagnosis of silent myocardial ischemia].

J Vojácek

Vnitr Lek 2002, 48(Supplement 1):56-60

Norman J. Holter attention drew to the possibility to use ambulatory ECG monitoring not only for the diagnosis of arrhythmias but also myocardial ischaemia by already in 1961. It was found that patients with chronic stable angina pectoris have multiple episodes of myocardial ischaemia characterized by transient depressions of the ST segment, very frequently without a clinical correlate. Electrocardiography thus was the first objective method to draw attention to the fact that angina pectoris is associated with approximately one fifth of ischemic episodes of the myocardium in patients with chronic ischaemic heart disease. This was later expressed objectively...

[What does the ECG reveal in infectious endocarditis?].

J Schildberger

Vnitr Lek 2002, 48(Supplement 1):61-63

The electrocardiogram should be recorded at the very beginning of infectious endocarditis. It provides information on the origin and complications of possible organic disease (aortal stenosis--left ventricular hypertrophy). Moreover regular follow up of ECG tracings can reveal changes signalizing spread of the infection beyond the endocardium. Thus the conduction system may be affected--bundle branch block, atrioventricular blocks grade I to III, ectopic functional tachycardia, extrasystoles, myocardium--by development of typical ECG changes during myocardial infarction after embolization of the vegetation into the coronary artery, or last not least,...

[The importance of electrocardiography in cardiomyopathies].

P Gregor

Vnitr Lek 2002, 48(Supplement 1):64-66

The author discusses possibilities and the importance of electrocardiography in different types of cardiomyopathies. ECG plays a fundamental role in particular in hypertrophic cardiomyopathies where it serves for screening. This pertains to fully developed forms as well as to latent morphologically not yet expressed forms and also to some special types of the disease (apical forms). ECG can be a very important method also in right ventricular arrhythmogenic cardiomyopathies (again above all for screening in paroxysmal ventricular tachycardias in left bundle branch block). In other types of cardiomyopathies the importance of ECG is small.

[Electrocardiography after heart transplantation].

J Fabián, E Goncalvesová

Vnitr Lek 2002, 48(Supplement 1):67-71

In the submitted review the authors describe the position and importance of electrocardiographic examination after transplantation of the heart (HTx). They describe findings recorded in animal experiments, typical ECG characteristics after HTx and their importance as well as the clinical application of this method for diagnosis of electrophysiological abnormalities specially in relation to rejection and reinnervation of the graft. The authors' conclusions are based on a critical analysis of relevant data in the literature as well as their own experimental and clinical experience.

[Electrocardiographic changes after heart transplantation].

L Hosková, I Málek, R Krausová, M Podzimková, J Pirk

Vnitr Lek 2002, 48(Supplement 1):72-75

Electrocardiographic (ECG) changes are described after heart transplantation in almost 75% patients. During the early postoperative period the usual finding are conduction disorders which in 3-5% call for implantation of a pacemaker. The most frequent persisting disorder is bundle branch block which is of clinical importance only when it has a progressive character. The incidence of postoperative atrial fibrillation or flutter is lower as compared with other cardiosurgical operations and their sudden development may be associated with acute rejection. Ventricular arrhythmias develop as a rule as a complication of advanced coronary disease of the graft...

[Importance of the ECG for evaluation of severity of pulmonary embolisms].

I Horák, K Dvorák

Vnitr Lek 2002, 48(Supplement 1):76-80

OBJECTIVE: To evaluate whether it is possible on the basis of ECG examination to judge the haemodynamic impact of pulmonary embolism.METHOD: To compare by retrospective analysis of hospital documentation of patients at the medical department the assessed ECG changes with the echocardiographic finding of pulmonary hypertension and right ventricular dilatation. As positive an ECG finding was evaluated involving changes of the ST-T segment in VI-V4, S1Q3T3 negative or right bundle branch block (RBBB). As a positive echocardiographic finding the authors evaluated the size of the right ventricle above 30 mm or the shape of the acceleration curve in...

[Importance of the ECG in pulmonary thromboembolisms in gynecology].

K Janků, N Volková, M Kaprálová

Vnitr Lek 2002, 48(Supplement 1):81-85

The authors analyze the diagnostic value of ECG examination in pulmonary thromboembolism which is a frequent complication in elderly women in postoperative gynaecological departments. They draw attention in particular to the importance of ECG in the differential diagnosis between cor pulmonale acutum and infarction of the inferior and anterior myocardial wall.

[ECG changes in aortic valve defects].

