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J J Heger

Publications and source records attributed to J J Heger.

90 records · Page 5Linked to original sources
PubMed1981

Clinical efficacy and electrophysiology during long-term therapy for recurrent ventricular tachycardia or ventricular fibrillation.

We evaluated the effects of amiodarone in 45 patients with recurrent ventricular tachycardia or ventricular fibrillation. At a mean follow-up time of 12.7 +/- 8.8 months (range, three to 36), amiodarone was successful in nine of 16 patients with recurrent ventricular fibrillation and 21 of 29 with recurrent ventricular tachycardia. During amiodarone therapy, ventricular tachycardia could be induced in 18 of 19 patients in whom it had been induced before therapy, but only six of these 19 had spontaneous recurrence during follow-up. Side effects included corneal microdeposits, hyperthyroidism, blue skin, nausea, and symptomatic bradycardia. Pulmonary fibrosis occurred in three patients. Doses of up to 2000 mg a day did not produce cardiac toxicity, but neurologic side effects precluded long-term therapy at this dose. We conclude that amiodarone is effective for long-term therapy of recurrent ventricular tachyarrhythmias, that induction of arrhythmia during therapy does not always predict efficacy, and that side effects are frequent but do not usually limit therapy.

Adult↗
PubMed1980

Studies with aprindine.

Aprindine is a very effective antiarrhythmic agent with a narrow therapeutic-toxic ratio. It has been used successfully in treating patients who have both supraventricular and ventricular tachyarrhythmias. Aprindine slows conduction in all cardiac fibers and suppresses digitalis-induced after-depolarizations. Voltage-clamp studies indicate that aprindine, in higher doses, suppresses the slow inward current in frog atria. In the dog subjected to coronary artery occlusion, aprindine may be arrhythmogenic, antiarrhythmic, or have no effect on the development of arrhythmias, depending on the temporal relationship between time of administration and time of occlusion.

Agranulocytosis↗
PubMed1980

Mexiletine therapy in 15 patients with drug-resistant ventricular tachycardia.

Mexiletine therapy was administered to 15 patients with chronic and recurrent episodes of ventricular tachycardia or ventricular fibrillation. All patients were intolerant of or had arrhythmias resistant to conventional antiarrhythmic agents. At maximal dosages of mexiletine 2 patients had more than 90 percent reduction in frequency of premature ventricular complexes, whereas 11 patients had less than 50 percent reduction, as measured on 24 hour electrocardiographic recordings. Mexiletine was unsuccessful in preventing or abolishing ventricular tachycardia in 11 patients. Adverse side effects occurred in nine patients (60 percent) and were severe enough to necessitate discontinuation of therapy in six patients (40 percent). Side effects appeared to be dosage-related. Pharmacokinetic analysis indicated a mean elimination half-life of 12.6 +/- 1.6 hours following oral administration of mexiletine. In the patients studied, mexiletine exhibited limited antiarrhythmic efficacy and was associated with frequent adverse side effects.

Adult↗
PubMed1979

Long-term changes in mitral valve area after successful mitral commissurotomy.

We examined the long-term effects of closed instrumental mitral commissurotomy on mitral valve area (MVA) in 18 patients, followed for as long as 14 years after successful operation. Each patient had preoperative and early postoperative cardiac catheterization; late postoperative determination of MVA was obtained 10-14 years (mean 12.2 years) after commissurotomy. In 17 patients, the MVA was determined by cross-sectional echocardiography and in one patient by repeat cardiac catheterization. Thirteen of 18 patients had no change in MVA between early postoperative study (mean MVA = 2.7 cm2) and late postoperative study (mean MVA = 2.9 CM2). MVA in five patients decreased 0.7-2.2 cm2 (mean 1.4 cm2) during the follow-up period. In these five patients, the mean MVA at early postoperative study was 2.7 cm2 and at late postoperative study was 1.3 cm2 (p less than 0.001). At late postoperative evaluation, cardiac symptoms were associated with severity of mitral stenosis but did not predict restenosis. A successful, closed, instrumental mitral commisurotomy can provide substantial long-term improvement in MVA.

Cardiac Catheterization↗
PubMedDate not supplied

New drugs for treatment of ventricular arrhythmias.

This article has attempted to review selected clinical features of new antiarrhythmic agents for treatment of recurrent ventricular tachycardia and ventricular fibrillation. While it is apparent that the ideal antiarrhythmic agent does not exist, whether it be a new or old antiarrhythmic drug, effective and safe antiarrhythmic drug therapy can nevertheless be administered to many patients if the pharmacologic principles and properties described herein are carefully considered.

Amiodarone↗