János Tomcsányi - Academia.edu (original) (raw)
Papers by János Tomcsányi
... Br Heart J 1991;66:3724. 4 Redington AN, Penny D, Shinebourne EA. ... the subject (not cited... more ... Br Heart J 1991;66:3724. 4 Redington AN, Penny D, Shinebourne EA. ... the subject (not cited) is included in the Sec-ond European Workshop in Aviation Cardiology.6 MICHAEL JOY St Peters Hospital Guildford Road Chertsey Surrey KT16 0PZ, UK 1 Treasure T, Janvrin S ...
Journal of the Autonomic Nervous System, 1994
![Research paper thumbnail of [Role of implantable loop recorder in the clinical diagnosis of syncope: Results of the introduction of an effective diagnostic tool]](https://attachments.academia-assets.com/39456319/thumbnails/1.jpg)
](Orvosi hetilap, 2015
Extension of electrocardiographic monitoring via loop recorder implantation may increase the diag... more Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. There were 52 loop recorder implantations within the study period. During the 167 (±136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. The high diagnostic rate of ...
The American journal of emergency medicine, 2015
Patients with acute abdominal or acute thoracic events occasionally develop a curious electrocard... more Patients with acute abdominal or acute thoracic events occasionally develop a curious electrocardiographic ST-segment elevation, where the upward shift of the baseline starts before the onset of the QRS complex. The shape of the complexes resembles a German military spiked helmet. It has been previously postulated that the “spiked helmet” sign is the result of an acute rise in intraabdominal or intrathoracic pressure causing pulsatile epidermal stretch that is in concert with the cardiac cycle. Here, we present 2 cases, where recognition of the spiked helmet sign led to immediate discovery of the underlying pathology. Removal of a large epigastric content resulted in the prompt resolution of the spiked helmet sign in the inferior leads, whereas suctioning of a large pneumothorax lead to the gradual disappearance of the spiked helmet sign in the chest leads. These cases provide the first definitive proof of a mechanical, noncardiac etiology of the spiked helmet sign.
Heart (British Cardiac Society), 2004
Orvosi hetilap, Jan 8, 2002
It is well known that the incidence of atrial fibrillation increased with age over 65 years. Howe... more It is well known that the incidence of atrial fibrillation increased with age over 65 years. However the role and incidence of atrial fibrillation in the admission in the regional hospital was not investigated. The aim of the study was to investigate the incidence, the commonest presenting features, associated cardiac conditions and the different types of atrial fibrillation which were admitted to our regional hospital during the last 10 month. The incidence of atrial fibrillation was 13% (mean age: 71 years). The presenting features were dyspnea (28%), palpitation (25%), heart failure (19%), angina (10%), syncope/vertigo (5%), symptoms-free (13%). The most frequently associated cardiac condition was hypertension (64%). The patients were treated with the following antiarrhythmic drugs: beta-adrenergic blocker: 25%, propafenon (15%), propafenon and beta-adrenergic blocker (25%), sotalol (17%), amiodarone (13%), others (5%). Nowadays atrial fibrillation is still a remarkable percentag...
Orvosi hetilap, Jan 31, 2002
High dose of angiotensin converting enzyme inhibitor is indicated in the treatment of heart failu... more High dose of angiotensin converting enzyme inhibitor is indicated in the treatment of heart failure and it is part of the treatment in the patients suffering from diabetes mellitus and nephropathy. The patients with preexisting renal insufficiency could have slowly elevated serum potassium level treated by angiotensin converting enzyme inhibitor. Seven acute admitted cases is presented with severe hyperkalaemia and life threatening arrhythmias caused by ACEI administration. Wide QRS accelerated rhythm was detected in two cases and bradyarrhythmias in five cases. Two patients died among the bradyarrhythmias. The authors call the attention of danger of high dose angiotensin converting enzyme inhibitor in patients with preexisting renal insufficiency and concomittant drugs elevating serum potassium level.
