ajmaline and Bradycardia

Topics: Ajmaline; Antiparkinson Agents; Bradycardia; Chlorine; Clinical Trials as Topic; Diarrhea; Drug Evaluation; Humans; Muscle Rigidity; Parkinson Disease; Stomach Diseases; Tremor

Topics: Ajmaline; Anti-Arrhythmia Agents; Antihypertensive Agents; Bradycardia; Dietary Supplements; Drug Contamination; Female; Herb-Drug Interactions; Humans; Hypertension; Hypotension; Phytotherapy; Plant Extracts; Plant Preparations; Reserpine

Bradycardic (heart rate<50/min) and tachycardic heart rhythm disturbances (100/min) require rapid therapeutic strategies. Supraventricular tachycardias (SVT) are sinus tachycardia, atrial tachycardia, AV-nodal reentrant tachycardia and tachycardia due to accessory pathways. Mostly SVT are characterized by small QRS complexes (QRS width<0.12 ms). It is essential to evaluate the arrhythmia history, to perform a good physical examination and to exactly analyze the 12-lead electrocardiogram. An exact diagnosis is then possible in >90% of SVT patients. Ventricular tachycardias have a broad QRS complex (>or=0.12 s), ventricular flutter and ventricular fibrillation are associated with chaotic electrophysiologic findings. For acute therapy, we will present the new concept of the "5A" that includes adenosine, adrenaline, ajmaline, amiodarone and atropine. Additional "B, C and D strategies" include betablocking agents, cardioversion as well as defibrillation. The "5A" concept allows a safe and effective antiarrhythmic treatment of all bradycardic and tachycardic arrhythmias as well as asystolia.

Topics: Adenosine; Adrenergic beta-Antagonists; Ajmaline; Amiodarone; Anti-Arrhythmia Agents; Atropine; Bradycardia; Defibrillators, Implantable; Electric Countershock; Electrocardiography; Emergencies; Epinephrine; Heart Rate; Humans; Pacemaker, Artificial; Signal Processing, Computer-Assisted; Tachycardia

The effects of a herbal drug, Ajmaloon (Hamdard, India), on the arterial blood pressure, heart rate (HR) and baroreceptor-heart rate reflex were studied in anesthetized rabbits and monkeys. Intravenously administered Ajmaloon produced a dose-dependent hypotensive response in both the species without any significant effect on the heart rate. Only in high doses (200 mg/kg or more). Ajmaloon produced a bradycardia response in rabbits. Even the highest dose (300 mg/kg) of Ajmaloon used in the present investigation did not cause arrhythmia or any other conduction disorder or respiratory distress. Baroreflex SAP-HR curve was shifted to the left of the control following treatment with 100 mg/kg intravenous Ajmaloon in both the species. Loss of tachycardia response to fall in arterial pressure in Ajmaloon treated animals indicated the drug induced suppression of normally existing sympathetic excitatory influence in response to hypotension. Baroreflex regulatory HR response to hypertension remains intact after intravenous administration of 100 mg/kg Ajmaloon, a dose much higher than the prescribed highest oral dose for humans. Intact baroreflex regulation of arterial blood pressure in response to hypertension in Ajmaloon treated mammals suggests that in patients besides lowering the blood pressure. Ajmaloon might not interfere with the normal blood pressure regulatory mechanism through arterial baroreceptors during hypertension.

Topics: Ajmaline; Analysis of Variance; Animals; Baroreflex; Blood Pressure; Bradycardia; Disease Models, Animal; Dose-Response Relationship, Drug; Female; Haplorhini; Heart Rate; Hypertension; Injections, Intravenous; Male; Phytotherapy; Plant Extracts; Plants, Medicinal; Rabbits; Random Allocation; Rauwolfia

