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Biomedical subjects

T Lanzetta

Publications and source records attributed to T Lanzetta.

At least 19 recordsLinked to original sources
PubMed1989

Efficacy of mexiletine in chronic ventricular arrhythmias: a multicentre double-blind medium-term trial.

In a multicentre double-blind, inpatient, placebo-controlled trial the effects on premature ventricular beats (PVBs) of mexiletine in a standard, submaximal dose were studied by Holter monitoring in 144 outpatients. After wash-out, mexiletine was administered for 14 days. The effects were re-tested, after one week of a placebo, in a second 14-day period of mexiletine administration. Of the patients 73% in the first period and 82.5% in the second period responded to mexiletine (a reduction of 75% or more of PVBs/24 h--p less than 0.001 compared with the placebo for both periods). Mexiletine also significantly reduced the Lown class of PVBs and the frequence of paired PBVs, ventricular tachycardia, multiform beats and R on T wave phenomenon. Mexiletine showed an equivalent effectiveness in the four main aetiological groups of arrhythmias. Fifty nine patients complained of adverse effects (gastrointestinal or neurological) the intensity of which led to the stopping of the treatment in 16 of them. These results show that mexiletine is highly effective, even in submaximal doses, in preventing ventricular arrhythmias of whatever origin.

Adult↗
PubMed1986

[Digoxin-propafenone interaction: values and limitations of plasma determination of the 2 drugs. Anti-arrhythmia effectiveness of propafenone].

Propafenon's influence on the pharmacokinetic and actions of digitalis and viceversa have been evaluated in 27 patients (25 with ventricular hyperkinetic arrhythmias and 2 with paroxismal atrial fibrillation). Patients were divided in two groups according to whether the drug firstly administered were digoxin or propafenon. Plasmatic digoxin and/or propafenon's concentrations, these last performed only in 12 patients, were determined before and during the association and after propafenon's interruption at 7.55-9-11 and at 3-8 p.m. During drug's association area under the plasmatic digoxin concentration curve (AUC 12h) increased on the average by 13.8% (from 19.27 +/- 6.002 ng hours/ml to 21.94 +/- 6.198 ng hours/ml: P less than 0.05) and by 19% at the first hour. Neverthless individual behaviour was not homogeneous since the plasmatic digoxin concentration (PDC) increased in 22 cases (81.4%) and decreased in 5 (18.6%). In 6 patients mean increase was 38.8% (from 16.72 +/- 3.0 ng hours/ml to 23.21 +/- 5.44 ng hours/ml) without signs of digoxin intoxication. Another patient with congestive heart failure and basal PDC 1.87 ng/ml experienced digoxin poisoning with fatal ventricular fibrillation after propafenon. Digoxin administration in the second group's patients produced a not significant increase of plasmatic propafenon concentration (PPC). There was a good correlation among propafenon's absolute amount and plasmatic concentration and antiarrhythmic effect and no correlation among PPC and body-weight related dose. Propafenon's to digitalis association induced, in propafenon's steady state, significant P-R longation from 170 to 190 ms (P less than 0.01) but HR, QRS and QTc didn't show any important change (P greater than 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1984

[Propafenone in refractory supraventricular arrhythmias].

Twelve patients with ventricular arrhythmias were given 300-900 mg oral of propafenon daily. We have obtained VT's suppression in 6 of 8 cases (75%) and "complex" VEB's suppression or significant reduction in 6 of 10 cases (60%). Total VEB have been strongly reduced (-91,2%) in 7 of 12 patients (58,3%). The effects of Propafenon on electrocardiographic intervals have not been significant at lower doses and only with 900 mg we have noted a significant (p less than 0,05) lengthening of the P-R (+27,1%) and QTc (+10,2%) intervals. Propafenon has never caused important negative inotropic effects. These results have been confirmed during a follow-up period of 5-19 months. In conclusion we believe that Propafenon must be considered a highly efficient drug for the treatment and prevention of refractory ventricular arrhythmias.

Adult↗
PubMed1984

[Sexual dysfunction in infarct patients and their partner: repercussions on the couple's relations].

We have studied the sexual dysfunction in 115 couples under 60 years a member of whom had overcome a myocardial infarction (M.I.) not less than 6 months and no more than 2 years. We used two distinct questionnaires filled in anonymously one by the patients, the other by their partners. 70 (60,8%) patients have sexual dysfunction in post infarction as: partner's lack of co-operation 34 (48,6%), premature ejaculation 12 (17,1%), erectile failure 7 (10%), frigidity 6 (8,6%), sexual dissatisfaction 4 (5,7%), retarded ejaculation 2 (2,9%), various disorders 5 (7,1%), 58 (50,4%) partners have sexual dysfunction as: frigidity 22 (37,9%), sexual dissatisfaction 19 (32,8%), partners lack of co-operation 7 (12,1%), erectile failure 3 (5,2%), retarded ejaculation 2 (3,5%), various disorders 5 (8,6%). An important factor in sexual dysfunction is the partner's fear concerning the coitus which could provoke another heart attack due to stress and consequently the consort's death. We emphasize the importance acquired by the physician's tasks in favouring a complete psychophysical recovery in patients with previous M.I. whenever there are no rehabilitation institutes.

