Preferencje help
Polish version English version Język
Widoczny [Schowaj] Abstrakt
Liczba wyników

Znaleziono wyników: 7

Liczba wyników na stronie
Pierwsza strona wyników Pięć stron wyników wstecz Poprzednia strona wyników Strona / 1 Następna strona wyników Pięć stron wyników wprzód Ostatnia strona wyników

Wyniki wyszukiwania

help Sortuj według:

help Ogranicz wyniki do:
Pierwsza strona wyników Pięć stron wyników wstecz Poprzednia strona wyników Strona / 1 Następna strona wyników Pięć stron wyników wprzód Ostatnia strona wyników
1
Content available remote

Pathophysiological mechanism of cardiac arrhytmias as a key for optimal nonpharmacological treatment

100%
Kozluk E.
Journal of Physiology and Pharmacology. Supplement
|
2006
|
tom 57
|
nr 11
69-77
Pathological automatism and triggered activity had focal origin. Thus, the treatment has to be aimed at ablation of the arrhythmogenic region. Some arrythmogenic places can be precisely characterized by analysis of ECG patterns. Among them are foci located close to the pulmonary veins, sinus node, ventricular outflow tracts or mitroaortic commissura. Classical ablation of these loci is highly successful. In other types of focal arrhythmias electroanatomical systems make possible to create 3D map, with activation sequence allowing for identification of the place where the arrhythmia could be eliminated. In reentrant mechanism of the arrhythmia the impulse circulates around the loop via the cardiac muscle. In case of the atrioventricular nodal reentrant tachycardia, atrial flutter or bundle branch ventricular tachycardia the loop can be easily outlined. Ablation can be performed using the anatomical method without induction of the tachycardia. In patients with the ventricular tachycardia with multiple forms or hemodynamically unstable it is possible to perform electranatomical map with visualization of the scar and the border zones. In this case the proarrhythmic region in the borderline zone is the aim of linear ablation without induction of tachycardias. In the chaotic tachycardias (atrial or ventricular fibrillation), the arrythmogenic substrate is too much dispersed to destroy them. Therefore, the ablation is aimed at the trigger which is initiating the arrhythmia (for instance the pathological Purkinje fibers). The excitability of the substrate may be also modified by pacemakers (ventricular or atrial resynchronization). In the life-threatening arrhythmias implantable cardioverter-defibrillator is necessary.
2

Morphology of the tendon of Todaro within the human heart in ontogenesis

51%
Kozlowski D., Grzybiak M., Kozluk E., Owerczuk A.
Folia Morphologica
|
2000
|
tom 59
|
nr 3
The tendon of Todaro, found in the right atrium of the heart, has considerable clinical importance in the fields of both cardiac surgery and invasive cardiology. The goal of this study was to examine the occurrence and degree of development of the tendon of Todaro in humans. Research was conducted on material consisting of 160 human hearts of both sexes from the age of 14 Hbd to 87 years of age. Classical anatomical methods were used and histological sections were prepared from 100 hearts of various age groups stained with Masson’s method in Goldner’s modification. The tendon of Todaro occurred in all examined hearts. In foetal hearts, in the area typical of the course of the tendon of Todaro, a very well-developed, white structure was observed, convexed into the lumen of the atrium. Histologically, this was young fibrous tissue with a characteristically large number of fibroblasts. Evenly in infants and newborns, a visible convex structure was also observed extending into the lumen of the right atrium, however, to a lesser degree than in foetuses. In the group of hearts of young adults, it was also possible to follow the course of the tendon of Todaro macroscopically. However, the older the heart was, the less the convex was visible, and in older adults it was completely invisible. In histological sections, it was observed that with ageing the number of connective tissue cells decreased, and fibres forming the lining increased. In the hearts of older adults the tendon of Todaro formed very small ribbons of connective tissue. Histologically, only small numbers of cellular elements were noticed. In the adult heart the examined tendon was located the deepest and did not connect to the endocardium. We can conclude that the tendon of Todaro is a stable structure, occurring in all examined hearts even when it is not macroscopically visible. Due to the morphological changes that affect the tendon of Todaro in human ontogenesis, for the cardiac surgeon, its relevance as an important topographical structure in the hearts of older adults is minimal.
3

The middle cardiac vein as a key for 'posteroseptal' space - a morphological point of view

39%
Kozlowski D., Kozluk E., Piatkowska A., Maruszak H., Gawrysiak M., Grzybiak M., Walczak F.
Folia Morphologica
|
2001
|
tom 60
|
nr 4
293-296
About 25% of accessory pathways (AP) run via “posteroseptal” space (PSS). There are three approaches for ablation of these pathways: from the right atrium, from the left atrium or from the ventricle and coronary sinus (CS). However in some cases AP is too far from all of them. Catheterisation of the middle cardiac vein (MCV) seems to be the only chance for successful ablation. Our aim was to evaluate the topography of the MCV in PSS. Classical anatomical investigation was carried out on the autopsy material of 98 consecutive human hearts (42 F, 56 M; age 57 ± 21 yrs). It was supported by transverse section performed under coronary sinus. Regions just behind the atrioventricular septum and behind the cavities were respectively classified as “septal”, right (RP) and left posterior (LP). Between them right (RPS) and left posteroseptal areas (LPS) were present. At the posterior view of the heart the angle between CS and MCV ranged from 75 to 90° in 62% of hearts, 60–75° in 18%, 30–60° in 10% and 90–130° in 10%. In 16% MCV ran via the “septal” region, 59% — LPS, 10% — RPS, 10% — RP and 5% — LP. At the ostium of 58% MCV a valve was observed, however there was no trouble with insertion of the 6F catheter into it. We concluded that it is possible to insert the 6F catheter into MCV, which makes it possible to perform ablation of epicardial postero-inferior accessory pathways. The origin of MCV is usually located in the left “posteroseptal” region and runs towards the left side of the posterior wall.
4