R Cerbák

Vnitr Lek 2002, 48(Supplement 1):86-89

ECG is nowadays no longer the dominant way of diagnosing aortic valve diseases. The basis of accurate diagnosis of these diseases is clinical examination, ECHO and catheterization of the heart, which is essential in the great majority of valve diseases, in particular to rule out coronary changes. ECG is however important for the primary evaluation of left ventricular hypertrophy, left ventricular overburdening, for detection of enlargement or overloading of the left atrium. It is irreplaceable for evaluation of impaired rhythm, or impaired conduction of the impulse. Thus we can prove atrial fibrillation, or flutter bundle branch block, disorders of...

[Evaluation of the ECG recording in abnormal positions of the heart in the thorax].

C Cíhalík

Vnitr Lek 2002, 48(Supplement 1):90-94

Abnormal localization of the heart in the chest is a rare congenital developmental disorder (1,10). Even if the heart is in these instances normally developed, its abnormal position leads in case of its affection by disease to diagnostic and therapeutic difficulties, in particular when an invasive procedure must be used. With regard to the entirely different position of individual cardiac departments it is necessary to differentiate carefully between dextrocardia and dextroversion (15). Dextroposition is only a marginal problem. A very satisfactory diagnostic method in these anomalies is the ECG tracing, where we encounter quite typical pictures. Dextrocardia...

[ECG in the diagnosis of supraventricular tachyarrhythmias].

J Kautzner

Vnitr Lek 2002, 48(Supplement 1):95-102

The development of catheter ablation techniques during the last decade provided new data about the mechanism of supraventricular tachyarrhythmias and at the same time, set new requirements for their classification. An accurate diagnosis of individual SVT can usually be made during an electrophysiologic study that precedes catheter ablation. Nevertheless, clinically acceptable differential diagnosis of SVT can be based on analysis of a standard 12-lead electrocardiogram. This may prove useful especially when selecting optimum antiarrhythmic drug according to a suspected mechanism of arrhythmia. At the same time, electrocardiogram during SVT serves as...

[Advantages and disadvantages of ECG diagnosis in left ventricular hypertrophy].

R Cífková

Vnitr Lek 2002, 48(Supplement 1):103-108

Left ventricular hypertrophy (LVH) develops as a response to press or volume overload of the left ventricle. It is encountered in systemic hypertension, aortal stenosis and aortal insufficiency, mitral valve insufficiency, some congenital cardiac defects and hypertrophic obstructive cardiomyopathy. The most frequent cause of LVH in the adult population is hypertension. Prevalence of left ventricular hypertrophy in hypertensive individuals varies considerably, depending on the applied diagnostic method and characteristic of the group of hypertonic subjects. The presence of ECG signs of LVH is an infaust prognostic sign which at any level of blood pressure...

[The electrocardiogram in patients with implanted cardiac pacemakers].

M Novák, P Kamarýt, J Müllerová

Vnitr Lek 2002, 48(Supplement 1):109-113

In the submitted review the authors present electrocardiographic record of patients with atrial, ventricular and dual-chamber pacemakers. They also describe specially ECG findings in complications of cardiostimulation. Recommended procedures in these situation: changing pacemaker programme or electric cardioversion or surgical solution--reimplantation of pacemaker generator and/or lead or implantation of second lead.

[The importance of electrocardiography in the development of new drugs--prolonged QT intervals as indicators of adverse effects].

P Jerie, P Vít

Vnitr Lek 2002, 48(Supplement 1):114-119

Both experimental animal studies and clinical observations have shown that drugs from various indication areas, such as psychotropic agents and antiarrhythmics can induce disturbances of cardiac rhythm and electrocardiographic abnormalities. Particularly, QT interval prolongation is associated with distinctive polymorphic ventricular tachycardias and often causes syncopes or cardiac arrest that represent a high risk of recurrent events including sudden death. In the last decade, several drugs in different indication areas, possessing these effects were withdrawn from the market and approvals were postponed or even refused. These events led to higher...

[Relation between anthropometric indicators and electrocardiogram variability].

V Regecová, D Andrásyová

Vnitr Lek 2002, 48(Supplement 1):120-129

AIM: To investigate which combination of anthropometrical parameters influence significantly the variability of the magnitude spatial vectors of atrial (sPmax), activation and ventricular (sQRSmax) activation and ventricular depolarization (sTmax). Quantification of these relationships can improve the reliability of criteria for normal values of ECG and VCG characteristics.SUBJECTS AND METHODS: The study group consisted of 195 healthy boys and men without signs of cardiac disease, with normal ECG and VCG, aged from 7 to 70 years, (median = 19 years). Electrocardiologic variables were obtained by Frank lead system in seated persons from a single...

[Will ECG combined with echocardiography detect viable myocardium in patients after myocardial infarct?].

