Six patients including three females with WPW syndrome (three with type A and three with type B) presenting with recurrent paroxysmal tachyarrhythmia were subject to electrophysiological studies. Apart from basal parameters, rapid atrial and ventricular pacing was done which confirmed electrophysiological characteristics of bundle of Kent operation. A single intravenous bolus of ajmaline 50 mg. was effective in blocking the bundle of Kent in all patients within 30 seconds of injection with the effect persisting for 15 minutes in one and from 25 to 60 minutes in the others. The most dramatic effect was prolongation of the HV interval with normalization of QRS complex with a marginal effect on the AH interval. The drug was also effective in breaking narrow QRS tachycardia in two patients and broad QRS tachycardia in one patient. Long-term oral therapy with ajmaline has proved effective in preventing recurrent tachyarrhythmias. We conclude that ajmaline is specifically effective and safe in the treatment of the WPW syndrome.

Adult↗

PubMedDate not supplied

An analysis of initial results of percutaneous transluminal coronary angioplasty for totally occluded coronary arteries.

A retrospective analysis of 680 Percutaneous Transluminal Coronary Angioplasties (PTCA) performed from April 1986 to October 1990 revealed that 81 patients had PTCA performed on 86 totally occluded coronary arteries (1.06 lesions/patient). Four of the 86 were acute occlusions. Angiographic success in the group as a whole was achieved in 57 (66%). Multivariate analysis identified only the target vessel as a statistically significant factor predictive of angiographic success from among a host of clinical and angiographic morphologic variables. Left anterior descending artery lesions were identified with the highest success. In addition the duration of occlusion was significantly lower for the successfully versus the unsuccessfully dilated chronic occlusions.

Adult↗

PubMedDate not supplied

Percutaneous transluminal coronary angioplasty in patients over the age of 65 years.

PTCA performed in 672 patients (646 patients < 65 years and 26 patients > or = 65 years) from March 1986 to September 1990 consisting of 619 males and 53 females are being discussed for the purpose of comparison of the results between patients in the < 65 years and > or = 65 years age groups. It was found that diabetes mellitus (50 vs 24.4.%, P < 0.01), obesity (46.1 vs 26%, P < 0.05), and hyperlipidaemia (66 vs 37.1%, p < 0.01) had a higher incidence among the elderly. Of the total 1047 lesions observed, 662 lesions in the < 65 years age group and 37 lesions in the > or = 65 years age group were dilated by PTCA (1.02 lesions/patient and 1.4 lesions/patient respectively). The lesion morphology showed higher degree of irregular contour in the < 65 years age group (23.6 vs 8.1%, p < 0.05), though the number of lesions with PTCA attempted in all age groups were almost similar. Major complications included one MI (3.8%) and two deaths (7.6%) in the > or = 65 years age group. During followup (mean duration: 8.2 months > or = 65 years and 13.5 months < 65 years age group) significantly higher percentage of patients < 65 years were asymptomatic when compared to elderly (50.2 vs 15.4% p < 0.05). Angina status was same more often in the elderly (23.1 vs 2.8% p < 0.01). The cumulative rate for repeat PTCA was similar for elderly and younger patients.

Age Factors↗

PubMedDate not supplied