ajmaline and Atrial-Flutter

Tachyarrhythmias which originate above the bifurcation of the bundle of His or incorporate tissue proximal to it are classified as supraventricular tachyarrhythmias (SVT). Primary treatment of SVT attempts to influence the underlying disease. Therapy is subdivided into drug therapy, electrotherapeutic tools (e.g. antitachycardia pacemakers, catheter ablation) and antiarrhythmic surgery. Antiarrhythmic agents which slow conduction and suppress premature beats are efficient for emergency and long-term treatment of supraventricular tachycardias. We evaluated some of the most relevant antiarrhythmic drugs for SVT including propafenone, diprafenone, cibenzoline, lorcainide and sotalol; in addition, usage and efficacy of quinidine/verapamil, disopyramide, amiodarone, ajmaline, adenosine and flecainide are summarized. The principles for acute management of tachycardia episodes with narrow and broad complexes are outlined. The reason for the selection as well as the efficacy in the termination of the tachycardias is described for different antiarrhythmic agents including verapamil, adenosine, ajmaline, propafenone and flecainide.

Topics: Ajmaline; Amiodarone; Anti-Arrhythmia Agents; Atrial Fibrillation; Atrial Flutter; Disopyramide; Flecainide; Humans; Imidazoles; Pre-Excitation Syndromes; Propafenone; Quinidine; Sotalol; Tachycardia, Paroxysmal; Tachycardia, Supraventricular; Verapamil

Topics: Action Potentials; Ajmaline; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Atrial Fibrillation; Atrial Flutter; Cardiac Complexes, Premature; Heart; Heart Conduction System; Humans; Lidocaine; Phenytoin; Practolol; Procainamide; Quinidine; Sparteine; Ventricular Fibrillation; Verapamil

Ajmaline, a reserpine derivative, is an effective class I antiarrhythmic agent. Herein we report two cases of ajmaline-induced abnormal QT prolongation accompanied by polymorphic ventricular tachycardia of the torsade de pointes type. Since ajmaline is increasingly used for the acute termination of wide complex tachycardia and as a diagnostic tool after syncope and in patients with idiopathic ventricular tachyarrhythmias, our observations suggest that caution should be exercised with regard to the effects of the drug on the QT interval and its potency to induce proarrhythmia of the torsade de pointes type.

Topics: Ajmaline; Anti-Arrhythmia Agents; Atrial Flutter; Electrocardiography; Female; Humans; Long QT Syndrome; Male; Middle Aged; Tachycardia; Tachycardia, Ventricular; Torsades de Pointes

The conservative management of supraventricular tachycardias is briefly surveyed and described. For exact treatment a description of different ways of origin of tachycardias such as focal activity or reentry-mechanisms is given. A diagram at the end shows the site of influence of different antiarrhythmic drugs in the atria and the AV-node as well as the accessory pathways in preexcitation. A list of antiarrhythmics according to their classification of Vaughan Williams and of Tournboul completes this survey.

Topics: Adrenergic beta-Antagonists; Ajmaline; Anti-Arrhythmia Agents; Atrial Fibrillation; Atrial Flutter; Digitalis Glycosides; Electrocardiography; Humans; Propafenone; Propiophenones; Tachycardia; Verapamil

Ajmaline was administered intravenously to six patients with the Wolff-Parkinson-White syndrome for the acute management of paroxysmal atrial flutter (three patients) or fibrillation (three patients) with a fast ventricular response (over the accessory pathway). Ajmaline increased refractoriness in the accessory pathway in all three patients with atrial flutter and stopped the flutter in one. The drug completely abolished preexcitation in two of the three patients with atrial fibrillation, decreasing the means ventricular rate of 240 and 300 beats/min to 110 and 180 beats/min, respectively. In the third patient with atrial fibrillation, ajmaline increased refractoriness over the accessory pathway, decreasing the mean ventricular rate of 300 beats/min to 160 beats/min. In two patients ajmaline was continued as an intravenous maintenance infusion until sinus rhythm was restored. It is concluded that ajmaline is an effective drug for the acute management of atrial flutter or fibrillation with a fast ventricular response in patients with the Wolff-Parkinson-White syndrome.