120 cases of class IC antiarrhythmic overdose, including propafenone, flecainide, ajmaline and prajmaline overdose, were evaluated with respect to clinical course, therapy and outcome. Whereas drug overdose in general has an overall mortality of less than 1%, intoxication with antiarrhythmic drugs of class IC was associated with a mean mortality of 22.5%. Nausea, which occurred within the first 30 minutes after ingestion, was the earliest symptom. Spontaneous vomiting probably led to self-detoxication in about half the patients. Cardiac symptoms including bradycardia and, less frequently, tachyrhythmia occurred after about 30 minutes to 2 hours. Therapeutic measures included administration of activated charcoal, gastric lavage and a saline laxative, catecholamines, and in some patients, hypertonic sodium bicarbonate, insertion of a transvenous pacemaker and hemoperfusion. Fatal outcome was mainly due to cardiac conduction disturbances progressing to electromechanical dissociation or asystolia. Resuscitation, which had to be performed in 29 patients, was successful in only two of them. No correlation was found between fatal outcome, the type of antiarrhythmic, and ingested dose. Since a specific treatment is not available and resuscitive procedures including sodium bicarbonate and insertion of a pacemaker are of limited therapeutic value, early diagnosis and primary detoxification are most important for prevention of fatal outcome.

Topics: Ajmaline; Anti-Arrhythmia Agents; Bicarbonates; Bradycardia; Drug Overdose; Flecainide; Hemoperfusion; Humans; Hypertonic Solutions; Nausea; Prajmaline; Propafenone; Resuscitation; Retrospective Studies; Sodium; Sodium Bicarbonate; Tachycardia; Vomiting

The cardiovascular effects of lithium have been indexed in literature since 1900, most frequently in cases of intoxication. We recently studied the exceptional case of a patient showing a serious sinus node dysfunction during lithium treatment. The serum lithium levels were always within the therapeutic range. After two endocardial explorations and withdrawal of lithium, we found that the sinus node dysfunction was due to lithium and reversible after withdrawal of it. Some ignored dysfunctions could exist with a regularly controlled treatment.

Topics: Ajmaline; Arrhythmia, Sinus; Bipolar Disorder; Bradycardia; Cardiac Pacing, Artificial; Electrocardiography; Humans; Lithium; Lithium Carbonate; Male; Middle Aged; Sinoatrial Node

The electrophysiological effects of ajmaline (1 mg/Kg i.v.) on sinus node were evaluated in 63 control subjects and in 12 pts with sick sinus syndrome (S.S.S.). In the control group the mean spontaneous cycle length (S.C.L.) was found significatively (less less than 0.001) reduced (8,?%), and corrected sinus node recovery time (C.S.N.R.T.) significatively (p less than 0.01) prolonged (30,2%) by the drug. In the patients with S.S.S. the S.C.L. was prolonged by 16% but not significatively and the C.S.N.R.T. by 60,7% (p less than 0.05). In 8/12 pts, with S.S.S. spontaneous sinoatrial blocks appeared or were more frequently observed following ajmaline injection. The use of ajmaline as a unic pharmacologic test for the differential diagnosis of symptomatic bradycardia in patients with atrioventricular associated conduction defects is discussed.

Topics: Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Bradycardia; Female; Heart Block; Humans; Male; Middle Aged; Tachycardia

