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Biomedical subjects

P Szekely

Publications and source records attributed to P Szekely.

15 recordsLinked to original sources
PubMed1983

A controlled trial of sotalol for 1 year after myocardial infarction.

We carried out a double-blind, randomized study, based at The Academic Department of Cardiology in Newcastle upon Tyne, to compare the effect of sotalol 320 mg once daily with that of placebo in patients from 20 hospitals who survived an acute myocardial infarction. Treatment was started 5-14 days after infarction in 1456 patients; 60% were randomized to sotalol and 40% to placebo. This represented 45% of those evaluated for entry. All patients were followed for 12 months and the analysis was done on an "intention-to-treat" principle. Sixty-four patients (7.3%) in the sotalol group died, compared with 52 (8.9%) in the placebo group. Although the mortality rate was 18% lower in the sotalol group, the difference was not statistically significant. There was a significant reduction in confirmed reinfarction, but not in all suspected reinfarctions.

Adult↗
PubMed1982

Controlled trial of sotalol for one year after myocardial infarction.

In a multicentre double-blind randomised study, the effect of sotalol 320 mg once daily was compared with that of placebo in patients surviving an acute myocardial infarction. Treatment was started 5--14 days after infarction in 1456 patients (60% being randomised to sotalol, and 40% to placebo) who represented 45% of those evaluated for entry. Patients were followed for 12 months. The mortality rate was 7.3% (64 patients) in the sotalol group and 8.9% (52 patients) in the placebo group. The mortality was 18% lower in the sotalol than in the placebo group, but this difference was not statistically significant. The rate of definite myocardial reinfarction was 41% lower in the sotalol group than in the placebo group (p less than 0.05). Although the differences in mortality were not significant, this trial supports the evidence that, in the year after myocardial infarction, beta adrenoceptor blocking drugs reduce mortality by 20--25%.

Adult↗
PubMed1977

Cardiac disorders.

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Arrhythmias, Cardiac↗
PubMed1970

Direct current shock and antidysrhythmic drugs.

A review is given of 457 episodes of atrial fibrillation that occurred in 318 patients and were treated by DC shock. Antidysrhythmic drugs, such as quinidine, procainamide, and propranolol, given singly or in combination, were used concomitantly in 389 instances, and DC shock alone was given in 68 instances. The combined effects of quinidine and DC shock, and of procainamide and DC shock were studied in the experimental animal.Combined DC shock and drug therapy gave a higher conversion rate than DC shock alone, and a statistically significant difference was found in respect of the group of patients receiving procainamide and propranolol together (p<0.01). Antidysrhythmic drugs failed on the whole to reduce the incidence of DC shock-induced dysrhythmias. However, the incidence of certain digitalis and DC shock-induced dysrhythmias was significantly less when propranolol and procainamide were given as pretreatment than when procainamide or quinidine was given alone (p<0.01). In animal experiments, quinidine had no protective action against digitalis and DC shock-induced ectopic tachycardias. Clinical and experimental observations suggest that the cardiotoxicity of these drugs may be enhanced by DC shock. Immediate or delayed post-shock rhythm disorders can be drug related and, therefore, great caution should be exercised in the use of antidysrhythmic drugs in conjunction with DC shock therapy.

Animals↗
PubMed1970

Maintenance of sinus rhythm after atrial defibrillation.

The long-term results of 356 episodes of atrial defibrillation by DC shock carried out in 250 patients are reviewed. In 78 per cent of the cases, atrial fibrillation recurred by the end of 12 months in spite of the administration of quinidine or procainamide or propranolol, singly or combined. However, when no antidysrhythmic drugs were used the recurrence rate was higher at all periods of observation and 100 per cent at the end of 12 months. The difference in the overall results between the untreated group and the treated groups with the exception of the propranolol group is significant (p less than 0.05). In addition, the propranolol group showed an obviously reduced recurrence rate at 1 month, but afterwards the results tended to approximate those in the untreated group. The period during which sinus rhythm could be maintained in patients who underwent valve operations was on the whole the same as in patients who did not have heart surgery. However, in a small number of patients sinus rhythm was maintained for longer periods after mitral valve replacement than before it. Sinus rhythm was maintained for significantly longer periods when atrial fibrillation lasted less than 1 year than when it had been present for more than 1 year (p less than 0.001). It is concluded that there is justification for a judicious antidysrhythmic prophylaxis after atrial defibrillation.

Atrial Fibrillation↗