Acute right ventricular infarction.
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Biomedical subjects
Publications and source records attributed to N Naqvi.
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Disopyramide phosphate was administered intravenously in a dose of 1.2 mg/kg body weight over one minute to nine patients after open-heart surgery and coronary artery bypass grafting. The haemodynamic changes were studied during and for 30 minutes after drug administration. Heart rate was unchanged throughout the study. During infusion the only significant changes were an increase in systemic blood pressure and systolic impedance signifying a direct increase in peripheral arterial resistance. Systemic blood pressure remained significantly higher for 10 minutes and systolic impedance for 30 minutes. Immediately after infusion max. dPower/dT, a measure of ventricular contractility, was significantly depressed for 15 minutes. Both cardiac output and aortic flow were significantly depressed for 30 minutes. DPTI/TTI, an estimate of subendocardial supply/demand ratio, showed an insignificant increase throughout the study. This study shows that intravenous disopyramide starts acting within 45 seconds of the start of infusion, directly increases peripheral arterial resistance, has a breif negative inotropic action, and does not reduce subendocardial blood flow.
Examination of the scalar ECG usually allows accurate identification of the various types of AV block. Meticulous attention to waveform identification and careful measurement are the essentials in this as in other fields of electrocardiography. In difficult cases, or where the defect is intermittent, additional recording techniques or special manoeuvres may be necessary. Modern techniques including multichannel ambulatory monitoring, stress testing, physiological and pharmacological manoeuvres, and recording of special surface and intracardiac ECGs are occasionally necessary.
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