Antiarrhythmic drugs in advanced organic heart disease.
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Amiodarone↗
Biomedical subjects
G Jahns
Publications and source records attributed to G Jahns.
[Analysis of the accuracy of the Holter system ICR 6201-G3].
UNLABELLED: The accuracy of the Holter System ICR 6201-G3 was investigated by evaluation of 32 Holter recordings taken randomly from the hospital's ECG laboratory. All events were classified into true positive, false positive and false negative diagnoses. Sensitivity (S) and predictive accuracy (PA) were calculated. RESULTS: QRS complexes: S 99.9%, PA 99.9%; supraventricular premature beats: S 98.3%, PA 81.1%; single ventricular premature beats: S 96.8%, PA 97.4%; ventricular couplets: S 96.4%, PA 95.6%; ventricular salvos: S 98.6%, PA 90.8%; pauses: S 100%, PA 91.7%. It is concluded that despite a relatively good overall accuracy of automatic arrhythmia detection, on account of the lower accuracy in the evaluation of all clinically important arrhythmias and of the markedly worse accuracy in some instances, a fully automatic use of the system cannot be recommended. Repetitive ventricular arrhythmias and asystolies must be controlled by hand.
Arrhythmias, Cardiac↗
Long term efficacy of class I antiarrhythmic agents and amiodarone in patients with malignant ventricular arrhythmias.
The long term efficacy of class I antiarrhythmic drugs and of amiodarone was investigated in 34 patients with severe organic heart disease accompanied by frequent complex ventricular arrhythmias. All patients had undergone cardiac catheterisation which included coronary angiography, and each patient underwent a short and a long term study phase. During the short term study 6 class I antiarrhythmic agents were administered orally in a randomised, single-blind fashion. The drugs investigated were disopyramide, flecainide, mexiletine, prajmalium, propafenon and tocainide. The response was judged to be effective when there was a 90% reduction of couplets and a 100% reduction of salvos. For long term treatment the patient was given one of the agents found to be effective in the short term testing. Holter monitoring was performed after 1 week, and 1, 3 and 6 months. If the drug administered initially was later found to be ineffective, the patient was given another effective class I agent. If during the short term study or the follow-up phase there was no positive response to any class I agent, the patient was given amiodarone. In 78% of the patients, one or more of the class I agents administered short term was effective. The percentage of effectively treated patients after 1 week was 56%, and was 28, 14, and 9% after 1, 3, and 6 months' treatment, respectively. In amiodarone-treated patients there was an effective response rate of 40% after 10 days, 50% after 1 month and 70% after 3 and 6 months.
Amiodarone↗
[The effect of amiodarone on thyroid gland function].
Plasma concentrations of T4, FT4, T3, rT3 and TBG, as well as of TSH before and after stimulation with TRH were studied in 25 patients, who had been treated with amiodarone for up to nine years. At the beginning of therapy, all the parameters mentioned above were found to be in the normal range in all patients. After two months of therapy, T4 had increased from 100 nmol/l +/- 24 nmol/l to 155 nmol/l +/- 32 nmol/l (p less than 0.01), and FT4 from 22 pmol/l +/- 10.5 pmol/l to 32 pmol/l +/- 8 pmol/l (p less than 0.01). T3 had decreased to the lower normal range (n.s.). TBG showed no significant changes. The TRH-tests had been normal in the beginning, but they remained positive in only 20% of the cases. At the end of the study, rT3 exceeded the normal range in all 25 patients. Two patients developed definite hyperthyroidism with elevations of T3 up to 4.7 nmol/l and 7.5 nmol/l, respectively. In one of them, we decided to discontinue amiodarone. Testing of thyroid function under antithyroid drug therapy revealed a hyperfunctioning autonomous adenoma, which was successfully eliminated by radioactive iodine therapy. In the other patient, it was not possible to withdraw amiodarone, so we initiated long-term treatment with antithyroid drugs. Our data support the assumption that amiodarone causes an impairment of the peripheral conversion of T4 to T3. As a result, one finds elevated serum concentrations of T4, which, in combination with the mainly negative TRH-test, must not be interpreted as proof of a hyperthyroid metabolic state being present. Hyperthyroidism is confirmed only if serum concentrations of T3 are also elevated.
Adolescent↗
Six-month space greenhouse experiments--a step to creation of future biological life support systems.
SVET Space Greenhouse (SG)--the first automated facility for growing of higher plants in microgravity was designed in the eighty years to be used for the future BLSS. The first successful experiment with vegetables was carried out in 1990 on the MIR Space Station (SS). The experiments in SVET SG were resumed in 1995, when an American Gas Exchange Measurement System (GEMS) was added. A three-month wheat experiment was carried out as part of MIR-SHUTTLE'95 program. SVET-2 SG Bulgarian equipment of a new generation with optimised characteristics was developed (financed by NASA). The new SVET-GEMS equipment was launched on board the MIR SS and a successful six-month experiments for growing up of two crops of wheat were conducted in 1996 - 97 as part of MIR-NASA-3 program. The first of these "Greenhouse" experiments (123 days) with the goal to grow wheat through a complete life cycle is described. Nearly 300 heads developed but no seeds were produced. A second crop of wheat was planted and after 42 days the plants were frozen for biochemical investigations. The main environmental parameters during the six-month experiments in SVET (substrate moisture and lighting period) are given. The results and the contribution to BLSS are discussed.
Bulgaria↗