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Papers by Wolfgang Scheibelhofer
European Heart Journal, 1988
The survival rate of 2256 patients with pacemakers was analyzed. Patients paced for Adams-Stokes ... more The survival rate of 2256 patients with pacemakers was analyzed. Patients paced for Adams-Stokes equivalents (e.g. dizziness) showed a significantly better survival rate than did patients with pacemakers implanted for Adam-Stokes attacks or heart failure (P less than 0.0001). The estimated survival of the latter two groups did not differ significantly. Of the deceased patients who had received a pacemaker for the treatment of heart failure, 54% died due to this condition despite pacemaker implantation. The relative percentage of cases of sudden death after pacemaker implantation was high in the groups with Adams-Stokes attacks (12%) and Adams-Stokes equivalents (13%). In patients paced for Adams-Stokes attacks, sudden death occurred more frequently in the first year after pacemaker implantation (P less than 0.015) than during the following years. Therefore, increased efforts should be made to monitor patients carefully after pacemaker implantation to enable prompt detection of malignant tachyarrhythmias, probably the cause of sudden death in a substantial number of patients with pacemakers.
Acta medica Austriaca, 1982
Hemodynamic advantages led to an increasing number of implantations of so called "physiologi... more Hemodynamic advantages led to an increasing number of implantations of so called "physiologic pacemakers", which preserve the natural sequence of atria and ventricles. The growing complexity of these systems renders ECG evaluation increasingly difficult. 85 patients had physiologic pacemakers implanted during the last 4 years and were controlled in our pacemaker outpatient clinic. Typical problems in ECG evaluation of the different pacemaking modes are discussed.
Acta medica Austriaca, 1982
We investigated 76 patients with carotid sinus syndrome followed over a time period of 12-40 mont... more We investigated 76 patients with carotid sinus syndrome followed over a time period of 12-40 months (mean 24 months). In 27 patients long-term ECG were recorded over 24 hours continuously. Carotid Doppler sonography was performed in all patients. 14 patients were studied electrophysiologically. The long-term ECG examinations in patients with carotid sinus syndrome showed a significant tendency to nocturnal bradycardia, and normal heart frequency during the day. In 41% of patients extracranial obstruction of internal carotid arteries could be demonstrated. During carotid sinus massage was a significant increase of the AH time, but there was no significant changes of the HV time. 12 out of 14 patients (86%) developed an AV-block during carotid sinus massage and atrial pacing. In 31 patients pacemakers were implanted. The indication for pacemaker implantation was the clinical symptom of syncope. These patients were observed over a period of 15-40 months (mean 24 months). 15 patients we...
Wiener klinische Wochenschrift, Jan 20, 1984
We compared the life expectancy of 1559 patients with an implanted pacemaker (PM) with a normal a... more We compared the life expectancy of 1559 patients with an implanted pacemaker (PM) with a normal age-matched population and found a significantly reduced survival rate in paced patients. Patients paced for heart failure have the lowest survival rate, whilst those paced for Adams-Stokes attacks do slightly better. Patients with Adams-Stokes equivalents do not differ significantly from our normal population. 54% of patients with PM implanted for heart failure died due to heart failure despite PM implantation. The relative percentage of sudden death after PM implantation is high in groups with Adams-Stokes attacks (16%) and Adams-Stokes equivalents (20%). In both of these groups sudden death occurred especially during the first two years after PM implantation. The high risk of sudden death after PM implantation should increase our efforts to monitor patients carefully after PM implantation for the occurrence of malignant tachyarrhythmias.