Histologic evaluation of the atrioventricular nodal artery in healthy humans and in patients with conduction disturbances

39%
Kozlowski D., Owerczuk A., Kozluk E., Grzybiak M., Adamowicz-Kornacka M., Walczak E., Walczak F.
Folia Morphologica
|
2000
|
tom 59
|
nr 3
The anatomy of the conduction system of the heart so relevant in the contemporary invasive cardiology is not fully understood. It has turned out that ablation procedures bring new information as to its structure and function, but in some cases can result in complete a-v block. Atrioventricular nodal artery located within the nodal-perinodal tissue can probably be damaged during the ablation procedures. Therefore, we decided to explore in detail the morphology and the topography of the atrioventricular nodal artery in healthy humans and in patients with clinical traits of a-v conduction disturbances requiring permanent pacing. The microscopic study was carried out on 30 normal human hearts specimens (17F, 3M) from 17 to 86 years of age, and on 20 hearts with conduction disturbances (11F, 9M) from 39 to 85 years of age. We found that the number of the atrioventricular node arteries is different and independent of the extent that induces block causing conduction disturbances. The topography of the artery in perinodal zone was consistent in normal hearts, yet in hearts with conduction disturbances we observed about 2% of deviations in its location. It might be the reason for generation of iatrogenic complications after invasive cardiological procedures. The morphology revealed changes in 50% of the examined hearts and their vessel walls, which was declared to be connected with ageing. This correlated with certain stages of atherosclerosis as well as hypertension characteristic of elderly patients. We observed that in 33% of hearts from control group small parietal thrombi were detected and in 60% of paced group respectively. Hence, it seems that the procedures in perinodal zone should be performed in its proximal part because of a minor probability of direct and indirect (through nodal artery) damage of the atrioventricular structure of the junction.
5

Morphology of the atrioventricular node in relation to the mechanism of atrioventricular nodal reentry tachycardia - a preliminary report

39%
Kozlowski D., Kozluk E., Kolodziej P., Grochowski P., Grzybiak M., Walczak F.
Folia Morphologica
|
1996
|
tom 55
|
nr 4
6

The morphological conditions of the permanent pacemaker lead extraction

33%
Kozlowski D., Dubaniewicz A., Kozluk E., Grzybiak M., Krupa W., Kolodziej P., Pazdyga A., Adamowicz-Kornacka M., Walczak E., Walczak F.
Folia Morphologica
|
2000
|
tom 59
|
nr 1
Pacemaker lead extraction is the treatment of choice in infectious complications regarding implantation procedure. The purpose of this study was to estimate the safety of the extraction in relation to the morphological changes of the pacing electrode. Research was carried out on materials consisting of 60 human hearts from 45 to 95 years of age (average 63 ± 15 yrs), with VVI or DDD pacing (pacing duration 84 ± 26 months) fixed in a formalin solution. Classical macroscopic anatomical methods were applied. In 44 hearts (73.3%) from the investigated group the posterior tricuspid leaflet was thickened only, and in 24 of these hearts the process regarded not only posterior leaflet but also the septal one and especially commissure between them. In 52 hearts (86.6%) inflammatory reaction spread also to the neighbouring part of the electrode. The length of the neointima-inflammatory tissue ranged from 4 to 8 mm (average 5 ± 2 mm). On the tip of the electrode in the right ventricle cavity in 56 hearts (93.3%) we observed that endocardial leads were surrounded by fibrous thickening , and partially covered by endocardial tissue. We concluded that from the anatomical point of view the extraction of the pacing electrode seems to be questionable, especially in long-term permanent pacing. The experimental traction shows that only recently implanted electrodes were removed without any complications and in others with fraction of the tip, myocardial tissue avulsion or such removal was not successful at all.
7

Preliminary evaluation of the topography of the his bundle with regards to ablation procedures

33%
Kolodziej P., Kozlowski D., Kozluk E., Grochowski P., Adamowicz M., Grzybiak M., Walczak E., Walczak F., Krus S.
Folia Morphologica
|
1996
|
tom 55
|
nr 4
Pierwsza strona wyników Pięć stron wyników wstecz Poprzednia strona wyników Strona / 1 Następna strona wyników Pięć stron wyników wprzód Ostatnia strona wyników
JavaScript jest wyłączony w Twojej przeglądarce internetowej. Włącz go, a następnie odśwież stronę, aby móc w pełni z niej korzystać.