J Spác, H Nĕmcová, J Cerný, I Dvorák

Vnitr Lek 2002, 48(Supplement 1):130-134

The objective of the submitted trial was to use combined examination of ECG at rest and after exercise to detect a viable heart muscle in patients with a postinfarction Q wave and ST elevations. The authors found that according to the character of changes of the ST elevation in ECG after exercise it is not possible to detect patients with a viable myocardium. During the combined procedure using analysis of the kinetic disorder at rest and increase of the ST segment in ECG after exercise it is possible in patients with hypokinesia or akinesia at the site of the Q wave to differentiate successfully 66% patients with a viable heart muscle. This combined...

[Evaluation of the ECG in epidemiologic studies of cardiovascular diseases--the Minnesota code].

H Rosolová, J Simon

Vnitr Lek 2002, 48(Supplement 1):135-138

The authors evaluate the importance of the Minnesota code for description of the ECG curve in epidemiological surveys. The ECG tracing is not evaluated clinically but is only described and changes are summarized into categories marked arbitrarily as minor and major ischaemic changes. In these categories their predictive value is assessed on a longitudinal basis. It was revealed that minor and major ischaemic changes have a predictive value for cardiovascular morbidity and mortality similarly as other risk factors of ischaemic heart disease. The authors mention some epidemiological surveys where the Minnesota code was used. Assessment of the ECG tracing...

[The importance of electrocardiographic changes at rest during exercise in deciding to perform immediate ("ad hoc") percutaneous transluminal coronary angioplasty].

I Riecanský, M Grozajová, V Fridrich, P Chnupa

Vnitr Lek 2002, 48(Supplement 1):139-143

In 100 patients (75 men and 25 women, mean age 53 years) who had "ad hoc" percutaneous transluminal coronary angioplasty (PTCA) on one or two vessels retrospectively the ECG records were evaluated (signs of necrosis or ischaemia) at rest and/or after exercise and compared with the finding of major obstruction (complete occlusion, stenosis > 50%) on coronarography. In obstruction of the ramus interventricularis anterior the positive ECG finding was consistent with the area of the impaired blood supply in 87%, in case of obstruction of the right coronary artery in 79%, in obstruction of the ramus circumflexus in 90%. In concurrent obstruction of two...

[Electrocardiography in the diagnosis of genetic heart diseases--the Brugada syndrome].

A Mádle

Vnitr Lek 2002, 48(Supplement 1):144-146

Electrocardiography celebrates its 100th anniversary but is still a useful and widely used examination method in cardiac diseases. Its importance can be demonstrated on its part in the diagnosis of a relatively newly described disease presented in this paper. It is a genetically conditioned anomaly of sodium channels of the cell membrane, called Brugada syndrome. The latter has a typical electrocardiographic tracing--elevations of the ST segment in leads V1-V3 along with a finding reminding of a right bundle branch block, absence of structural cardiac disease and an increased incidence of serious ventricular arrhythmias and sudden arrhythmic death.

[ST segment elevation in the ECG stress test in coronary disease].

J Simícek, D Michalík

Vnitr Lek 2002, 48(Supplement 1):147-149

The authors investigated in 1986-1991 a group of 122 men after myocardial infarction, their mean age was 56 years, the follow up period 35 and at least 24 months. During the ergometric test "symptom limited" 18 days after the attack it was negative in 55% of the men, in 28% positive (depression of ST and/or coronary pain (and in 17% there were elevations of ST above the pathological Q wave. By the end of the follow up period nobody with a negative baseline test died. 6% with a positive test died, 62% patients with elevation of the ST. All patients with ST had elevations an impaired regional ventricular motility with a low ejection fraction (32%) during...

[Heart rate turbulence--a new ECG predictor for risk of sudden death].

V Melenovský, D Wichterle, J Simek, J Malík

Vnitr Lek 2002, 48(Supplement 1):150-154

Heart Rate Turbulence (HRT) is a newly described physiological chronotropic response of sinus rhythm following a single ventricular premature beat (VPB) consisting of early acceleration and later deceleration of heart rate. Using two large independent cohorts of postinfarction patients, the absence of HRT was retrospectively validated to be a potent multivariate risk predictor, stronger than a number of currently available risk stratifiers. Although exact pathophysiological mechanism of HRT remains speculative, it is now believed that HRT arises from the haemodynamic changes and baroreceptor reflexes that occur following a VPB. Therefore, HRT descriptors...

[ECG mapping in clinical practice].