Pacing and Clinical Electrophysiology, 2007
A 72-year-old female patient had been having two or three episodes each year of spontaneously ter... more A 72-year-old female patient had been having two or three episodes each year of spontaneously terminated palpitations with a rapid heartbeat. She had no history of heart disease. On the day of her admission, she had an attack of tachycardia lasting over an hour and accompanied by an increasing shortness of breath. Prehospital electrocardiogram (ECG) revealed a narrow-QRS tachycardia. Carotid massage and adenosine (a 6-mg and a 12-mg iv. bolus) did not terminate the arrhythmia and the patient was referred to us for admission.
Pacing and Clinical Electrophysiology, 2005
Pacing and Clinical Electrophysiology, 1999
We present a case of early (within the first 24 hours) development of malignant torsades de point... more We present a case of early (within the first 24 hours) development of malignant torsades de pointes (TdP) associated with intravenous amiodarone therapy. After correction of predisposing factors (heart failure, hypokalemia, digoxin) amiodarone again resulted in torsades. This observation suggests that in patients who have experienced amiodarone-induced proarrhythmia, amiodarone administration under different, more stable clinical conditions may still be hazardous.
Mayo Clinic Proceedings, 2012
Journal of Electrocardiology, 1996
The cases of two patients with ventricular parasystole revealed a new depressive effect of adenos... more The cases of two patients with ventricular parasystole revealed a new depressive effect of adenosine on ventricular parasystolic activity. To the authors' knowledge, this is the first report that clearly demonstrates the disappearance of "true" parasystole.
Journal of Electrocardiology, 2009
Discriminating among the various coronary obstruction patterns influences early management decisi... more Discriminating among the various coronary obstruction patterns influences early management decisions. One of the most important tasks is the identification of ST-elevation myocardial infarction caused by left main occlusion. We present a case of single-lead ST-segment elevation in aVR caused by acute left main coronary artery occlusion.
Journal of Electrocardiology, 2011
Journal of Electrocardiology, 2008
26. Nelwan SP, Kors JA, Crater SW, et al. Simultaneous comparison of 3 derived 12-lead electrocar... more 26. Nelwan SP, Kors JA, Crater SW, et al. Simultaneous comparison of 3 derived 12-lead electrocardiograms with standard electrocardiogram at rest and during percutaneous coronary occlusion. J Electrocardiol 2008;41:230. 27. Feild DQ, Feldman CL, Horáček BM. Improved EASI coefficients: their derivation, values, and performance. J Electrocardiol 2002;35 (Suppl):23. 28. Horáček BM, Warren JW, Field D, Feldman CL. Statistical and deterministic approaches to designing transformations of electrocardiographic leads. J Electrocardiol 2002;35(Suppl):41. 29. Feild QD, Zhou SH, Gregg RE, Lindauer JM, Helfenbein ED. Technical challenges and future directions in lead reconstruction for reduced lead systems. J Electrocardiol 2008;41:xxx.
Journal of Cardiovascular Electrophysiology, 2002
A 65-year-old man was hospitalized for progressive dyspnea and palpitation. His past medical hist... more A 65-year-old man was hospitalized for progressive dyspnea and palpitation. His past medical history was unremarkable except for implantation of a VVI pacemaker for symptomatic carotid sinus hypersensitivity and hypertension. Prior ECGs showed normal QT and QTc intervals. The patient was not taking any drugs that are known to affect repolarization. The admission ECG revealed atrial brillation with rapid ventricular response at 140 beats/min. The QT intervals measured 0.36 seconds. Echocardiography demonstrated mild global hypokinesis with a left ventricular ejection fraction of 0.40. Hematologic, biochemical, and electrolyte analyses were unrevealing.
Journal of Cardiovascular Electrophysiology, 2004
Journal of Cardiovascular Electrophysiology, 2007
Journal of Cardiovascular Electrophysiology, 2014
... Br Heart J 1991;66:3724. 4 Redington AN, Penny D, Shinebourne EA. ... the subject (not cited... more ... Br Heart J 1991;66:3724. 4 Redington AN, Penny D, Shinebourne EA. ... the subject (not cited) is included in the Sec-ond European Workshop in Aviation Cardiology.6 MICHAEL JOY St Peters Hospital Guildford Road Chertsey Surrey KT16 0PZ, UK 1 Treasure T, Janvrin S ...
