[Effects of digoxin on ventricular arrhythmias in patients with mitral valve defects]. / Vliianie digoksina na zheludochkovye narusheniia ritma u bol'nykh mitral'nymi porokami serdtsa.

A study was undertaken to examine 55 (27 females and 28 males) patients aged 25 to 74 years who had ventricular arrhythmias. Twenty five patients were diagnosed as having mitral valvular disease concurrent with predominant stenosis, 30 presented with prevalent mitral dysfunction. Twenty eight patients showed Stages I to IIA circulatory failure, and 27 had Stages IIB to III heart failure. All the patients displayed perpetual ciliary arrhythmia of various duration. More frequent and severe ventricular arrhythmias were recorded in mitral valvular disease patients with predominant mitral dysfunction than in those with stenoses. When the plasma digoxin concentration was less than 1.1 ng/ml in patients with a low end-diastolic volume and initial signs of circulatory failure, the agent produced an antiarrhythmic effects on ventricular arrhythmias in many cases, in mitral valvular disease patients with predominant stenosis in particular. The arrhythmogenic effect of digoxin was found in 47.6% patients with prevalent mitral dysfunction concurrent with Stages IIB-III circulatory failure. The agent may show arrhythmogenic action in mitral valvular disease patients with prevalent mitral dysfunction who had larger cardiac volumes and plasma digoxin concentrations of no more than 1.6 ng/ml in the absence of clinical signs of digitalis intoxication.

[Anti-arrhythmic effectiveness of allapinin in ventricular arrhythmia in patients with circulatory failure]. / Antiaritmicheskaia effektivnost' allapinina pri zheludochkovykh narusheniiakh ritma u bol'nykh s nedostatochnost'iu krovo-obrashcheniia.

Antiarrhythmic efficacy of allapinin was assessed in 15 patients with heart failure combined with ventricular arrhythmias (48 h ECG monitoring). The drug was administered against a background of maintenance therapy with digoxin at a daily dose of 75 mg (digoxin concentration in blood plasma was 1.51 +/- 0.12 ng/ml). The drug was shown to possess marked antiarrhythmic activity causing a decrease of the total number of ventricular extra systoles by an average of 72.3%, group ventricular extrasystoles--by 84.5%. The drug can be recommended in combination with cardiac glycosides to patients with severe heart failure combined with ventricular arrhythmias.

[Anti-arrhythmia and arrhythmogenic actions of digoxin in ventricular rhythm disorders in patients with circulatory insufficiency]. / Antiaritmicheskoe i aritmogennoe deistvie digoksina pri zheludochkovykh narusheniiakh ritma u bol'nykh s nedostatochnost'iu krovoobrashcheniia.

Three-day ECG monitoring before and after digitalization of 55 patients with heart failure (HF) was performed. Digoxin did not make a considerable effect on the frequency of detection of high gradations of ventricular arrhythmias. Nevertheless it significantly reduced the mean number of ventricular extrasystoles (VES) per hour and the mean number of complex VES per hour in 8 (33.3%) patients out of 24 with frequent extrasystoles. A significant increase in the VES mean number per hour and in the complex VES mean number per hour was observed in 6 (25%) patients out of 24 with basal frequent extrasystoles. In patients with the antiarrhythmic effect of digoxin indices of the central hemodynamics (diastolic pressure in the pulmonary artery and ejection fraction) were significantly better and in patients with the arrhythmogenic effect of digoxin significantly worse in the absence of a significant difference between digoxin and K+ concentration in the plasma. Digoxin possessed a moderately pronounced antiarrhythmic effect mainly in the patients with HF early stages and in moderately pronounced disturbances of the central hemodynamics. In patients with severe manifestations of HF and with considerable deterioration of indices of the central hemodynamics digoxin in therapeutic concentrations can make an arrhythmogenic effect.