Wiener klinische Wochenschrift, Jan 12, 1986
Initial experience of His-bundle ablation is presented in 12 patients with intractable supraventr... more Initial experience of His-bundle ablation is presented in 12 patients with intractable supraventricular arrhythmias which were not amenable to treatment with conventional drugs. In 8 patients His-bundle ablation resulted in total AV-block and in 2 patients significant improvement without total AV-block was achieved. During long-term follow-up (mean 5.3 months) tachycardia recurred in 1 patient with total AV-block resulting in an overall success rate of 75%. A permanent pacemaker was implanted in 10 patients. 1 patient developed deep leg vein thrombosis as a direct result of this procedure and in 2 patients there were complications due to pacemaker implantation. His-bundle ablation appears to be a promising tool in the management of intractable supraventricular tachycardia.
Pediatric Cardiology, 1987
After repair of coarctation, exercise testing was performed in 20 patients with an isolated coarc... more After repair of coarctation, exercise testing was performed in 20 patients with an isolated coarctation (group I) and in 26 with additional congenital cardiac malformations (group II). Ages at time of operation were significantly different in both groups (7.9 +/- 6.0 years in group I; 4.6 +/- 3.8 years in group II; p less than or equal to 0.01). Simultaneous blood pressures were obtained from upper and lower limbs at rest and after exercise. There was no significant difference regarding the systolic blood pressures at rest (122.5 +/- 15.6 mmHg in group I versus 119 +/- 15.8 mmHg in group II). Seven (14%) of the patients were hypertensive; five of them had blood pressure gradients between arms and legs of 15-45 mmHg. But the gradients at rest were found to be significantly different in both groups (9.0 +/- 10.5 mmHg in group I; 18.5 +/- 16.1 mmHg in group II; p less than or equal to 0.05). Six patients, all in group II, had gradients greater than or equal to 30 mmHg at rest. After exercise there were no significant differences in systolic blood pressure and gradients in both groups. Values for blood pressures and gradients at rest and after exercise showed a positive correlation (blood pressure r = 0.76, p less than or equal to 0.001; gradient r = 0.44, p less than or equal to 0.01). Thus exercise testing can provide valuable information about blood pressure and gradient changes during physical activity, but angiography is required to reveal restenosis or residual stenosis.
Pacing and Clinical Electrophysiology, 1982
Induction of ventricular tachycardia by pacemaker programming. The induction of ventricular tachy... more Induction of ventricular tachycardia by pacemaker programming. The induction of ventricular tachycardia or ventricular fibrillation by competitive pacing, especially in the setting of acute myocardial ischemia, is well known. A case of ventricular tachycardia induced by a multiprogrammabie unipolar cathodai ventricular pacemaker is reported. The arrhythmia was caused by reprogramming, which necessitates a short switch to fixed rate pacing in this modei (Spectrax 5985 SX). This potential hazard is not well established in patients with unipolar pacemakers. The use of the magnet as one of the preconditions for reprogramming should be ovoided in future pacemakers.
Pacing and Clinical Electrophysiology, 1984
Pacing and Clinical Electrophysiology, 1983
Wiener klinische Wochenschrift, Jan 28, 1984
Amiodarone (AM) is one of the most potent antiarrhythmic drugs, the value of which is limited by ... more Amiodarone (AM) is one of the most potent antiarrhythmic drugs, the value of which is limited by reversible and irreversible side-effects (SE). 59 patients, 50 male, 9 female (age 33 to 81 years) entered the study with ventricular tachycardia (VT, 68%), WPW-tachycardia (12%), non-sustained VT (12%) or untreatable paroxysmal atrial fibrillation or supraventricular tachycardia (8%). Prior to AM the patients had received 1 to 8 different antiarrhythmic drugs (m 3.5) and maximal 9 different combinations of antiarrhythmics. The drug regimen started with a loading dose of 1200 mg/d for 1 to 2 weeks and was continued with a maintenance dose of 200 to 600 mg/d. The patients were followed up 1 to 41 months (m 14 m). The drug effect was evaluated using clinical criteria (recurrence of arrhythmias, death), computer-assisted analysis of several 24 hr long-term ECGs and programmed electrophysiological stimulation. Three- to six-monthly the patients were seen in our outpatient department for chec...
