[The characteristics of the autonomic regulation of the heart rate in patients with IHD and ventricular arrhythmias under obzidan therapy]. / Osobennosti vegetativnoi reguliatsii serdechnogo rtima u bol'nykh IBS s zheludochkovymi aritmiiami pri terapii obzidanom.

Propranolol hydrochloride was administered to 30 patients with stable angina pectoris suffering from coronary heart disease (CHD). Of them 18 patients had ventricular extrasystole, 12 had ventricular tachycardia. All the patients underwent resting ECG, bicycle ergometry, transesophageal pacing, 24-h ECG monitoring. Vegetative cardiac regulation was determined using mathematical analysis of at least 100 successive intervals R-R at rest before and after therapy (120 mg day of propranolol hydrochloride). The authors estimated characteristics of the variance analysis and two secondary values--stress index and centralization index calculated by spectral characteristics of the rhythm. Only in CHD patients with ventricular tachycardia the treatment shifted the vegetative tone in the direction of parasympathetic nervous system. It is concluded that propranolol hydrochloride affects cardiac rhythm depending on the initial condition of vegetative regulation of cardiac activity.

[The myocardial blood supply in chronic alcoholism patients studied by myocardial scintigraphy with 201Tl]. / Izuchenie krovosnabzheniia miokarda u bol'nykh khronicheskim alkogolizmom s pomoshch'iu stsintigrafii miokarda s 201Tl.

To study myocardial perfusion, 201Tl myocardial scintigraphy was used to examine 25 patients with chronic alcoholism and alcoholic damage to the heart. 201Tl myocardial scintigraphy was performed at rest and repeatedly 3-7 days later by using the bicycle ergometer exercise test. The total 201Tl uptake at rest was 2.3 +/- 0.2%. The resting scintigrams of the patients showed a profound irregularity of 201Tl distribution and a diffuse decrease in its washout. The increment of 201Tl uptake in response to exercise was 20.6%. Exercise scintigrams displayed steady perfusion defects mainly of anteroseptal site. There was an improvement of tracer washout in the exercise test as compared at rest. Thus, 201Tl myocardial scintigraphy allows perfusion disturbances to be detected in patients with alcoholic damage to the heart. Myocardial scintigraphy performed at the peak of exercise records a decreased increment of 201Tl extraction, suggesting a lower perfusion reserve in patients with alcoholic heart damage.

[Antioxidant therapy in the arrhythmic form of alcoholic heart damage]. / Antioksidantnaia terapiia pri aritmicheskoi forme alkogol'nogo porazheniia serdtsa.

The impact of antioxidative therapy with dibunol on the clinical course of an arrhythmic type of alcoholic damage was studied. A total of 20 patients with Stage II chronic alcoholism (mean age 38.1 +/- 1.9 years) and ventricular premature contraction were examined. The diagnosis of cardiac alcoholic damage was established after comprehensive studies. The effects of dibunol on the pattern of ventricular arrhythmias were tested by 24--hour Holter monitoring: control, on days 10 and 20 of therapy. The daily dosage of dibunol was 20 mg per kg body weight. The results of studies suggest that dibunol exerts a beneficial effect on the clinical course of the disease and the nature of ventricular arrhythmias by reducing the number of ventricular extrasystoles by 51.4%.

[Cardiac arrhythmia and myocardial contraction in opium and ephedrone addiction]. / Narusheniia ritma serdtsa i sokratimost' miokarda pri opiinoi i éfedronovoi narkomanii.

Sixty-two patients with opium and ephedrone abuse were studied. They underwent 24-hour Holter monitoring, resting ECG and echocardiography, 18 of them having volumetric loading with polyglucine, 400.0 ml, i.v. Sinus tachycardia was detected in 67.4%, ventricular extrasystole in 4.7%, supraventricular extrasystole with infrequent paroxysms of supraventricular tachycardia in 11.6%. Despite the fact that signs of heart failure were absent and myocardial contractility was normal at rest, echocardiography along with volume loading allow one to reveal in patients some abnormal contractile alterations in the left ventricle. These include its increased volumes, decreased ejection fraction and circulatory shortening rate of myocardial fibers, which suggests that the compensatory potentials of the myocardium are reduced in drug abuse.

[Anti-arrhythmic therapy of patients with recurrent ventricular tachycardias after prior myocardial infarction]. / Antiaritmicheskoe lechenie bol'nykh s retsidiviruiushchimi zheludochkovymi takhikardiiami posle perenesënnogo infarkta miokarda.

An examination of 30 patients with paroxysmal ventricular tachycardias following prior myocardial infarction showed that drug tests by using invasive and noninvasive monitoring of the action of antiarrhythmic agents allowed beneficial pharmacotherapy to be chosen for their long-term use in 20% of this category of patients. The remaining 80% were resistant to antiarrhythmic drug therapy, which was associated with the highly unfavourable prognosis confirmed by 50% mortality on a 2-year follow-up. Open heart surgeries were performed in 3 cases refractory to antiarrhythmic therapy. The operations aimed at liquidating the source of tachycardia produced a full antiarrhythmic effect. The application of this method for treating patients with postinfarction cardiosclerosis is limited by severe organic heart lesion that determines the high risk of operative mortality. This makes it necessary to intensively develop other methods of non-drug therapy providing less surgical intervention and to introduce them into practice.

