[Surgical treatment of children with ectopic atrial tachycardia]. / Khirurgicheskoe lechenie detei s éktopicheskoi predserdnoi takhikardiei.

Up-to-date electrophysiologic investigations of the heart, carried out in 212 children with arrhythmias, demonstrated a focus of ectopic atrial tachycardia in 21 (9.9%); 17 of those underwent long-term treatment (up to 10 years) with antiarrhythmic drugs. Kordaron produced a positive effect (discontinuation of the attacks) in 1 case only. Combined use of several antiarrhythmic drugs controlled the frequency of tachycardia in 4 patients. Signs of dilatation cardiomyopathy were in evidence in 60% of children with permanent ectopic tachycardia. Seven of 12 patients who failed to respond to medication were eventually subjected to radical surgery. All but one were discharged from hospital without additional medication and with normal heart rhythm. One child developed groups of extrasystoles generated by the lower right-atrial portion during the 2nd week after surgery. They diminished and eventually disappeared after a supportive digoxin treatment. Surgery is therefore regarded as an effective and radical treatment for ectopic atrial tachycardia in children.

[Ambulatory electrophysiological diagnosis of heart rhythm disorders]. / Ambulatornaia élektrofiziologicheskaia diagnostika narushenii serdechnogo ritma.

A noninvasive method of electrophysiologic investigation (EPI) making use of programmed esophageal electrostimulation of the heart has been developed on the basis of EPI carried out in 2158 inpatients (including 1273 procedures involving esophageal electrostimulation of the heart). Its introduction in an outpatient cardiologic clinic in Kaunas made it possible to investigate 522 patients with heart rhythm disorders in 1985 alone. Effective antiarrhythmic therapy could be selected for 389 (74.5%) patients on an outpatient basis, while 133 (25.5%) patients had to be referred to hospital for more detailed EPI, implantation of an indwelling pacemaker or radical surgery. It is demonstrated that an adequate antiarrhythmic treatment can be selected on an outpatient basis.

[Various problems of examining and treating children with ventricular pre-excitation syndrome]. / Nekotorye voprosy issledovaniia i lecheniia detei s sindromom prezhdevremennogo vozbuzhdeniia zheludochkov.

Thirty-three children, aged 6 months to 14 years, with the pre-excitation syndrome were examined. Esophageal electrophysiological heart studies were conducted in all cases, and intracardiac electrophysiological studies, in 11 of those. Functional characteristics of the accessory pathways were established, and the most efficient treatment chosen. Nine children were in need of surgical treatment because of the short effective refractory period of the accessory pathways and life-threatening arrhythmias. Radical operations (surgical interruption of the accessory pathways) were performed in 22 children.

[Method of transesophageal electrostimulation of the ventricles in clinical practice]. / Metodika chrespishchevodnoi élektrostimuliatsii zheludochkov v klinike.

Possibilities of improving the efficacy of the trans-esophageal ventricular electrostimulation were studied in 22 patients with pacemaker weakness, the Wolff-Parkinson-White syndrome, transverse block and other disorders of the rhythm and conductivity of the heart. It has been shown that the amplitude of impulses in trans-esophageal ventricular electrostimulation may be decreased on the average to 32.36 +/- 1.37 V with the help of a specially-designed electrode, the optimal positioning of its cathode contact in the esophagus and the lengthening of electrical impulses. Trans-esophageal electrostimulation of the ventricles broadens the possibilities of the noninvasive electrophysiological examination and the treatment of complicated disturbances of the cardiac rhythm and conductivity.

[Justification of the indications for radio-frequency electrostimulation of the atria and the results of its use in paroxysmal supraventricular tachycardias]. / Obosnovanie pokazanii k radiochastotnoi élektrostimuliatsii predserdii i rezul'taty ee primeneniia pri paroksizmal'nykh supraventrikuliarnykh takhikardiiakh.

Re-entry tachycardia was found in 182 patients of a total of 275 subjected to electrophysiological investigation of heart function; in 26 of those, a radio-frequency atrial electrostimulation system was implanted. Early postoperative complications were noted in 3 patients: subcutaneous hematoma in 2, and skin decubitus in 1. Long-term follow-up (as long as 7 years) confirmed the efficiency of atrial radio-frequency pacing.

[Value and methodology of electric stimulation in intracardiac examination of patients with ventricular pre-excitation syndrome]. / Znachenie i metodika elektrostimuliatsii pri vnutriserdechnykh issledovaniiakh bol'nykh s sindromom prezhdevremennogo vozbuzhdeniia zheludochkov.

The procedures involved in different techniques of cardiac electrostimulation for the diagnosis of the pre-excitement syndrome were examined in 154 patients. In a group of 150 patients with provoked (140) or spontaneous (10) tachycardia developing in response to endocardial electrocartography, the paroxysmal supraventricular tachycardia was noted in 95.5%, atrial flutter in 11.4%, atrial flutter-fibrillation in 5.7%, atrial fibrillation in 29.8%, A-V tachycardia in 3.7%. The methods of diagnostic cardiac electrostimulation are of great importance in determining the type, localization, electrophysiologic properties and mechanisms of heart rhythm disorders and in selecting a rational therapeutic method.

[Transesophageal precardiac electrostimulation in a functional study of the sinus node]. / Chrespishchevodnaia predserdnaia élektrostimuliatsiia pri issledovanii funktsii sinusovogo uzla.

The transoesophageal electrostimulation of the heart has been used to evaluate the function of the sinus node in 103 patients. The artificial rhythm was enforced in 94.2% of cases. The syndrome of sinus node weakness was diagnosed in 32 patients. The transoesophageal electrostimulation of the atria is a safe and simple method for diagnosis of functional sinus node disorders.