[Bradycardia and/or asymptomatic and symptomatic sinus dysrhythmias. Value and limitations of the functional indices adopted].
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Biomedical subjects
Publications and source records attributed to A Brat.
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A study was carried out on the electrophysiological effects of a sublingually administered antianginal drug: nifedipine (20 mg). The results show a significant shortening of sinus cycle length from 925 +/- 249 msec to 810 +/- 245 msec, (p less than 0.005) and the disappearance of some interpolation and echo zones. There are no significant effects on the other evaluated parameters of sino-atrial and AV-node function. In one case, during atrial pacing, a second-degree, Wenckebach type, A-V block was present only before nifedipine. The following conclusions were reached: 1. nifedipine has no significant electrophysiological effect on the human heart; 2. the electrophysiological effects observed are probably indirect and related to the vasodilating effect of the drug; 3. the absence of direct cardiac electrophysiological actions may be useful in patients suffering from coronary artery disease and presenting disturbances in the formation and/or conduction of the cardiac impulse.
The authors have studied the bioavailability of a commercially available digoxin solution in capsule. Data obtained were different from that reported by other authors using experimental preparations. Single-dose and steady-state studies evidenced a similar bioavailability for capsules and standard tablets. These results introduce the new problem of the inadequate bioavailability of capsules.
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The electrophysiological effects of Oxyfedrine on sino-atrial function and on A-V junctional and subjunctional conduction have been studied in 16 patients with sinus node and/or atrial dysrhythmias. The following effects have been observed: --a positive chronotropic effect on the sinus node; --an essentially indirect (rate-dependent) shortening of the Functional and Effective Refractory Periods (FRP and ERP) of the atria without variation of the Intra-Atrial Conduction Time (HRA-LRA). There was no significant shortening of the Maximal Atrial Latency (max AL), of the Corrected Sinus Node Recovery Time (CSNRT) and of the Sino-Atrial Conduction Time (SACT). The limits of Zones I, II, III of the sinus node response to atrial extra-stimuli were reduced with no significant change in their duration, expressed as percentage of the Sinus Cycle Length (SCL); --an improvement in the A-V junctional conduction (shortening of the A-H interval for comparable cycle lengths) due to a relatively shortened A-V junctional ERP. The use of the drug in patients with sinus bradycardia and/or atrial dysrhythmias and conduction disturbances, is proposed.
A description is given of the electrocardiograms of three subjects with artificial demand pacemakers in whom no inhibition of the idioventricular rhythms occurs, thus causing unusual relationships between the artificial and the spontaneous rhythms. The latter are protected and therefore appear to be parasystolic. In the first two cases, interpolated artificial beats are inscribed in the spontaneous rhythm. In the third case, the spontaneous parasystole is intermittent and alternates with concealed extrasystolic beats originating in the same focus.
Concealed AV junctional extrasystoles are described which, conducted in a restrograde manner to the sinoatrial junction, interfere with sinus impulses, thus simulating a second-degree, 2:1, sinoatrial block.
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