ajmaline and Pre-Excitation-Syndromes

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

A comparative study of antiarrhythmic drugs was performed in 81 patients with atrial fibrillation attacks in the presence of preexcitation syndrome. The first intravenous administration of cordarone was effective in 84.06%, disopyramide--in 69%, ajmaline in 44.8, verapamil in 42.1, novocaine amide in 39.4 and ethacizin in 38.5% of the patients. The first oral administration of quinidine and kinilentin arrested 80.4% of arrhythmia attacks, disopyramide 66.7% propranolol and mexitil 37.5 and 33.3%, respectively. Prospective evolution of antiarrhythmic therapy manifested with decreased therapeutic efficacy of the drugs from 55.7 to 26.2% in the whole group during the period of 1-5 years.

Topics: Adult; Aged; Aged, 80 and over; Ajmaline; Amiodarone; Anti-Arrhythmia Agents; Atrial Fibrillation; Disopyramide; Female; Humans; Male; Mexiletine; Middle Aged; Moricizine; Pre-Excitation Syndromes; Procainamide; Propranolol; Quinidine; Time Factors; Verapamil

The 12 lead electrocardiographic (ECG) findings were reviewed in 17 patients having two or more accessory pathways as documented during electrophysiologic study in all 17 patients and by intraoperative mapping in 8. Twelve patients had findings suggesting the presence of more than one atrioventricular (AV) pathway. These were 1) more than one P wave configuration during orthodromic circus movement tachycardia (four patients); 2) a "mismatch" between the location of the ventricular and atrial ends of the accessory pathway as assessed when comparing exclusive AV and ventriculoatrial conduction over the accessory pathway during antidromic and orthodromic circus movement tachycardia, respectively (seven patients); 3) atrial fibrillation showing more than one pre-excitation pattern (six patients); 4) a spontaneous change from orthodromic to antidromic circus movement tachycardia and vice versa (two patients); 5) a spontaneous change from one type of antidromic tachycardia to another (two patients); and 6) a change in pre-excitation pattern after administration of a drug that prolongs the anterograde refractory period of the accessory pathway (three patients). The retrospective nature of this study does not allow conclusions as to the true value of the ECG in predicting the presence of more than one accessory pathway. This issue needs to be evaluated in a prospective study.

Topics: Adolescent; Adult; Ajmaline; Atrial Fibrillation; Atrioventricular Node; Cardiac Pacing, Artificial; Child; Electrocardiography; Electrophysiology; Female; Heart Conduction System; Humans; Male; Pre-Excitation Syndromes; Procainamide; Tachycardia, Supraventricular

Topics: Adenosine Triphosphate; Adult; Ajmaline; Electrocardiography; Female; Heart Conduction System; Humans; Male; Middle Aged; Pre-Excitation Syndromes