[The effect of calypsol, thiopental sodium and fentanyl on the functional status of the sinoatrial node and the heart conduction system in patients with paroxysmal arrhythmias]. / Vliianie kalipsola, tiopental-natriia i fentanila na funktsional'noe sostoianie sinoatrial'nogo uzla i provodiashchei sistemy serdtsa u bol'nykh s paroksizmal'nymi narusheniiami serdechnogo ritma.

64 patients with paroxysmal arrhythmias caused in 44 cases by collateral atrioventricular pathways have been studied. Endocardial programmed electrical cardiostimulation was applied. It has been established that calypsol at a dose of 2 mg/kg significantly improves the functional state of the sinoatrial node, atrioventricular conduction and conduction in collateral atrioventricular pathways functioning both anterogradely and retrogradely. Fentanyl, already at a dose of 2.5 micrograms/kg inhibits considerably the functional state of the sinoatrial node, without affecting conduction in the normal AV system and in collateral atrioventricular pathways. Thiopental sodium at a dose of 7 mg/kg improves slightly the functional state of the sinoatrial node.

[The use of transvenous destruction of the atrioventricular junction for correcting hemodynamic disorders caused by ventricular-atrial conduction]. / Primenenie transvenoznoi destruktsii atrioventrikuliarnogo soedineniia dlia korrektsii narushenii gemodinamiki, vyzvannykh zheludochno-predserdnoi provodimost'iu.

The authors studied disorders of central and intracardiac hemodynamics occurring in electrostimulation of the ventricles attended by retrograde stimulation of the cardia. The experiments were conducted on 8 anesthetized dogs in whom, after disclosure of intact ventriculoatrial conduction, transvenous destruction of the atrioventricular junction was performed. Clinical study was carried out in 12 patients with continuous electrostimulation of the ventricles which caused retrograde stimulation of the atria, and in 19 patients with supraventricular tachyarrhythmia who were subjected to transvenous endocardial destruction of the atrioventricular junction. Due to the development of severe hemodynamic disorders in electrostimulation of the ventricles attended by retrograde stimulation of the atria the last named condition should be changed to ventriculoatrial dissociation which promotes growth of contractile activity and stroke volume of the left ventricle. Transvenous destruction of the atrioventricular junction is a reliable method for blocking retrograde conduction.

[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.

[Transesophageal electrostimulation of the atria in assessing the degree of the coronary bed lesion in ischemic heart disease patients]. / Chrespishchevodnaia élektrostimuliatsiia predserdii pri otsenke stepeni porazheniia koronarnogo rusla u bol'nykh ishemicheskoi bolezn'iu serdtsa.

Electrocardiographic changes in response to esophageal atrial electrostimulation were examined in relation to the severity of coronary-bed affection in 99 patients with suspected coronary heart disease. Esophageal atrial electrostimulation was equal, in terms of specificity and sensitivity (73 and 78%, respectively), to bicycle ergometry (77 and 74%), and was superior to it by far in terms of adjustment to diagnostic electrocardiographic criteria. A direct relationship was demonstrated between total ST depression induced by esophageal atrial electrostimulation and the extent of coronary-bed affection expressed as the number of affected coronary arteries or the impaired blood supply area.

[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.