[Rhythmic and conductive disorders in the acute stage of cardiac infarct]. / Ritumni i provodni narusheniia v ostriia stadii na surdechniia infarkt

Rhythm and conductive disturbances were established in 170 (63,8%) out of 266 patients with fresh cardiac infarction, in the greatest part with prophylactically applied lidocain i.m. With age advancing a growth in their incidence is established but no statistical difference between the age groups 20-59 and 60-90 was found. Rhythm disturbances are found more frequently in women (81,6%) as compared with the men 58,7%) while the incidence in patients with posterior (62, 5%) and anterior (65, 7%) infarction is the same. Th-disturbances due to electrical instability and failure are more frequent in anterior infarction. Statistical difference (P less than 0,001) was established concerning the rhythm disturbances in patients with heart failure and without it, with a prevalence of sinus tachycardia, auricular fibrillation, ventricular extrasystoles, ventricular tachycardia and bundle branch block. The timely diagnosis and the treatment with medicaments led to the restoration of sinus rhythml in 79 out of 94 disturbances and with electrical shock in 12 out of 16. Parallelly with the classica netirhythm medicines (chinidine and procainamid), newer ones are used as tachmalin, lidocaine, abta-blockers, sympaticomimetics and temporary intracardial electric stimulation.

[Our experience in using temporary and permanent electric stimulation in conduction disorders]. / Nashiiat opit ot prilozhenieto na vremenna i postoianna elektricheska stimulatsiia pri provodnite narusheniia

The results from the observation of 49 patients with complete and incomplete AV block are reported, 33 of them with attacks of MAC syndrome; asystolia 25, ventricular tachycardia and ventricular fibrillation--8. Temporary electric stimulation is carried out in 31 patients (21 with chronic complete AV block and 10 with incomplete and complete with recent cardiac infarction). In all patients with chronic AV block but one, implantation of a permanent artificial rhythm nuide was necessary. The prognosis of the patients with implanted permanent stimulator is determined by the myocardial state, out of six patients with cardiac insufficiency -- three died in a period of 1 to 12 months. Recommendations are presented for active finding out and dispensary control of patients with conduction disturbances and wider application of temporary electric stimulation in the intensive care and treatment units.