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PubMed1992

[Clinical and echocardiographic evaluation of the effects of atrial defibrillation in patients with idiopathic cardiomyopathy].

To elucidate the effects of atrial defibrillation in patients with idiopathic cardiomyopathy, we clinically and echocardiographically assessed 6 patients with hypertrophic cardiomyopathy (HCM) and 7 patients with dilated cardiomyopathy (DCM). Their mean age was 57 +/- 14 years and the mean duration of their atrial fibrillation (Af) was 47 +/- 29 days. There were no differences in age and the duration of Af between the HCM and DCM groups. We assessed the effects of defibrillation on the NYHA functional classification, heart rate (HR), systolic blood pressure (S-BP), M-mode echocardiographic data (LVDd, LVDs, %FS, LAD) and transmitral pulsed Doppler echocardiographic findings (peak velocity, time-velocity integral of rapid and atrial filling waves). These indices were obtained before and 52 +/- 22 days after defibrillation, and were compared with each other. 1. HR decreased (HCM: 87 +/- 16-->58 +/- 7/min, DCM: 93 +/- 19-->70 +/- 14/min) and total left ventricular filling increased (HCM: 6 +/- 1-->11 +/- 4 cm, DCM: 6 +/- 1-->10 +/- 2 cm) after defibrillation, and the increment of %FS (HCM: 36 +/- 6-->41 +/- 6%, DCM: 16 +/- 6-->25 +/- 11%) was observed. Four of 6 HCM patients and 5 of 7 DCM patients also improved with regard to the NYHA classification. 2. After defibrillation, LVDd increased in HCM (42 +/- 4-->47 +/- 4 mm), but not in DCM. However, LVDs decreased in DCM (52 +/- 9-->44 +/- 12 mm), but not in HCM. We concluded that atrial defibrillation had a beneficial effect on the recovery of the left ventricular function both in HCM and DCM due to the reduction in HR and increase in left ventricular filling. The mode of LV functional improvement after defibrillation varied depending on the state of patient's basal pathophysiology .

Adult↗
PubMed1992

[Clinico-immunological aspects of idiopathic ventricular arrhythmia].

The clinicoimmunological study revealed immunocompetence dysfunction in 28 patients with idiopathic ventricular arrhythmias resistant to ritmilen. After sodium nucleinate immunomodulation, ritmilen therapy proved to be beneficial in 46.6% of the patients. A positive result was obtained only in the patients who showed the same or close values as in healthy individuals. The comparison has led to the conclusion that idiopathic ventricular arrhythmias are directly related to immune dysfunction and to the recommendation that sodium nucleinate should be used in the multimodality therapy of the arrhythmias.

Adjuvants, Immunologic↗
PubMed1991

[Evaluation of the possibility of selection of individual anti-arrhythmia therapy].

Antiarrhythmic therapy was chosen for 3-7 days by modified chronic electrophysiological study at three stages: (1) the efficacy of a drug, its action onset and termination were defined; (2) a dosage was chosen on an individual basis and the duration of drug potency was specified; (3) the dosage regimen of a drug given as a course therapy was confirmed by the results of trials. Its choice was made on the basis of the oral administration of a tested drug and multiple programmed electric cardiostimulation. In late periods (3-37 months), the therapy was effective and safe in 51 (86%) of 59 patients. The drug regimens and doses were in poor agreement with conventional ones in 49% of the patients. The method proposed makes it possible to choose antiarrhythmic therapy on an individual basis and reduce the number of complications.

Adolescent↗
PubMed1991

[Effect of ritmilen on myocardial refractility and cardiac impulse conduction in patients with paroxysmal tachycardia].

By choosing antiarrhythmic therapy, ritmilen, 3 mg/kg, was given to 30 patients with atrial, atrioventricular, reciprocal and ventricular tachycardias. The agent was found to have the highest effect on atrial myocardial refractoriness in patients with atrial tachycardias and on ventricular refractoriness in patients with ventricular tachycardias (longer effective and functional refractory periods). Intraventricular pathways are the major site of ritmilen's effect on anterograde conduction. Profound changes were found in patients with atrial and ventricular tachycardias. The cholinolytic action of ritmilen on the atrioventricular node was detected in 20% of the patients, whereas sinus rhythm increased in 90%, which may be attributable to asymmetric vagus innervation of sinoatrial and atrioventricular nodes.