European Heart Journal, 1988
The survival rate of 2256 patients with pacemakers was analyzed. Patients paced for Adams-Stokes ... more The survival rate of 2256 patients with pacemakers was analyzed. Patients paced for Adams-Stokes equivalents (e.g. dizziness) showed a significantly better survival rate than did patients with pacemakers implanted for Adam-Stokes attacks or heart failure (P less than 0.0001). The estimated survival of the latter two groups did not differ significantly. Of the deceased patients who had received a pacemaker for the treatment of heart failure, 54% died due to this condition despite pacemaker implantation. The relative percentage of cases of sudden death after pacemaker implantation was high in the groups with Adams-Stokes attacks (12%) and Adams-Stokes equivalents (13%). In patients paced for Adams-Stokes attacks, sudden death occurred more frequently in the first year after pacemaker implantation (P less than 0.015) than during the following years. Therefore, increased efforts should be made to monitor patients carefully after pacemaker implantation to enable prompt detection of malignant tachyarrhythmias, probably the cause of sudden death in a substantial number of patients with pacemakers.
Acta medica Austriaca, 1982
Hemodynamic advantages led to an increasing number of implantations of so called "physiologi... more Hemodynamic advantages led to an increasing number of implantations of so called "physiologic pacemakers", which preserve the natural sequence of atria and ventricles. The growing complexity of these systems renders ECG evaluation increasingly difficult. 85 patients had physiologic pacemakers implanted during the last 4 years and were controlled in our pacemaker outpatient clinic. Typical problems in ECG evaluation of the different pacemaking modes are discussed.
Acta medica Austriaca, 1982
We investigated 76 patients with carotid sinus syndrome followed over a time period of 12-40 mont... more We investigated 76 patients with carotid sinus syndrome followed over a time period of 12-40 months (mean 24 months). In 27 patients long-term ECG were recorded over 24 hours continuously. Carotid Doppler sonography was performed in all patients. 14 patients were studied electrophysiologically. The long-term ECG examinations in patients with carotid sinus syndrome showed a significant tendency to nocturnal bradycardia, and normal heart frequency during the day. In 41% of patients extracranial obstruction of internal carotid arteries could be demonstrated. During carotid sinus massage was a significant increase of the AH time, but there was no significant changes of the HV time. 12 out of 14 patients (86%) developed an AV-block during carotid sinus massage and atrial pacing. In 31 patients pacemakers were implanted. The indication for pacemaker implantation was the clinical symptom of syncope. These patients were observed over a period of 15-40 months (mean 24 months). 15 patients we...
Wiener klinische Wochenschrift, Jan 20, 1984
We compared the life expectancy of 1559 patients with an implanted pacemaker (PM) with a normal a... more We compared the life expectancy of 1559 patients with an implanted pacemaker (PM) with a normal age-matched population and found a significantly reduced survival rate in paced patients. Patients paced for heart failure have the lowest survival rate, whilst those paced for Adams-Stokes attacks do slightly better. Patients with Adams-Stokes equivalents do not differ significantly from our normal population. 54% of patients with PM implanted for heart failure died due to heart failure despite PM implantation. The relative percentage of sudden death after PM implantation is high in groups with Adams-Stokes attacks (16%) and Adams-Stokes equivalents (20%). In both of these groups sudden death occurred especially during the first two years after PM implantation. The high risk of sudden death after PM implantation should increase our efforts to monitor patients carefully after PM implantation for the occurrence of malignant tachyarrhythmias.