[Comprehensive evaluation of the severity of illness in patients with ventricular arrhythmias by using a mathematical method]. / Kompleksnaia otsenka tiazhesti sostoianiia bolnykh s zheludochkovymi aritmiiami s pomoshchíu matematicheskogo metoda.

A comprehensive method for objectivization of the condition in patients with ventricular arrhythmias has been first developed and tested. Equations for determining the severity indices for ventricular arrhythmias, coronary dysfunction, heart failure, and arterial hypertension have been derived on the basis of isolation and mathematical formalization of clinical and instrumental signs of the above abnormalities. With the derived indices it is possible to make a valid comprehensive assessment of the severity of ventricular arrhythmias, to identify the syndrome predominant in the clinical course of the syndrome, and to quantify the efficiency of inpatient and long-term outpatient therapy.

[Use of a Soviet-made device for recording late ventricular potentials]. / Ispol'zovanie otechestvennoi ustanovki dlia registratsii pozdnikh potentsialov zheludochkov.

Late ventricular potentials (LVP) were detected with an ECG signal-averaging installation developed at the Institute of Radio Engineering and Electronics, USSR Academy of Sciences. A total of 103 patients were examined: 33 with sustained ventricular tachycardia (VT), 30 with unsustained VT and high-grade ventricular premature contraction, 20 with coronary heart disease, postinfarction cardiosclerosis without arrhythmias and 20 apparently healthy subjects (controls). LVPs are the most susceptible to sustained VT in the presence of postinfarction cardiosclerosis (77%), their specificity is lower (70%). LVPs are a low sensitive marker (35%) for sustained idiopathic VT. In unsustained VT and high-grade premature ventricular contraction, LVPs were recorded infrequently in 1 (3%) of the 30 patients.

[Elaboration of a quantitative method of evaluation of disease severity in patients with ventricular disorders of cardiac rhythm]. / Razrabotka kolichestvennogo metoda otsenki tiazhesti sostoianiia u bol'nykh s zheludochkovymi narusheniiami ritma serdtsa.

Mathematical approaches to the evaluation of the severity of the pathological process were used to develop an objective quantitative method to assess the severity of ventricular arrhythmias. The method is highly informative and reliable. It may be useful in the control of the efficacy of antiarrhythmic therapy and in the application of a differential approach to choice of therapy strategy for the patients.

[Electrophysiological mechanisms of the effect of allapinin in patients with paroxysmal supraventricular tachycardia]. / Elektrofiziologicheskie mekhanizmy deistviia allapinina u bol'nykh s paroksizmal'nymi nadzheludochkovymi takhikardiiami.

An intracardiac electrophysiological study was undertaken to examine 15 patients with paroxysmal supraventricular tachycardias. Allapinin intravenously given in a dose of 0.4 mg/kg, was tested for effects. The agent was demonstrated to cause a substantial inhibition of rapid retrograde pathway function in atrioventricular nodal tachycardia and abnormal antero- and retrograde pathway function. This is the major aspect of the drug's action that prevents the development of episodes of paroxysmal supraventricular tachycardias. The agent fails to virtually affect the function of the atrioventricular node in the anterograde direction in the two types of the tachycardia. Thus, allapinin has the mechanism of action that is typical of quinidine-like drugs used in supraventricular tachycardias.

[The use of the phase-image method for noninvasive topical diagnosis in certain forms of heart rhythm disorders]. / Ispol'zovanie metoda fazovykh izobrazhenii dlia neinvazivnoi topicheskoi diagnostiki pri nekotorykh formakh narushenii ritma serdtsa.

The authors describe the results of mapping additional conduction pathways in WPW syndrome and ectopic sources of the ventricular rhythm with the aid of phasic images (PI). The mapping data were compared to the readings of 12 ECG leads and to the electrophysiological findings. The mapping with the aid of PI turned out informative in both patients' groups. The PI method demonstrated the possibility of Kent's bundle mapping in latent WPW syndrome. The use of the PI method is suggested to be the first stage in the mapping of Kent's bundle in WPW patients suffering from supraventricular tachycardias as well as of pathological rhythm sources in ventricular tachycardias refractory to drug therapy in patients who are to undergo surgical treatment.

[Effectiveness of single intravenous administration of cordarone, ethacizine and obsidan in ventricular extrasystole in patients with chronic alcoholism during withdrawal]. / Effektivnost' odnokratnogo vnutrivennogo vvedeniia kordarona, étatsizina i obzidana pri zheludochkovoi ékstrasistolii u bol'nykh khronicheskim alkogolizmom v sostoianii abstinentsii.

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.