F Boudík, M Aschermann, Z Anger

Vnitr Lek 2002, 48(Supplement 1):155-163

First the authors present a review of important cornerstones in the history of the electrocardiogram (ECG) and ECG mapping. The first to describe the electric cardiac field based on twenty ECGs was A.D. Waller in 1889. The decisive cornerstone for practical use was the introduction of a string galvanometer in 1901 by W. Einthoven and his triaxial lead system. Another very important cornerstone in the development of ECG were the findings of F.N. Wilson. Merits as regards the development and application of ECG mapping are due to B. Taccardi. Workers of the Second Medical Clinic in Prague enhanced after 15 years of studies and comparison of ECG maps with...

[Effect of adrenergic stimuli on electrocardiographic and vectorcardiographic characteristics of ventricular repolarization].

D Andrásyová, V Regecová, E Kellerová, M Tonkovic

Vnitr Lek 2002, 48(Supplement 1):164-169

Autonomic effect of various stimuli on haemodynamic variables is usually tested by changes in blood pressure (BP) and/or heart rate (HR). It is known that increased sympathetic drive of ventricles can interfere with repolarization process. This study was focused on reactive changes of maximal spatial T vector (sTmax), R-R and QTc intervals, in relation to BP changes in 79 boys and men, averaged age 17 +/- 2 years, 36 from them were adolescents with elevated BP (high normal or hypertension I according to WHO/ISH 1999) (ZTK), 19 normotensives (NTK), and 24 normotensive sportsmen. R-R, QTc intervals and maximal spatial T vector were recorded by a PC (Cardiag...

[The intracardiac electrocardiogram in the diagnosis of arrhythmias].

M Kozák

Vnitr Lek 2002, 48(Supplement 1):170-177

During the last 15 years in arrhythmology brisk development of the use of endocardial electrocardiograms (IECG) occurred. At first the objective was to describe the characteristics of the conduction system of the heart (recording of Hisogram), next assessment of pathological features of the conduction system (such as bradyarrhythmias), electric activation of the myocardium in existing arrhythmias with the outcome of the diagnosis and accurate localization of additional pathways in endocardial mapping. The next logical step reacting to knowledge of intracardial mapping was the development of new therapeutic methods--DC and subsequently radiofrequency...

[Three-dimensional presentation of the electrocardiogram: new possibilities in comparative studies using cardiologic imaging methods].

L Bachárová, A Mateásik, D Chorvát

Vnitr Lek 2002, 48(Supplement 1):178-182

The aim of the study was to demonstrate a biomathematical model for the topographic presentation of orthogonal electrocardiogram DECARTO, to present the possibilities for visualisation and processing of ECG in relation to others cardiological imaging methods. In DECARTO (Dipolar ElectroCARdioTOpography), the orthogonal ECG is used as an input signal, the signal is processed by the means of a biomathematical model and presented as areas of activated points on a spherical surface closely surrounding the heart, so-called decartograms. Decartograms can be visualised using the projection of the spherical image surface onto geometrically defined planar or...

[Lead systems in orthogonal electrocardiography].

J Holcík, J Musil

Vnitr Lek 2002, 48(Supplement 1):183-187

The paper deals with evaluating quality of some orthogonal and pseudoorthogonal electrocardiographic lead systems as Frank lead system, signals derived from standard electrocardiographic leads by Levkov's transform and some signals of the standard 12 lead system that roughly fulfill condition of geometrical orthogonality. The signals of the lead systems were assessed by means of a mathematical criterion of two vector orthogonality which was originally proposed for purposes of electrocardiography and proved by Netusil. Experiments done with signals of the CSE database of short-time rest ECG records have revealed that the best ECG lead orthogonality...

[Orthogonal electrocardiography].

I Ruttkay-Nedecký

Vnitr Lek 2002, 48(Supplement 1):188-191

The orthogonal electrocardiography was a further development of Einthovens conception of electrocardiography. It eliminates the redundancy of the 12-lead ECG and offers a more precise and illustrative image of the model of an equivalent dipole. It was the prerequisite of the development of vectorcardiography. It improves the diagnostic performance of electrocardiology, especially by decreasing the spread of parameters used to characterize normal cardiac electrogenesis. It may be assumed that clinical electrocardiography will not petrify its standard 12-lead system but will utilize the possibilities offered by the more rational lead systems of orthogonal...

[The ECG and acute coronary syndromes in patients under 40 years of age--case reports of an obese smoker in comparison with an active female athlete].

O Ludka, J Spinar

Vnitr Lek 2002, 48(Supplement 1):192-195

The authors describe two cases of acute coronary syndrome by patients to the age of 40, of which anamnestical data and clinical manifestation were quite different. According to present recommendation of European Society of Cardiology neither one of them fulfilled standards for acute or created myocardial infarction. The discovery of ECG changes or echocardiographical findings lead to an introducing of coronarography examination that proved the important stenosis of coronary arteries and both cases were closed as a created (case 1) and acute (case 2) myocardial infarction.