Adult↗
PubMed1990

Results of the treatment of cardiac arrhythmias with Palpitin.

1) Palpitin has distinguishable antiarrhythmic effect in different type of cardiac arrhythmias of both supraventricular and ventricular origin, and of various ethiopathogeneses. 2) Antiarrhythmic effect is observed in most patients, already 24 hours after initiation of treatment. 3) Untoward effects, although occurring relatively frequently, usually do not cause such severe alterations which lead to a discontinuance of therapy. 4) Palpitin may be used in long-term treatment of outpatients.

Adult↗
PubMedDate not supplied

[Palpitin--an anti-arrhythmic drug in ischemic heart disease].

The effectiveness was assessed of the antiarrhythmic treatment with Palpitin in 30 patients with ischaemic heart disease (IHD). The control group comprised 15 patients with IHD and arrhythmia, treated with propranolol. In all patients ECG recording by Holter's method was done before the treatment and after 14 days of the treatment. The effectiveness of Palpitin was expressed as improvement in 66% of cases (reduction of ectopic beats by 75%), and in 40% of cases complete regression of arrhythmia was achieved. These results were slightly better than in the group treated with propranolol (improvement in 60% of cases). Palpitin during the treatment caused no increase in the manifestations of cardiac failure and produced no disturbances of atrioventricular conduction. Fairly frequently the patients complained about mucosal dryness and sporadically about dyspeptic symptoms, but these symptoms were not disturbing the course of the treatment.

Adult↗
PubMed1990

A comparison of systolic time intervals measured by impedance cardiography and carotid pulse tracing.

The purpose of this study was to compare the systolic time intervals (STI) obtained by impedance cardiography and by the conventional carotid technique. This comparison was done with respect to: 1) correlations between variables obtained by the two methods, 2) ability to reflect drug-induced changes, 3) reliability in terms of reproducibility and 4) heart rate dependency of the variables measured. The study included 25 unmedicated patients with ischaemic heart disease and 36 healthy subjects. We obtained significant correlations between STI-variables measured by the two methods (p less than 0.001) and found that left ventricular ejection times were longer when determined by the carotid technique (p less than 0.01). We found a significant correlation between drug-induced changes in STI-variables measured by the two methods (p less than 0.001). Both methods had a high degree of reproducibility and this parameter was significantly better within the same day, when impedance cardiography was used (p less than 0.01). The error due to the reading of STI-tracings obtained by impedance cardiography was very small when performed by the same observer. We found the pre-ejection period to be independent upon heart rate, while the left ventricular ejection time depended upon this parameter. We conclude that impedance cardiography and carotid technique differ with respect to the measurement of left ventricular ejection times, but not with respect to the measurement of other STI-variables. We furthermore conclude that both methods are reliable, but we recommend the use of impedance cardiography because it is easier to apply, it may be more precise and it can be used for simultaneous measurements of other haemodynamic variables.

Cardiac Output↗
PubMed1990

[The potentials for curing atrial flutter by the combined use of transesophageal electrical stimulation and anti-arrhythmia preparations].

Potentialities of the recovery of the sinus rhythm were studied in 21 patients with atrial flutter (AF) using frequent transesophageal electric cardiac pacing (TEEP) per se and after intravenous injection of ritmilen and novocainamide under outpatient conditions. TEEP made it possible to arrest AF in 24% of patients and to transform flutter into steady atrial fibrillation in 48% of patients. In 28% of cases, the pacing turned out ineffective. Subsequent administration of antiarrhythmic drugs made the rhythm return to normal in 24% of patients, whereas repeated TEEP conducted after drug administration in additionally 33% of patients. The efficacy of frequent TEEP combined with administration of ritmilen and novocainamide amounted to 81%.

Adult↗

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