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Biomedical subjects

A A Adgey

Publications and source records attributed to A A Adgey.

At least 163 records · Page 9Linked to original sources
PubMed1981

Recurrence of ventricular fibrillation in acute ischemic heart disease.

We assessed factors during an initial episode of ventricular fibrillation that may be predictive of recurrence. Of 141 consecutive patients with acute ischemic heart disease who survived an initial episode of ventricular fibrillation, 41 (29%) had recurrent ventricular fibrillation during hospitalization. The incidence of recurrent ventricular fibrillation was lower among those with an acute myocardial infarction than among those with acute ischemic episode. Recurrent ventricular fibrillation occurred more frequently among patients with secondary ventricular fibrillation complicating an acute myocardial infarction than among those with primary ventricular fibrillation. Primary ventricular fibrillation than occurred within 2 hours of the onset of symptoms was no more likely to be recurrent than when it occurred later. Age, sex, site of infarction, place of arrest, adequacy of initial resuscitation, interval onset of symptoms to the initial episode of ventricular fibrillation, onset of symptoms to intensive care and delay before initial attempted defibrillation were not significantly related to the recurrence of ventricular fibrillation.

Acute Disease↗
PubMed1980

Chronic Q fever endocarditis.

Eight patients with chronic Q fever endocarditis were treated with tetracycline for up to 40 months. In addition, five of these patients received co-trimoxazole. Six patients had prosthetic valves. Two patients who had Q fever endocarditis on their native valves required valve replacement because of haemodynamic difficulties: in only one did the Q fever endocarditis contribute to the haemodynamic difficulty. One patient died. It is suggested that medical treatment is continued until clinically and haematologically there is no evidence of endocarditis and the Q fever phase 1 antibody titre is less than 200. No recurrence of Q fever endocarditis has been detected in three of our patients who have now stopped treatment.

Adult↗
PubMed1980

Coronary patient--early treatment?

While the negative attitude of the DHSS towards emergency coronary care in the UK continues, some 30 000 deaths from coronary artery disease occur annually outside hospital. The majority of premature deaths occur in middle-aged men of economic importance to the country and to their families. Coronary heart disease is the major cause of death in the Western world. The majority of deaths are sudden and result from ventricular fibrillation. Correction of ventricular fibrillation outside hospital is a practicable proposition. If the Seattle results were extrapolated to the UK, and allowing for the saving of lives in rural areas by trained general practitioners, then some 7500 lives might be saved annually in Great Britain.

Coronary Care Units↗
PubMed1980

Management of ventricular septal rupture in acute myocardial infarction.

Four patients with rupture of the interventricular septum after myocardial infarction are described. This condition carries a grave prognosis. Surgical repair of the septum is almost always urgently required if the left-to-right shunt is large (QP/WS > 3). Results are better if surgery can be deferred for six weeks to allow the infarcted area to heal and the tissues to be come firmer. This delay may be achieved by using a combination of agents to reduce afterload and to exert a positive inotropic effect. The timing of surgical intervention was an important factor in the survival of three of the four patients.

Female↗
PubMed1980

Amiodarone-induced ventricular fibrillation.

Amiodarone, 600 mg orally daily, was used in an attempt to control supraventricular tachyarrhythmias in a patient with the sick sinus syndrome. Twenty days from the onset of therapy the Q-T interval lengthened. Episodes of ventricular flutter, ventricular fibrillation and self-terminating ventricular tachyarrhythmia (torsade de pointes) developed on the 28th day of amiodarone therapy. Temporary cardiac pacing prevented further episodes of ventricular fibrillation. Despite the suggestion that this drug may be given in large doses for long periods of time since it has a wide safety margin, we feel that the risk of lethal arrhythmias is such that caution is required in its use.

Amiodarone↗
PubMed1979

Observations on haemodynamic effects of mexiletine.

The haemodynamic effects of intravenous mexiletine have been studied in 16 patients with valvular heart disease without clinical evidence of heart failure. A bolus injection of 150 mg administered to 6 of the 16 patients resulted in a mean plasma concentration above the therapeutic range for at least 5 minutes after the drug was given. A small but significant rise in the mean pulmonary artery pressure occurred. In 10 patients, the effects of intravenous mexiletine were compared with those of intravenous saline in a double blind trial. No significant difference was found in the haemodynamic effects, though both saline and mexiletine produced a small rise in the mean pulmonary artery pressure. Mexiletine when administered to patients without heart failure in doses known to be clinically effective did not have important adverse haemodynamic effects.

Adult↗
PubMed1978

The clinical pharmacology of mexiletine.

1. Mexiletine was given to 156 patients by intravenous or oral routes of administration. 2. There was great interpatient variation in kinetics and plasma concentrations with both routes of administration. 3. The mean volume of distribution was 6.63 l/kg. The mean plasma elimination haf-life after chronic oral therapy was 11.31 h. 4. Plasma concentrations between 0.75 and 2.00 microgram/ml were usually effective. Within this therapeutic range severe side effects were uncommon. 5. Plasma concentrations within this range were achieved in 72% of patients when doses of 10--14 mg-1 kg-1 day were given orally.

Administration, Oral↗
PubMed1978

Observations on intravenous administration of lignocaine in patients with myocardial infarction.

Lignocaine was administered intravenously to 36 patients with acute myocardial infarction. A bolus of 100 mg followed by an infusion of 2 mg/minute failed to maintain plasma levels above 2 microgram/ml. A bolus of 100 mg followed by 4 mg/minute also failed to maintain satisfactory plasma concentrations during the first hour of therapy. A bolus of 75 mg was combined with an infusion of 10 mg/minute for 20 minutes followed by 1.5 mg/minute. Satisfactory plasma concentrations during the first hour were observed in 94 per cent of the estimations. No important adverse side effects occurred during the infusion of 10 mg/minute.

Arrhythmias, Cardiac↗
PubMed1978

Long-term oral antiarrhythmic therapy with mexiletine.

Forty-eight patients with ischaemic heart disease received oral mexiletine for the control or prevention of ventricular arrhythmias. The most frequently used doses were 200, 250, and 300 mg 8-hourly. The treatment period varied from 2 days to more than 1 year (median 3 months). No ventricular arrhythmias were detected in more than one-half of the patients. Severe side effects occurred in 15 (31%) of the 48 patients. Major ventricular arrhythmias were observed in 14 (29%) of the 48 patients at a time when the majority had plasma concentrations within the therapeutic range. The value of mexiletine in the management of patients at risk of sudden death is likely to be limited.

Administration, Oral↗
PubMed1977

Transthoracic ventricular defibrillation in adults.

A prospective study of the energy required for transthoracic ventricular defibrillation in adults showed that in 42 (81%) out of 52 episodes of ventricular fibrillation shocks of 100 watt-seconds (Ws) of stored energy were successful. Out of 233 episodes, 222 (95%) were converted by 200 W s shocks. Among patients in whom primary ventricular fibrillation occurred within one hour of the onset of acute myocardial infarction, 200 W s shocks were successful in 40 (98%) out of 41 episodes. When low-energy shocks failed, a stored energy of 400 W s invariably succeeded. The need for large and expensive defibrillators that store more than 400 W s and are less readily available is therefore questioned.

Adult↗