[Comparison of the anti-arrhythmic effectiveness of ethacizine, ethmozine, cordarone, mexitil and ritmilen in elderly patients with ventricular extrasystole].
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Antiarrhythmic effects of cordarone, ethacizine, and obsidan were evaluated in 30 patients with chronic alcoholism in whom premature ventricular contractions were recorded at a rate of at least of 5 per minute by 30-minute ECG monitoring when they were admitted to a narcologic hospital, having the alcohol withdrawal syndrome. Cordarone, ethacizine, and obsidan were found to reduce the total number of premature ventricular contractions by 90% or more within an hour after their single intravenous injection in 80, 100, and 50% of the patients, respectively.
Bonnecor was tested for its antiarrhythmic activity in patients with acute myocardial infarction in the first 24 hours of the disease complicated by arrhythmias as ventricular premature beats (VPB). Proceeding from the comparison of its clinical efficiency and pharmacokinetic parameters in 38 patients, the optimal dosage of the drug was formulated. When given intravenously to the patients in dose of 25-37.5 mg bonnecor produced 92% antiarrhythmic responses, failed to shorten heart rate and to lower blood pressure; the agent led to a prolonged P-Q interval as evidenced by ECG. The antiarrhythmic activity, the dose of the drug, and its plasma concentration were found to be closely related. The mean effective bonnecor concentration was ascertained to be 0.45 +/- 0.24 micrograms/ml.
Partial integral rheography was used to study the volume velocity of brain blood supply (BBS) in 39 flying operators aged 20-39 years during continuously increasing bicycle ergometer testing. In good exercise tolerance, the dynamics of cerebral blood flow was found to be biphasic: 1) a rapid increase in BBS volume velocity at the first stages of exercise and 2) its subsequent stabilization. Stabilization of cerebral blood flow at 25% levels of blood minute volume was achieved by tonic tension autoregulation of the intracerebral arteries and adequate venous return. During the bicycle ergometer testing, the examinees with transient premature contractions showed impaired autoregulation, i.e. a considerable decrease in regional artery tone, cerebrovascular hyperperfusion and circulatory disorder resulting in the ++cerebro-cardiac syndrome with extracardiac premature beats. With drug therapy of extracardiac premature contractions, the tone of cerebral arteries and the level of intracranial hemodynamics should be borne in mind and corrected.
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It is a real challenge, for the doctor internist-cardiologist, who deals everyday, with problems of arrhythmia, especially in pilots of combat aircraft, to discover those rare cases of premature ventricular contractions (PVC) where exists great probability that PVC were caused by ischemic heart disease. Appearance of complex PVC in aircrew is seldom. Isolated appearance of single, unifocal PVC in young pilots without any symptoms and in absence of organic changes or functional heart disorder, should be considered as normal medical finding.
During a prolonged (24-hour) intravenous administration in a dose of 126 mg, allapinine produced a stable pronounced antiarrhythmic effect in 90% of the patients with frequent premature ventricular contraction and adverse reactions in the central nervous system in 65% of the cases. However, the latter effect of allapinine is short-term and ceased independently without altering the infusion rate. More serious adverse effects (hypotensive reactions, proarhythmic effects) occurred in 4% of the cases.
A total of 30 apparently healthy male pipe-rolling workers having various working conditions and no resting ESG abnormalities in cardiac arrhythmias. A continuous ECG recording was performed in all the examinees during a working day, followed by interpretation of the records separately at rest and during work and automatic calculation of heart rate per min and of the number of supraventricular and ventricular premature contractions per hour. There was a heating microclimate- and hard labour-induced increase in heart rate and the number of premature contractions, ventricular premature contractions in particular.
PURPOSE: To study the spontaneous variability of single (VPCs) and coupled (CVPCs) in patients with chronic Chagas' disease (CCD). PATIENTS AND METHODS: Twenty patients with CCD, 14 male, in class I and II NYHA, with frequent VPCs and VCPCs, free of drug therapy were studied. 21 hour Holter monitoring was done for 4 subsequent days. The data analysis assessed the variation in the frequency of VPCs and CVPCs between patients, seven hour periods one hour periods in a hierarchical model by a Poisson process. RESULTS: a) the frequency of VPCs follows a circadian rhythm, closely related to the hourly variations of the mean heart rate; b) disregarding the heart rate influence on the variability of the ventricular arrhythmia, its behavior was at random and unpredictable; c) the minimal percentual reduction in VPCs/h that discriminated between antiarrhythmic effect and spontaneous between antiarrhythmic effect and spontaneous between antiarrhythmic effect and spontaneous variability was 121.86% for seven-hour, 58.42% for 21-hour and 38.45% for 42-hour electrocardiographic monitoring periods; d) the same approach for the VCPCs revealed values of 133.6%, 63.21% and 41.3% respectively. CONCLUSION: The large variability of ventricular arrhythmia in CCD during a 24 hour period makes necessary observations always longer. The minimal percentual reduction in VPCs/h that discriminated between antiarrhythmic effect and spontaneous variability might be 58.42% for two 21-hour electrocardiography monitoring periods.
The antiarrhythmic effects of Encainide in acute intravenous and long-term oral therapy were investigated in 10 patients suffering from chronic atrial ectopic beats previously non-responsive to conventional therapy. The efficacy of Encainide was assessed by 24-hour ECG monitoring during the acute i.v. application and in 4 week intervals over a period of 4 to 6 months. Plasma concentrations of Encainide and the O-demethyl- (ODE) and 3-methoxy-O-demethyl metabolites (3-MODE) were determined after i.v. administration and during oral therapy. A significant reduction of arrhythmias by 76% was found after 1.0 mg/kg Encainide given intravenously. Atrial ectopic beats with bundle branch block QRS-morphology were reduced by more than 90% after only 0.5 mg/kg. During long-term oral therapy 6 of the 9 patients were treated successfully. Following i.v. administration Encainide-plasma concentrations rapidly decreased with a half life of approximately 75 min in the final distribution phase. During oral therapy Encainide levels were not detectable under steady state conditions 4 to 6 hours after the last dose, or they were only minimal, but the average concentrations of ODE and 3-MODE were 71.3 +/- 21.3 and 75.6 +/- 13.5 ng/ml. Encainide increased PR interval and QRS duration significantly. QT-interval changed as a result of the QRS-prolongation. Encainide was well tolerated during acute and chronic therapy. No severe side effects were seen, except in one case, in which dose reduction by 50% was necessary because of blurred vision.(ABSTRACT TRUNCATED AT 250 WORDS)
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