Adult↗
PubMed1984

[Erb's muscular dystrophy and congestive myocardiopathy. Description of a case with a whoop due to tricuspid insufficiency].

We describe a case of Erb's limb girdle muscular dystrophy with congestive cardiomyopathy and functional tricuspid insufficiency. The association of these two diseases is rare and the presence of a "whoop" has seldom been found in tricuspid's insufficiency. The integration of clinical, radiological and phonocardiographic data with respiratory and postural changes of the murmur have suggested the correct diagnosis that has been further confirmed by the response to nifedipine. The favourable effect of this drug on the auscultatory findings has laid the foundation of a rational therapeutic approach that has proven to be effective also in the patient's follow-up.

Adult↗
PubMed1976

[Effects of verapamil on sinusal function and on atrioventricular conduction along normal and abnormal pathways, in patients with pre-existing troubles of excitation conduction (author's transl)].

Effects of verapamil (5 mg i.v.) on excitation conduction in 20 patients who already had a basic alteration (7 with ventricular pre-excitation syndrome) were studied by His electrogram, during spontaneous sinusal rhythm and atrial electrostimulation in increasing frequencies. In 4 cases, a test crossed with atropine was carried out. The effects of the drug on the effective refractory period of the A-V node and the anomalous tract in 3 patients with W.P.W. syndrome of Kent's bundle were studied. The effects were: no significant modifications in the sinusal frequency; increase in the corrected preautomatic pause only in cases with sick sinus node syndrome and serious basic compromise of the sinus node function; slowing down of A-V conduction in the supra-hisian area and increase of the effective refractory period of the A-V node; no modification of the intra-atrial conduction, or the under-hisian and intraventricular A-V conduction; uneven slowing down of conduction along the anomalous tract of the pre-excitation syndrome of the James bundle; modification of the effective refractory period of the anomalous tract of the Kent bundle type, variable from case to case. On the basis of the electrophysiological properties, the possibilities and limits of use of the drug in sick sinud node syndrome in the common supraventricular paroxymal tachycardias, in atrial fibrillation, atrial flutter and arrhythmias of the ventricular pre-excitation syndrome are emphasized.

Adult↗
PubMed1975

[Venous infusion of nerapamil in the treatment of refractory angina pectoris and arrhythmia due to associated electric instability].

The therapeutic effect of Verapamil in 45 patients with angina that had failed to respond to other drugs is described. Angina was distinguished in terms of its clinical and ECG features. Verapamil was administered i.v., usually in infusions of 10-250 mg/day over periods of hours or days; alternatively, direct injections of 2,5-5 mg were employed. The effect on arterial pressure is particularly stressed. In the great majority of cases, there was a marked improvement in the symptomatology and in arrhythmic changes arising during angina. The importance of the therapeutic effects of the drug is examined and its possible mechanisms of action are discussed.

Adult↗
PubMed1975

[Anti-arrhythmic therapy with verapamil by intravenous infusion].

Rapid and slow venous infusion of various doses of Verapamil in a mixed series of 185 cases of arrhythmia since 1968 is reported. Results and electrophysiological and ECG changes observed for each type of arrhythmia examined are considered separately: atrial fibrillation-flutter, supraventricular paroxystic tachycardia (atrial and/or junctional), and hyperkinetic ventricular arrhythmia. An association of i.v. Verapamil and a quinidine salt per os is suggested as an alternative to cardioversion in cases of recent atrial fibrillation-flutter. Results obtained in the treatment of arrhythmia due to electrical instability following angina and of angina following arrhythmia are also described. A study of His potentials as the premiss for using Verapamil in subjects with stimulus conductivity changes, including W.P.W. syndrome, is also reported. I.v. Verapamil was used in association with atrial and/or ventricular electrostimulation, and/or with electrical counter-shock in cases of arrhythmia (mostly supraventricular) that were especially refractory. Attention is drawn to the use of Verapamil in the control of arrhythmia after electrical cardioversion.

Adolescent↗
PubMed1975

[High-frequency electric stimulation of the atrium in treatment of supraventricular tachycardias and atrial flutter].

The authors report the results of rapid atrial stimulation in the treatment of 12 cases of junctional tachycardia (J.T.), 20 cases of atrial tachycardia (A.T.) and 43 cases of atrial flutter (A.F.). Sinus rhythm was restored in 91.6%, 70% and 60.4% of the cases for J.T., A.T. and A.F. respectively, either when pacing was discontinued or following a period of atrial fibrillation (from a few minutes to several hours). Fifteen per cent of the cases of A.T. and 25.5% of the cases of A.F. turned into stable atrial fibrillation with reduction of ventricular rate. The authors believe that this technique is a valuable alternative to D.C. countershock when medical treatment has proved ineffective and when countershock may be hazardous.

Adult↗