Journal of the Autonomic Nervous System, 1994
Orvosi hetilap, 2015
Extension of electrocardiographic monitoring via loop recorder implantation may increase the diag... more Extension of electrocardiographic monitoring via loop recorder implantation may increase the diagnostic yield of syncope work-up. In this retrospective observational study, the authors wanted to evaluate the diagnostic performance of implantable loop recorder in the everyday clinical practice. The authors analyzed the electronically stored data of all patients who underwent loop recorder implantation between 2005 and 2014 in their cardiology department because of recurrent syncope of undetermined origin. There were 52 loop recorder implantations within the study period. During the 167 (±136) days of monitoring, 36 (69.2%) diagnostic events occurred. In two-thirds of events, (46.2% of all monitored patients) a specific arrhythmia diagnosis was reached, allowing definitive treatment in these cases. In this selected population, there was no correlation between age, presence of known high-risk predictors, or accompanying trauma, and the mechanism of syncope. The high diagnostic rate of ...
The American journal of emergency medicine, 2015
Patients with acute abdominal or acute thoracic events occasionally develop a curious electrocard... more Patients with acute abdominal or acute thoracic events occasionally develop a curious electrocardiographic ST-segment elevation, where the upward shift of the baseline starts before the onset of the QRS complex. The shape of the complexes resembles a German military spiked helmet. It has been previously postulated that the “spiked helmet” sign is the result of an acute rise in intraabdominal or intrathoracic pressure causing pulsatile epidermal stretch that is in concert with the cardiac cycle. Here, we present 2 cases, where recognition of the spiked helmet sign led to immediate discovery of the underlying pathology. Removal of a large epigastric content resulted in the prompt resolution of the spiked helmet sign in the inferior leads, whereas suctioning of a large pneumothorax lead to the gradual disappearance of the spiked helmet sign in the chest leads. These cases provide the first definitive proof of a mechanical, noncardiac etiology of the spiked helmet sign.
Heart (British Cardiac Society), 2004
Orvosi hetilap, Jan 8, 2002
It is well known that the incidence of atrial fibrillation increased with age over 65 years. Howe... more It is well known that the incidence of atrial fibrillation increased with age over 65 years. However the role and incidence of atrial fibrillation in the admission in the regional hospital was not investigated. The aim of the study was to investigate the incidence, the commonest presenting features, associated cardiac conditions and the different types of atrial fibrillation which were admitted to our regional hospital during the last 10 month. The incidence of atrial fibrillation was 13% (mean age: 71 years). The presenting features were dyspnea (28%), palpitation (25%), heart failure (19%), angina (10%), syncope/vertigo (5%), symptoms-free (13%). The most frequently associated cardiac condition was hypertension (64%). The patients were treated with the following antiarrhythmic drugs: beta-adrenergic blocker: 25%, propafenon (15%), propafenon and beta-adrenergic blocker (25%), sotalol (17%), amiodarone (13%), others (5%). Nowadays atrial fibrillation is still a remarkable percentag...
Orvosi hetilap, Jan 31, 2002
High dose of angiotensin converting enzyme inhibitor is indicated in the treatment of heart failu... more High dose of angiotensin converting enzyme inhibitor is indicated in the treatment of heart failure and it is part of the treatment in the patients suffering from diabetes mellitus and nephropathy. The patients with preexisting renal insufficiency could have slowly elevated serum potassium level treated by angiotensin converting enzyme inhibitor. Seven acute admitted cases is presented with severe hyperkalaemia and life threatening arrhythmias caused by ACEI administration. Wide QRS accelerated rhythm was detected in two cases and bradyarrhythmias in five cases. Two patients died among the bradyarrhythmias. The authors call the attention of danger of high dose angiotensin converting enzyme inhibitor in patients with preexisting renal insufficiency and concomittant drugs elevating serum potassium level.
