ABSTRACT
We described key approaches to the realization of the pilot project, which is being carried out in Almazov National Medical Research Centre in order to implement basic medical education in close integration of science and education.
ABSTRACT
AIM: To assess whether arrhythmias may be corrected with the anxiolytic Adaptol in subjects with anxiety disorders. SUBJECTS AND METHODS: On the basis of the data of psychological and mental testing (Stroop test) and the results of Holter monitoring, the authors selected among 59 patients with non-coronarogenic ventricular arrhythmias (VA) and an inadequate response to antiarrhythmic therapy 21 patients with manifest anxiety disorders, in whom a psychogenic factor had played a significant role in the genesis of VA, which served as an indication for Adaptol use. Reexaminations were made 30 days after initiation of therapy with Adaptol 500 mg t.i.d. RESULTS: Adaptol used to treat VA in patients with high anxiety, unlike the controls, exerted a significant antiarrhythmic effect: the average daily and average hourly number of ventricular ectopic complexes significantly decreased while there were no changes in the control group (untreated with Adaptol). In 95% of the patients, the positive Stroop mental test became negative, i.e. it failed to provoke arrhythmia (p < or = 0.01), made test performance easy, and diminished a blood pressure response to the test. The number of patients with moderate and high situational anxiety decreased by 3 times (p < or = 0.01); the general condition improved in the majority of patients. CONCLUSION: The psychogenic factor plays a significant and sometimes determining role in the genesis of non-coronarogenic VA. When used alone and in combination with antiarrthythmics, Adaptol proved to be effective in treating non-coronarogenic VA in patients with higher anxiety.
Subject(s)
Anxiety/drug therapy , Biureas , Psychological Tests , Ventricular Premature Complexes , Adult , Anti-Anxiety Agents/administration & dosage , Anti-Anxiety Agents/adverse effects , Anti-Arrhythmia Agents , Anxiety/complications , Anxiety/physiopathology , Biureas/administration & dosage , Biureas/adverse effects , Drug Monitoring/methods , Electrocardiography, Ambulatory , Exercise Test , Female , Humans , Male , Middle Aged , Treatment Outcome , Ventricular Premature Complexes/diagnosis , Ventricular Premature Complexes/drug therapy , Ventricular Premature Complexes/etiology , Ventricular Premature Complexes/psychologyABSTRACT
This review considers of modern concepts of microvolt T-wave alternans (TWA): its pathophysiological basis at cellular level, particulars of quantitative analysis of TWA, modulating effects of autonomic nervous system and drugs, prognostic efficacy in predicting susceptibility to ventricular arrhythmia in comparison with other modern prognostic factors of sudden cardiac death.
Subject(s)
Anti-Arrhythmia Agents/therapeutic use , Arrhythmias, Cardiac/diagnosis , Death, Sudden, Cardiac , Electrocardiography , Electrophysiologic Techniques, Cardiac , Heart Conduction System/physiopathology , Arrhythmias, Cardiac/complications , Arrhythmias, Cardiac/drug therapy , Arrhythmias, Cardiac/physiopathology , Autonomic Nervous System/drug effects , Autonomic Nervous System/physiopathology , Death, Sudden, Cardiac/etiology , Death, Sudden, Cardiac/prevention & control , Electrocardiography/classification , Electrocardiography/drug effects , Electrocardiography/standards , Electrophysiologic Techniques, Cardiac/classification , Electrophysiologic Techniques, Cardiac/standards , Heart/physiopathology , Heart Conduction System/drug effects , Heart Rate/drug effects , Humans , Predictive Value of Tests , Risk Assessment , Sensitivity and SpecificityABSTRACT
The authors consider modem views on tachyinduced cardiomyopathy, which occurs as a result of an increase in atrial or ventricular contraction rate. Data of experimental and clinical studies are presented. The issues of pathogenesis, the clinical significance, the questions of diagnostics, and possibilities of treatment of tachyinduced cardiomyopathy are reflected.
