The New Approach to Preventive Antiarrhythmic Therapies of Paroxysmal Tachycardias by Means of Electrophysiological Research of Heart
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: firstname.lastname@example.org
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.
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