[Changes in systemic and intracardiac hemodynamics during bicycle ergometry in patients with fibrillation arrhythmia treated with allapinin before and after sinus rhythm recovery]. / Izmenenie sistemnoi i vnutriserdechnoi gemodinamiki vo vremia veloérgometrii u bol'nykh s mertsiatel'noi aritmiei na fone priema allapinina do i posle vosstanovleniia sinusovogo ritma.

In atrial fibrillation, allapinine was shown to enhance rhythm by 7% and to increase cardiac output (p less than 0.05), as well as to slightly lower mean blood pressure and peripheral vascular resistance at rest. With exercise, both in atrial fibrillation, and sinus rhythm, there was a decrease in end-diastolic and end-systolic volumes of the left ventricle (p less than 0.05), a slight drop in ventricular ejection, that was statistically significant only with sinus rhythm (p less than 0.05). Physical exercise was not followed by an apparent additional aggravation of myocardial contractility, which makes allapinine preferable for long-term application to preserve sinus rhythm in patients without evident signs of heart failure.

[Cardiac arrhythmias in patients with chronic alcoholism during abstinence]. / Narushenie ritma serdtsa u bol'nykh khronicheskim alkogolizmom v sostoianii abstinentsii.

A study was undertaken to examine 25 chronic alcoholics in abstinence. A 24-hour monitoring was performed during and extra this state. Chest x-ray study, bicycle ergometry, ultrasonic study of the heart, transesophageal pacing and blood thyroid hormone levels were applied to exclude other causes of cardiac arrhythmias. In alcoholic abstinence, various cardiac arrhythmias appeared as ventricular premature beats (including those of high grade), supraventricular premature beats, supraventricular tachycardias and paroxysmal atrial fibrillation were recorded in all 25 patients. When the abstinence was absent, no cardiac arrhythmias were found in 11 (44%) patients, in 14 (56%) patients who had various arrhythmias, their frequency and number of attacks significantly being lower.

[Effect of a new anti-arrhythmia drug allapinin on hemodynamics in patients with a persistent form of atrial fibrillation before and after restoration of sinus rhythm]. / Vliianie novogo antiaritmicheskogo preparata allapinina na gemodinamiku u bol'nykh s postoianno'i formoi mertsatel'noi aritmii do i posle vosstanovleniia sinusovogo ritma.

Echocardiographic study was performed in 24 patients with persistent atrial fibrillation (PAF) without clinical signs of circulatory failure. When treated with allapinin , all the patients with PAF showed a significant increase in heart rate (HR) and cardiac output (CO) and a decrease in total peripheral vascular resistance (TPVR). No substantial changes in the major hemodynamic parameters were found in patients with higher left ventricular dimensions; however, a significant rise in end systolic volume (ESV) was noted. There was significantly lower HR, diminished ESV, higher stroke volume and increased CO, elevated ejection fraction and TPVR with sinus rhythm. In PAF patients without apparent signs of circulatory failure, hemodynamic effects of allapinin may be accounted for by its direct vasodilatory action on the arterial bed and by its ability to affect cardiac autonomic innervation. A moderate cardiodepressive effect of the agent may be reflected by deteriorated latent signs of myocardial incompetence which are levelled off following sinus rhythm recovery.

[Use of phase images in radionuclide ventriculography for topical diagnosis of Wolff-Parkinson-White syndrome and sources of pathologic rhythm of the heart ventricles]. / Primenenie fazovykh izobrazhenii v radionuklidnoi ventrikulo-grafii dlia topicheskoi diagnostiki sindroma Vol'fa-Parkinsona-Yaita i istochnikov patologischeskikh ritmov v zheludochkakh.

The paper presents the results of the mapping of various types of the Wolff-Parkinson-White syndrome and ventricular arrhythmias by using phase images of radionuclide ventriculograms as compared to 12 leads and electrophysiological studies. Phase images are a highly informative method that supplements an electrophysiological study in the topical diagnosis of abnormal tracts and ventricular arrhythmias.

[Comparative study of the effects of verapamil, ethmozin and ethacizine on provoked attacks of atrioventricular nodal reciprocal tachycardia]. / Sravnitel'noe izuchenie vliianiia verapamila, etmozina i étatsizina na provotsirovanie pristupov atrioventrikuliarnoi uzlovoi retsiproknoi takhikardii.

27 patients underwent serial electrophysiological studies by using transesophageal atrial stimulation. A-V nodal reciprocal tachycardia was documented by intracardiac electrophysiological examinations. Sustained tachycardia was induced in all the patients before drug administration. On day 4 after oral verapamil, 320 mg/day, ethmosine, 800 mg/day, and ethacizine, 150 mg/day, the patients were subjected to transesophageal atrial stimulation. An antiarrhythmic effect was regarded to be reached if the authors failed to induced sustained tachycardias again. Verapamil, ethmosine, and ethacizine were found to be beneficial in 21 (78%), 13 (48%) and 21 (78%) patients, respectively. A comparative analysis demonstrated that ethacisine was not inferior to verapamil, but ethmosine produced less effects than verapamil and ethacizine. The crossover and individual efficacy shown by each drug suggests that it is necessary to use the technique of serial testing and to choose beneficial drugs from a possibly wide range of medicaments for each patient.