ajmaline and Heart-Failure

Topics: Acute Disease; Adult; Aged; Ajmaline; Aminocaproates; Arrhythmias, Cardiac; Clinical Trials as Topic; Female; Heart; Heart Block; Heart Failure; Humans; Male; Middle Aged; Myocardial Infarction; Rupture; Shock, Cardiogenic

Topics: Ajmaline; Animals; Anti-Arrhythmia Agents; Cardiotonic Agents; Drug Therapy, Combination; Drug Tolerance; Heart Failure; Rats; Rats, Wistar; Strophanthins

Forty-three patients in the acute phase of myocardial infarction who were resistant to conventional doses of lidocaine received Ajmaline intravenously (50 mg bolus followed by constant infusion rate of 1-1.5 mg/min). Dangerous ventricular arrhythmias were abolished in 72% of this group of patients (group A). In the remaining patients (28%), Ajmaline was found to be ineffective (group B). There was no reduction of systolic or diastolic blood pressure and there was an insignificant increase in heart rate. Atrio-ventricular or intraventricular conduction defects appeared in 46% of the patients described. There was a statistically significant increase in occurrence of heart blocks in group B patients and among these complete left bundle branch block (CLBBB) was the most prevalent. Atrio-ventricular or intraventricular conduction defects were transient, appearing between 8-36 h (mean 23 h), and were not accompanied by reduction of ventricular rate. Conduction defects disappeared within several hours (up to 24 hours) after Ajmaline was discontinued. It is concluded that Ajmaline administered by this regimen is an effective alternative agent for patients with ventricular arrhythmia not controlled by lidocaine in the acute phase of myocardial infarction.

Topics: Ajmaline; Cardiac Complexes, Premature; Digoxin; Heart Conduction System; Heart Failure; Humans; Lidocaine; Myocardial Infarction; Time Factors; Ventricular Fibrillation

For the practicing physician the medicamentous treatment of the patients with infarction is the main problem of the secondary prevention in the prehospital phase as well as in the after-treatment. In these cases in the acute phase not the myocardial insufficiency is in the centre of the out-patient care, but the therapy of the disturbances of cardiac rhythm, which mainly cause the high lethality in the early phase. Therefore, uncomplicated infarctions, in whch care must be taken only for a sedation of sympathico-adrenergic reactions and a volume reduction of the heart, should be differed from complicated cases. However, an immediate transport to the hospital must be guaranteed. If there appear a contraction insufficiency of the left ventricle or threatening disturbances of the rhythm, additionally glycosides and saluretics must be administered as well as an aimed antiarrhythmic therapy must be initiated. The necessary medicamentous measures are described dependent upon the diagnosis of brady- and tachycardiac disturbances of the rhythm. The author enters briefly the problems of volume substitution, treatment of acidosis as well as the administration of beta-sympathicolytics and gluco-corticoids. - In the after-treatment of infarctions anticoagulants are the only medicaments to be prescribed, when findings completely without complications are present. If, however, there are signs of activity of the coronary heart disease in the post-infarction phase, a basic therapy with a glycoside and anticoagulants as well as an individually to be varied additive therapy with nitro-preparations, beta-sympathicolytics, saluretics, anti-hypertensive agents and antiarrhythmic agents are necessary.

Topics: Acidosis; Adrenergic beta-Antagonists; Aftercare; Ajmaline; Ambulatory Care; Anticoagulants; Arrhythmias, Cardiac; Atropine; Cardiac Complexes, Premature; Cardiac Glycosides; Glucocorticoids; Heart Block; Heart Failure; Hospitalization; Humans; Lidocaine; Meperidine; Metaproterenol; Morphine; Myocardial Infarction; Nitroglycerin; Tachycardia

Topics: Adolescent; Adult; Ajmaline; Blood Pressure; Cardiac Output; Depression, Chemical; Electrocardiography; Female; Heart; Heart Failure; Heart Rate; Heart Ventricles; Hemodynamics; Humans; Injections, Intravenous; Male; Middle Aged; Propane; Stimulation, Chemical; Time Factors

Topics: Ajmaline; Arrhythmias, Cardiac; Digoxin; Electric Countershock; Female; Glucagon; Heart Failure; Humans; Lanatosides; Middle Aged; Mitral Valve Insufficiency; Phenytoin; Phytotherapy; Plants, Medicinal; Pulmonary Edema; Quinidine; Rauwolfia; Water-Electrolyte Balance

Topics: Ajmaline; Anemia; Anti-Arrhythmia Agents; Arrhythmia, Sinus; Arrhythmias, Cardiac; Atrial Fibrillation; Cardiac Complexes, Premature; Heart Failure; Humans; Hypertension; Hyperthyroidism; Rauwolfia; Tachycardia

Topics: Ajmaline; Heart Failure; Humans; Hypnotics and Sedatives; Rauwolfia