Pacing and Clinical Electrophysiology, 2007
A 72-year-old female patient had been having two or three episodes each year of spontaneously ter... more A 72-year-old female patient had been having two or three episodes each year of spontaneously terminated palpitations with a rapid heartbeat. She had no history of heart disease. On the day of her admission, she had an attack of tachycardia lasting over an hour and accompanied by an increasing shortness of breath. Prehospital electrocardiogram (ECG) revealed a narrow-QRS tachycardia. Carotid massage and adenosine (a 6-mg and a 12-mg iv. bolus) did not terminate the arrhythmia and the patient was referred to us for admission.
Pacing and Clinical Electrophysiology, 2005
Pacing and Clinical Electrophysiology, 1999
We present a case of early (within the first 24 hours) development of malignant torsades de point... more We present a case of early (within the first 24 hours) development of malignant torsades de pointes (TdP) associated with intravenous amiodarone therapy. After correction of predisposing factors (heart failure, hypokalemia, digoxin) amiodarone again resulted in torsades. This observation suggests that in patients who have experienced amiodarone-induced proarrhythmia, amiodarone administration under different, more stable clinical conditions may still be hazardous.
Mayo Clinic Proceedings, 2012
Journal of Electrocardiology, 1996
The cases of two patients with ventricular parasystole revealed a new depressive effect of adenos... more The cases of two patients with ventricular parasystole revealed a new depressive effect of adenosine on ventricular parasystolic activity. To the authors' knowledge, this is the first report that clearly demonstrates the disappearance of "true" parasystole.
Journal of Electrocardiology, 2009
Discriminating among the various coronary obstruction patterns influences early management decisi... more Discriminating among the various coronary obstruction patterns influences early management decisions. One of the most important tasks is the identification of ST-elevation myocardial infarction caused by left main occlusion. We present a case of single-lead ST-segment elevation in aVR caused by acute left main coronary artery occlusion.
Journal of Electrocardiology, 2011
Journal of Electrocardiology, 2008
26. Nelwan SP, Kors JA, Crater SW, et al. Simultaneous comparison of 3 derived 12-lead electrocar... more 26. Nelwan SP, Kors JA, Crater SW, et al. Simultaneous comparison of 3 derived 12-lead electrocardiograms with standard electrocardiogram at rest and during percutaneous coronary occlusion. J Electrocardiol 2008;41:230. 27. Feild DQ, Feldman CL, Horáček BM. Improved EASI coefficients: their derivation, values, and performance. J Electrocardiol 2002;35 (Suppl):23. 28. Horáček BM, Warren JW, Field D, Feldman CL. Statistical and deterministic approaches to designing transformations of electrocardiographic leads. J Electrocardiol 2002;35(Suppl):41. 29. Feild QD, Zhou SH, Gregg RE, Lindauer JM, Helfenbein ED. Technical challenges and future directions in lead reconstruction for reduced lead systems. J Electrocardiol 2008;41:xxx.
Journal of Cardiovascular Electrophysiology, 2002
A 65-year-old man was hospitalized for progressive dyspnea and palpitation. His past medical hist... more A 65-year-old man was hospitalized for progressive dyspnea and palpitation. His past medical history was unremarkable except for implantation of a VVI pacemaker for symptomatic carotid sinus hypersensitivity and hypertension. Prior ECGs showed normal QT and QTc intervals. The patient was not taking any drugs that are known to affect repolarization. The admission ECG revealed atrial brillation with rapid ventricular response at 140 beats/min. The QT intervals measured 0.36 seconds. Echocardiography demonstrated mild global hypokinesis with a left ventricular ejection fraction of 0.40. Hematologic, biochemical, and electrolyte analyses were unrevealing.
Journal of Cardiovascular Electrophysiology, 2004
Journal of Cardiovascular Electrophysiology, 2007
Journal of Cardiovascular Electrophysiology, 2014