ABSTRACT
The paper proposes an original algorithm for the management of patients with ventricular arrhythmia from its first registration to choice of treatment policy. Using modern diagnostic methods, much attention is paid to the identification of myocardial structural and ischemic changes and also to the involvement of the autonomic and central nervous systems in ventricular arrhythmogenesis. The diagnostic problems are solved step-by-step. The role of psychological diagnosis is accentuated. Longitudinal electrocardiogram monitoring with telemetric data transmission can promptly initiate treatment of patients in an outpatient setting and, in a number of cases, without discontinuing work. The key point of the algorithm proposed is to prevent sudden cardiac death.
Subject(s)
Algorithms , Ventricular Fibrillation/diagnosis , Ventricular Fibrillation/therapy , HumansABSTRACT
A total of 178 patients with labile arterial hypertension were examined for the effect of propranolol and clonidine on the central hemodynamics, plasma renin, dopamine- beta-hydroxylase, urine kallikrein, and blood prekallikrein and kallikrein. The results suggest that basic to changes in the hemodynamics produced by a single administration of propranolol is its beta-adrenoblocking effect proper. The decrease in the general peripheral resistance due to prolonged propranolol therapy may be determined by activation of the blood kallikrein-kinin system and enhancement of the descending inhibition of the sympathetic nervous system because of activation of the central alpha-adrenoreceptors under long-term blockade of beta-adrenoreceptors of the central nervous system. The changes in the hemodynamics produced by low doses of clonidine may be accounted for by its central alpha-adrenomimetic effect.