18 patients with sinus bradycardia (8 SB) and tachycardia-bradycardia syndrome (10 TBS) were investigated using various vagan reflex manoeuvres, atrial pacing (AP), pharmacological tests and His bundle (HB) recordings, to assess autonomic influences, sinus node function and atrioventricular (AV) conduction. Three types of responses (R) were defined as normal (N), supernormal (SN), poor autonomic (PA). Poor reflex responses to vagal manoeuvres, performed in 12 patients, have no statistical significance. MxCSRT at AP suppression was measured in 13 patients: it was normal (less than or equal to 500 msec) in 8 and increased (from 680 to 4,200 msec) in 5 patients with appearance of junctional escapes. Moreover, AP suppression revealed a sinoatrial block (SAB) in 1 patient with normal MxCSRT. Isoprenaline, administered intravenously (3-6 mug) in 9 patients, showed 4 NR, 3 PAR und 2 SNR (unusual sinus tachycardia, 1; atrial fibrillation, 1). Atropine (0.5-1 mg), used in 15 patients, revealed 5 PAR and 1 SNR. Prostigmine (0.5 mg), used in 11 patients, induced 6 NR and 5 PAR. Lanatosid C (0.08 mg), administered in 16 patients, showed 10 NR, 5 PAR and 1 SNR. Finally, ajmaline (100 mg), given in 13 patients, revealed 5 junctional rhythms and one 2:1 SAB. HB recorded in 17 patients showed an increase of AH interval (greater than 140 msec) in 5 patients and a slight increase (60 msec) of HV interval in 2 patients. Three patients developed 2nd-degree AV block at paced rates greater than or equal to 110/min. Abnormal responses at AP suppression and reduced drug responses were noted in 5 patients suffering from Adam-Stokes attacks; a permanent pacemaker was inserted in 4 of these 5 patients. In conclusion, provocative tests, in 18 patients with SB or TBS, suggest a diffuse process disease involving the autonomic function of both sinus node and AV junction (11 patients) and the AV system (6 patients). These immediate results must be correlated with histological findings in the conduction system, as shown in one of our cases previously reported.

Topics: Adult; Aged; Ajmaline; Arrhythmia, Sinus; Atropine; Blood Pressure; Bradycardia; Bundle of His; Digitalis Glycosides; Female; Heart Arrest; Heart Conduction System; Heart Rate; Humans; Isoproterenol; Male; Middle Aged; Neostigmine; Pacemaker, Artificial; Sinoatrial Block

Topics: Ajmaline; Anti-Arrhythmia Agents; Aprindine; Arrhythmia, Sinus; Arrhythmias, Cardiac; Bradycardia; Humans; Isoproterenol; Lidocaine; Myocardial Infarction; Pacemaker, Artificial; Phenytoin; Procainamide; Propranolol; Quinidine; Tachycardia; Verapamil

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: Ajmaline; Arrhythmias, Cardiac; Atrial Fibrillation; Bradycardia; Caffeine; Cardiac Complexes, Premature; Digitalis Glycosides; Heart Block; Humans; Lidocaine; Metaproterenol; Phenytoin; Procainamide; Tachycardia; Ventricular Fibrillation; Verapamil

Topics: Adrenergic beta-Antagonists; Ajmaline; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Atropine; Bradycardia; Humans; Lidocaine; Metaproterenol; Phenytoin; Procainamide; Quinidine; Tachycardia; Verapamil

Topics: Adrenergic beta-Agonists; Ajmaline; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Bradycardia; Digitalis; Electrocardiography; Heart; Hemodynamics; Humans; Lidocaine; Phenytoin; Phytotherapy; Plants, Medicinal; Plants, Toxic; Procainamide; Propranolol; Quinidine; Tachycardia

Topics: Ajmaline; Amino Alcohols; Bradycardia; Electric Stimulation; Electrophysiology; Heart Conduction System; Humans; Injections, Intravenous; Metaproterenol; Pacemaker, Artificial; Propiophenones; Propylamines; Sparteine; Verapamil

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: Aconitum; Ajmaline; Animals; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Blood Pressure; Bradycardia; Capillary Resistance; Cardiac Output; Cardiac Volume; Ethers; Ethylamines; Glycerol; Heart Rate; Lidocaine; Male; Phenytoin; Procainamide; Propranolol; Quinidine; Rats; Respiration, Artificial; Sparteine

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

Topics: Adrenergic beta-Antagonists; Ajmaline; Analgesics; Arrhythmias, Cardiac; Bradycardia; Child; Child, Preschool; Digitalis Glycosides; Electric Countershock; Electrocardiography; Humans; Infant; Infant, Newborn; Infant, Newborn, Diseases; Metaproterenol; Pacemaker, Artificial; Sparteine; Tachycardia; Tachycardia, Paroxysmal

Topics: Adult; Ajmaline; Arrhythmias, Cardiac; Bradycardia; Electrocardiography; Humans; Male; Middle Aged; Ventricular Fibrillation