[The electrocardiogram in primary pulmonary hypertension].

J Murín, S Kinová, J Jaber, J Bulas

Vnitr Lek 2002, 48(Supplement 1):196-200

Primary pulmonary hypertension is a rare disease characterized by a rise of arterial pressure in the pulmonary artery without a known cause. The authors define, based on a case-history, the etiopathogenesis of the disease, its diagnosis and approach to treatment. They analyze the contribution of ECG examination for detection of right ventricular hypertrophy and for monitoring the therapeutic success with the finding above all of repolarization changes in the right precordium. The patient had a transplantation of the lungs.

[Complete atrioventricular block (with Adams-Stokes syndrome) in systemic connective tissue disease. Electrocardiographic development in three patients].

J Vachtenheim

Vnitr Lek 2002, 48(Supplement 1):201-205

The association of high grade atrioventricular heart block with systemic connective tissue diseases is very rare. To date, only sporadic case reports or reviews appeared in the literature. Three cases of such association observed by the author are described here. The patients were a 51 years old man with systemic sclerosis and two women, a 64 years old patient with visceral nodous seropositive rheumatoid arthritis, and second was a 74 years old patient with systemic lupus erythematosus, the oldest of the group of patients with this disease. In two of the three patients, Adams-Stokes attack was a cause of death. The author did not observe this high...

[The deceptiveness of the electrocardiographic image in patients with Wolff-Parkinson-White syndrome].

J Ulrich

Vnitr Lek 2002, 48(Supplement 1):206-209

The urgent character of the clinical importance of the Wolff-Parkinson-White syndrome is among others also due to some treacherous characteristics of the electrocardiographic tracing. Three of them are mentioned in the submitted paper. The lability of the electrocardiographic tracing--spontaneous and induced--makes sometimes early detection difficult. The risk of confounding the ECG tracing of Wolff-Parkinson-White syndrome with myocardial infarction is considerable and sometimes underrated. Diagnosis of the ECG picture of myocardial infarction in a subject with Wolff-Parkinson-White syndrome may be associated with great difficulties. The electrocardiographic...

[Is the negative T-wave on the ECG always a sign of ischemia? (human stress cardiomyopathy?) ].

V Rozsíval

Vnitr Lek 2002, 48(Supplement 1):210-212

A 74-year-old woman was admitted on account of chest pain which developed after a death in the family. On the ECG on admission there were negative T waves (the picture of extensive subapicardial ischaemia). Coronarography made on the subsequent day was quite normal. The laboratory finding (CK, CK-MB, AST) did not suggest an acute coronary attack. Ultrasound examination of the heart revealed only slight hypokinesia of the anterior wall. ECG returned to normal within 3 months. Four years later the patient is asymptomatic. The ECG finding and clinical course suggest the clinical entity of "stress cardiomyopathy", which is not a well known and unequivocally...

[The signal-averaged ECG in long-term monitoring of patients with fulminant myocarditis].

J Kvasnicka, Z Tusl, J Ceral, A Babu

Vnitr Lek 2002, 48(Supplement 1):213-215

A case of a 24 year-old patient with fulminant myocarditis is described. The lymphocytic myocarditis was proved by endocardial biopsy. The patient had been followed for 15 months clinically, by transthoracic ultrasound and by the signal averaged ECG. The clinical and ultrasound parameters of the left ventricular systolic dysfunction subsided within 6 months, STT changes on the routine 12-lead ECG within 2 months. On the signal-averaged ECG, changes were observed in both the time and in the frequency domain. When the results of the initial examination (6 weeks after the beginning of the disease) were compared with the examination at the 7th month of...

[Signs of extreme vagotonia in the electrocardiogram of an Olympic 5km running champion].

J Chrástek

Vnitr Lek 2002, 48(Supplement 1):216-219

Hypokinesia (lack of exercise)--a disease caused by lack of physical activity leads among others to a predominance of the sympathetic nerve in the circulation. Its manifestations are briefly described according to Kraus-Raab's hypothesis of 1961. The opposite of a hypokinetic man are trained (hyperkinetic) sportsmen, in particular long-distance runners. Their neurovegetative balance is shifted to the side of the vagus (parasympathetic nerve). This is described as training vagotonia. On the example of ECG tracings of an Olympic 5 km runner, the Tunisian Mohamed Gammoudi, the author describes its manifestations at rest, during the orthostatic test and...