Topics: Adult; Aged; Ajmaline; Atrial Fibrillation; Atrial Flutter; Electrocardiography; Female; Heart Rate; Humans; Injections, Intravenous; Male; Middle Aged; Wolff-Parkinson-White Syndrome

Topics: Adrenergic beta-Antagonists; Ajmaline; Amiodarone; Anti-Arrhythmia Agents; Arrhythmia, Sinus; Arrhythmias, Cardiac; Atrial Fibrillation; Atrial Flutter; Cardiac Pacing, Artificial; Digoxin; Disopyramide; Electric Countershock; Humans; Phenytoin; Procainamide; Quinidine; Tachycardia; Tachycardia, Paroxysmal; Verapamil

Topics: Adult; Aged; Ajmaline; Anti-Arrhythmia Agents; Atrial Flutter; Electric Countershock; Humans; Middle Aged; Potassium Magnesium Aspartate; Procainamide; Propranolol; Strophanthins; Thiamine Pyrophosphate; Verapamil

Topics: Ajmaline; Atrial Flutter; Electrocardiography; Female; Heart; Humans; Male; Middle Aged

A case of agranulocytosis (min. leucocyte count 980/mm3) after 4 weeks of treatment with an ajmalin derivate is reported. Recovery could be achieved by taking away the antiarrhythmic drug. It appears that these agranulocytoses only happen after a dosage of more than 300 mg/die, and that they have an intermediate position between allergic and toxic agranulocytosis (phenothiazine type).

Topics: Aged; Agranulocytosis; Ajmaline; Atrial Fibrillation; Atrial Flutter; Humans; Male

Topics: Adrenergic beta-Antagonists; Ajmaline; Anti-Arrhythmia Agents; Atrial Fibrillation; Atrial Flutter; Cardiac Complexes, Premature; Humans; Lidocaine; Quinidine; Tachycardia; Tachycardia, Paroxysmal; Verapamil

Topics: Aconitine; Ajmaline; Animals; Anti-Arrhythmia Agents; Atrial Fibrillation; Atrial Flutter; Blood Pressure; Dogs; Dose-Response Relationship, Drug; Drug Evaluation, Preclinical; Heart Rate; Hemodynamics; Infusions, Parenteral; Vascular Resistance

Topics: Aconitum; Ajmaline; Animals; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Atrial Fibrillation; Atrial Flutter; Azepines; Benzoates; Cardiac Complexes, Premature; Dogs; Electrocardiography; Epinephrine; Heart Block; Male; Ouabain; Tachycardia

Topics: Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Atrial Fibrillation; Atrial Flutter; Coronary Disease; Female; Heart Diseases; Humans; Injections, Intravenous; Male; Middle Aged; Tachycardia

Topics: Adrenergic beta-Antagonists; Ajmaline; Arrhythmia, Sinus; Arrhythmias, Cardiac; Atrial Fibrillation; Atrial Flutter; Bradycardia; Cardiac Complexes, Premature; Digitalis Glycosides; Humans; Hypnotics and Sedatives; Reserpine; Tachycardia

Topics: Adrenergic beta-Antagonists; Ajmaline; Atrial Fibrillation; Atrial Flutter; Atropine; Bradycardia; Cardiac Complexes, Premature; Heart Block; Humans; Lidocaine; Metaproterenol; Phenytoin; Procainamide; Quinidine; Tachycardia; Verapamil

Topics: Acetanilides; Adrenergic beta-Antagonists; Ajmaline; Amino Alcohols; Arrhythmias, Cardiac; Atrial Fibrillation; Atrial Flutter; Bretylium Compounds; Digitalis Glycosides; Electric Countershock; Humans; Lidocaine; Phenytoin; Propranolol; Propylamines; Pyridines; Quinidine; Tachycardia, Paroxysmal; Ventricular Fibrillation

Topics: Adrenergic beta-Antagonists; Ajmaline; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Atrial Fibrillation; Atrial Flutter; Bradycardia; Digitalis Glycosides; Humans; Phenytoin; Procainamide; Quinidine; Sympatholytics; Tachycardia

Topics: Ajmaline; Atrial Fibrillation; Atrial Flutter; Cardiac Complexes, Premature; Humans; Rauwolfia; Tachycardia; Tachycardia, Paroxysmal; Toxicology

Topics: Ajmaline; Alkaloids; Atrial Flutter; Cardiac Complexes, Premature; Humans; Rauwolfia; Tachycardia; Tachycardia, Paroxysmal