Wiener klinische Wochenschrift, Jan 12, 1986
Initial experience of His-bundle ablation is presented in 12 patients with intractable supraventr... more Initial experience of His-bundle ablation is presented in 12 patients with intractable supraventricular arrhythmias which were not amenable to treatment with conventional drugs. In 8 patients His-bundle ablation resulted in total AV-block and in 2 patients significant improvement without total AV-block was achieved. During long-term follow-up (mean 5.3 months) tachycardia recurred in 1 patient with total AV-block resulting in an overall success rate of 75%. A permanent pacemaker was implanted in 10 patients. 1 patient developed deep leg vein thrombosis as a direct result of this procedure and in 2 patients there were complications due to pacemaker implantation. His-bundle ablation appears to be a promising tool in the management of intractable supraventricular tachycardia.
Pediatric Cardiology, 1987
After repair of coarctation, exercise testing was performed in 20 patients with an isolated coarc... more After repair of coarctation, exercise testing was performed in 20 patients with an isolated coarctation (group I) and in 26 with additional congenital cardiac malformations (group II). Ages at time of operation were significantly different in both groups (7.9 +/- 6.0 years in group I; 4.6 +/- 3.8 years in group II; p less than or equal to 0.01). Simultaneous blood pressures were obtained from upper and lower limbs at rest and after exercise. There was no significant difference regarding the systolic blood pressures at rest (122.5 +/- 15.6 mmHg in group I versus 119 +/- 15.8 mmHg in group II). Seven (14%) of the patients were hypertensive; five of them had blood pressure gradients between arms and legs of 15-45 mmHg. But the gradients at rest were found to be significantly different in both groups (9.0 +/- 10.5 mmHg in group I; 18.5 +/- 16.1 mmHg in group II; p less than or equal to 0.05). Six patients, all in group II, had gradients greater than or equal to 30 mmHg at rest. After exercise there were no significant differences in systolic blood pressure and gradients in both groups. Values for blood pressures and gradients at rest and after exercise showed a positive correlation (blood pressure r = 0.76, p less than or equal to 0.001; gradient r = 0.44, p less than or equal to 0.01). Thus exercise testing can provide valuable information about blood pressure and gradient changes during physical activity, but angiography is required to reveal restenosis or residual stenosis.
Pacing and Clinical Electrophysiology, 1982
Induction of ventricular tachycardia by pacemaker programming. The induction of ventricular tachy... more Induction of ventricular tachycardia by pacemaker programming. The induction of ventricular tachycardia or ventricular fibrillation by competitive pacing, especially in the setting of acute myocardial ischemia, is well known. A case of ventricular tachycardia induced by a multiprogrammabie unipolar cathodai ventricular pacemaker is reported. The arrhythmia was caused by reprogramming, which necessitates a short switch to fixed rate pacing in this modei (Spectrax 5985 SX). This potential hazard is not well established in patients with unipolar pacemakers. The use of the magnet as one of the preconditions for reprogramming should be ovoided in future pacemakers.
Pacing and Clinical Electrophysiology, 1984
Pacing and Clinical Electrophysiology, 1983
Wiener klinische Wochenschrift, Jan 28, 1984
Amiodarone (AM) is one of the most potent antiarrhythmic drugs, the value of which is limited by ... more Amiodarone (AM) is one of the most potent antiarrhythmic drugs, the value of which is limited by reversible and irreversible side-effects (SE). 59 patients, 50 male, 9 female (age 33 to 81 years) entered the study with ventricular tachycardia (VT, 68%), WPW-tachycardia (12%), non-sustained VT (12%) or untreatable paroxysmal atrial fibrillation or supraventricular tachycardia (8%). Prior to AM the patients had received 1 to 8 different antiarrhythmic drugs (m 3.5) and maximal 9 different combinations of antiarrhythmics. The drug regimen started with a loading dose of 1200 mg/d for 1 to 2 weeks and was continued with a maintenance dose of 200 to 600 mg/d. The patients were followed up 1 to 41 months (m 14 m). The drug effect was evaluated using clinical criteria (recurrence of arrhythmias, death), computer-assisted analysis of several 24 hr long-term ECGs and programmed electrophysiological stimulation. Three- to six-monthly the patients were seen in our outpatient department for chec...