Republican Specialized Center of Cardiology, Tashkent, Uzbekistan
*Corresponding author: Bakhrom Z. Jalolov, PhD, Republican Specialized Center of Cardiology. 4 Osie str., 100052, Tashkent, Uzbekistan Tel: 998-71-2373816, 998-97-1568118. Fax: 998-71-2341667 E-mail: jalolov_b_73@mail.ru
As many as 126 patients with paroxysmal tachycardia (PT) were surveyed. Depending on the way of selection of preventive antiarrhythmic therapies (AAT) the patients were divided into two groups, namely Group 1 and Group 2. Group 1 was the control group in which the treatment selected was a known method. AAT for Group 1 was appointed on the basis of an intravenous test during intracardiac electrophysiological investigation (EPI); for the per oral test the same preparation was performed the next day during transesophageal EPI (TEPI) by "saturation" of the preparation for 3 to 5 days. If it was not possible to induce a PT, treatment would be according to the intracardiac EPI. In Group 2 a selection of therapy was performed by an offered method. Etmozine, verapamil, propafenone, and quinidine were used for treatment of both groups. An advanced method of chronic intracardiac EPI, based on repeated induced PT and tachyarrhythmia with background per oral testing of AAT during their "saturation", allows to increase the efficiency of treatment in the remote period up to 98% and by an individual dose approach and the scheme of purpose of preparations which were found to correspond only in 47% of cases. The predictive criterion of the long-term efficiency of AAPs, revealed during their "saturation" in reciprocal orthodromic AV tachycardia (ROAVT) and reciprocal intranodal AV tachycardia (RIAVT), was the elimination of a zone of vulnerability or its acute reduction: for ROAVT, reduction of Wenkebach "point" to not less than 30 impulses per minute is necessary; for a tachycardia also with AF, elimination or acute reduction of a zone of vulnerability, along with increase of the ERP of AV connections in the antergrade direction and decrease of Wenkebach "point" to not less than 30 impulses per minute is required. For patients with ROAVT and AF, frequency of reproducibility of PT and tachyarrhythmia above the authentic level on performing intracardiac ECS, compared to TEPI, also does not differ for patients with RIAVT.
1.Bredikis Yu, Dumchus A. The electrical stimulation of the heart. Vilnius: Medicine, 1984.
2. Capucci A, Boriani G, Botto GL, et al Conversion of recent-onset atrial fibrillation by single oral loading dose of propafenone or flecainide. Am J Cardiol 1994; 74:503-505.
3. Chazov EI, Belenkow YN. The Rational pharmacotherapy of cardiovascular disease. Moscow: Litterra, 2005.
4. Epstein LM, Scheinman MM. Modification of the atrioventricular node. A new approach to the treatment of supraventricular tachycardias. Cardiol Clin 1990; 8(3):567-74.
5. Gintant G, Hoffman B. Use-dependent block of cardiac sodium channels by quaternary derivatives of lidocaine. Pflugers Arch 1984; 400(2):121-129.
6. Golitsyn SP. Treatment of patients with ventricular arrhythmias. Kardiologiia 1998; 10:67-77.
7. Hayes D, Von Feldt L, Neubauer S. Does P-wave amplitude predict occurrence of atrial fibrillation following DDD implant? PACE 1991; 14(4):675.
8. Kozlov VL, Rjabykina GV, Akchurin RS, et al. Diagnostic value of dynamics of electric potential of an impulse at patients after implantation of pacemaker at monopolar heart stimulation. Kardiologiia 1995; 35:72-77.
9. Wellens HJ, Brugada P, Stevenson WG. Programmed electrical stimulation of the heart in patients with life-threatening ventricular arrhythmias: what is the significance of induced arrhythmias and what is the correct stimulation protocol? Circulation 1985; 72(1):1-7.
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