[Assessment of heart rhythm in patients with dilated cardiomyopathy based on daily ECG monitoring data]. / Otsenka ritma serdtsa u bol'nykh s dilatatsionnoi kardiomiopatiei po dannym sutochnogo monitorivanniia EKG.

The quantitative and qualitative characteristics of arrhythmias were examined, using continuous 24-hour ECG monitoring, in 25 patients with dilatation cardiomyopathy. Supraventricular extrasystole was found in 100% of patients with the sinus rhythm, and ventricular extrasystoles, in 94% of patients, being most commonly associated with poor prognosis (polytopic extrasystoles in 84%, paired extrasystoles in 60%, and paroxysmal ventricular tachycardia in 40%). Disorders of atrio-ventricular conductivity were recorded in 47.6% of patients with the sinus rhythm, 23.8% of those showing a permanent 1st-degree block, and the rest, a transient block of the 1st--3d degree. It was demonstrated that arrhythmias could serve as a permanent sign of dilatation cardiomyopathy, being most commonly of a complex nature and associated with poor prognosis.

[Disorders of heart rhythm and conduction in dilated and hypertrophic cardiomyopathies]. / Narusheniia ritma i provodimosti serdtsa pri dilatatsionnoi i gipertroficheskoi kardiomiopatii.

Idiopathic cardiomyopathies are characterized by diversity of clinical manifestations, among which heart rhythm abnormalities are the most common. The authors carried out qualitative and quantitative evaluations of heart rhythm abnormalities in patients with dilated and hypertrophic cardiomyopathies (DCMP, HCMP) and compared those abnormalities according to the data of daily ECG monitoring. Forty patients with DCMP and 30 with HCMP were examined. In 8 (25%) patients with DCMP and in 2 (6.7%) with HCMP, permanent atrial fibrillation was recorded. Among patients with sinus rhythm, supraventricular premature heart beats were found in 30 (96.8%) patients with DCMP and in 24 (85.7%) with HCMP. However, their number during 24 h exceeded 500 in 9 (29%) and in 7 (25%) patients, respectively. Supraventricular paroxysmal tachycardia (greater than or equal to 3 complexes at HR greater than or equal to 100/min) was recorded in 7 (22.6%) patients with DCMP and in 4 (14.3%) patients with HCMP. Ventricular premature heart beats were recorded in 38 (95%) patients with DCMP and in 21 (70%) patients with HCMP, polytopic in 31 (77.5% and 17 (56.7%), coupled in 227 (67.5%) and 10 (33.3%), ventricular paroxysmal tachycardia (greater than or equal to 3 complexes at HR greater than or equal to 100/min) in 22 (55%) and 5 (16.7%) patients, respectively. AV conduction abnormalities among patients with sinus rhythm were noted in DCMP and HCMP, in 12 (38.7%) and 1 (3.6%) cases, respectively. Thus, heart rhythm abnormalities are often encountered in both patients with DCMP and HCMP. However, in patients with DCMP, heart arrhythmias are graver and prognostically unfavourable.(ABSTRACT TRUNCATED AT 250 WORDS)

[Heart rhythm disorder in congestive cardiomyopathy (data from ECG at rest and from daily ECG monitoring)]. / Narushenie ritma serdtsa pri zastoinoi kardiomiopatii (dannye EKG pokoia i sutochnogo monitorirovaniia EKG).

In 55 patients with congestive cardiomyopathy, types of arrhythmias were studied according to the 12 lead data of the ECG at rest and daily monitoring observation. Arrhythmias have ascertained to be one of the constant signs of this disease. Interventricular conduction disturbances (72.7%), atrioventricular block of low degree (56.1%), ventricular extrasystole (40%), and atrial fibrillation (20%) are most frequently recorded on the ECG at rest. While recording the ECG for a day with a Holter monitor, polytopic ventricular extrasystole was revealed in 100% of the patients studied. Ventricular and supraventricular tachycardia paroxysms were found in 54.5% of the cases. This observation is of prognostic significance as it indicates a risk of sudden death.