[State of the atrial myocardium in patients with paroxysmal form of fibrillation arrhythmia]. / Sostoianie miokarda predserdii u bolnykh s paroksizmal'noi formoi mertsiatel'noi aritmii.

Seven two patients with coronary heart disease complicated with paroxysmal atrial fibrillation were studied by using accelerated atrial vector cardiography and M-mode echocardiography. Vector cardiography made it possible to reveal the signs of left atrial hyperfunction with normal left atrial echocardiographic dimensions. There were lower values for left ventricular myocardial contractility in parallel with higher echocardiographic dimensions of the left atrium. In the patients examined, progression of cardiosclerosis was accompanied by decreased amplitude values for the P loop on the vector cardiogram strip along with slower intraatrial conduction with an increase in the size of the left atrial cavity.

[Significance of echo- and vectorcardiographic studies of the heart atrium in the assessment of intracardiac hemodynamics and myocardial contractility]. / Znachenie ékho- i vektorkardiograficheskogo issledovaniia predserdii v otsenke vnutriserdechnoi gemodinamiki i sokratimosti miokarda.

Seventy three patients with coronary heart disease (CHD) complicated by paroxysmal atrial fibrillation (PAF) were examined. Vectorcardiography developed by I. A. Akulinichev and M-mode echocardiography were used to assess the status of left atrial and ventricular myocardia. An interrelationship was examined between the electrophysiological and echocardiographic parameters of myocardial performance, depending on the stage of circulatory insufficiency (CI). The patients with PAF-complicated CHD, unlike those with CHD alone, showed more severe myocardial conduction abnormalities despite the stage of CI. There were signs of compensatory left ventricular overload in the absence of clinical signs of CI. Comparison of ultrasound examination findings with high performance atrial vectorcardiographic ones increases the possibility of accurately assessing the cardiac performance by using noninvasive tools of examinations.

[Use of ethacizine tablets in paroxysms of atrial flutter and fibrillation]. / Opyt ispo'lzovaniia étatsizina v tabletkakh pri pariksi'zmakh trepetaniia i mertsaniia predserdii.

Tablets of ethacizine (a phenothiazine series agent) were used for relieving paroxysms of atrial fibrillation and flutter in 30 patients during 103 attacks. The agent produced a favourable effect in 15 patients in 80 paroxysms of atrial fibrillation. The mean time of sinus rhythm recovery was 1.9 hours. It is effective when given in a single dose of 100 mg with its subsequent administration 6 hours later in the absence of the effect. This agent administered in 50 mg dose produced no results. This scheme of relieving paroxysms of atrial flutter was useful when they lasted not more than 7 days; it is not recommended in initial disturbances of intraventricular conduction. Ethacizine tablets can be used both under hospital and outpatient conditions.

[Results of the treatment of paroxysmal atrial fibrillation with ethacizine]. / Rezu'ltaty lecheniia paroksizma'lnoi mertsate'lnoi aritmii étatsizinom.

Ethacizine was given to 28 patients with frequent (at least once a week) paroxysms of cardiac fibrillation (PCF), the larger proportion of the patients was those with coronary heart disease. The long-term use of ethacisine was preceded by an acute drug test in which the drug was administered orally in a starting dose of 100 mg to assess its effects on myocardial conduction and contractility. Its positive effect as evidenced by reduction in PCF frequency by 70% per more was seen in 19 (68%) patients. The antiarrhythmic effect of the drug showed up on day 2 after initiation of the therapy. Analysis of the relationship between the drug's positive effect and the changes in the atrial myocardium showed that the most potent effect (up to 80%) was observed in patients with coronary heart disease complicated with PCF in the presence of "combined" changes in the atrial myocardium as compared to "hemodynamic" changes. The authors studied the most common adverse effects resulted from the therapy, the most dangerous of them included abnormal right bundle branch conduction (1 case) and sinoauricular block (1 case).

[Value of echocardiography and amplified atrial vectorcardiography for selecting the methods of therapy and prevention of paroxysmal atrial fibrillation]. / Znachenie EkhoKG i usilennoi predserdnoi VKG dlia vybora metoda terapii i profilaktiki paroksizma'lnoi mertsate'lnoi aritmii.

Atrial and left-ventricular myocardial activity was assessed in 85 coronary patients with paroxysmal atrial fibrillation. Their age varied between 43 and 88 years. The methods used included ECG, amplified atrial vectorcardiography after I. T. Akulinichev's schedule (amplification: 1 mv = 100 mm) and M-scan echocardiography. The comparison of these methods has substantiated criteria for the selection of differential treatment and preventive measures in these patients, on the basis of the prevailing type of atrial myocardial changes ("arrhythmic", "hemodynamic" or "combined" ones). A supportive treatment with cardiotonic agents is advisable in cases of the "hemodynamic" type with apparent signs of the overstrain (dilation) of the left atrium or both atria. In the "arrhythmic" variant, where conductivity, automatism and excitation disorders are predominant, antiarrhythmic agents (cordaron, quinidine, adrenoblockers) are indicated while the "combined" type calls for combined treatment with cardiotonic and antiarrhythmic agents.

[Effect of cordarone on the eye (results of long-term follow-up of the treatment and prevention of arrhythmia)]. / Vliianie kordarona na organ zreniia (rezul'taty dlitel'nogo nabliudeniia pri lechenii i profilaktike narushenii ritma serdtsa).

Thirty-one patients who received a prolonged maintenance therapy with cordarone to treat and prevent cardiac arrhythmias underwent an ophthalmologic examination. The treatment lasted 1.5 to 51 months. The signs of keratopathy were detected in 24 (77.4%) patients using a slit lamp biomicroscopy. There is a relationship between the severity of keratopathy and a daily dose of cordarone: in most cases signs of stage I keratopathy were detectable when the daily dose was up to 200 mg. Keratopathy appears to be reversible after the drug has been discontinued.