ajmaline and Tachycardia--Paroxysmal

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

The more recent antiarrhythmic drugs sometimes with more complex action extend the therapeutic possibilities. In addition, numerous other substances are in clinical trial. An ideal antiarrhythmic agent with a reliable action, persistent effective levels, easily absorbable and with few side effects is not found among them. The indication for therapy in ventricular extrasystole is made on the grounds of an ominous ECG criteria and a presumed clinical threat. Controversial results of lidocaine therapy of acute mayocardial infarction are possibly due to pharmacokinetic factors. For "inhomogeneous repolarization" with increased tendency to ventricular fibrillation inducing drugs should be avoided. Malignant cardiac rhythm irregularities possible leading to sudden death require systemic therapeutical testing. In this case, combinations of antiarrhythmic drugs have the highest effectiveness.

Topics: Action Potentials; Ajmaline; Amiodarone; Anti-Arrhythmia Agents; Bretylium Compounds; Calcium; Cardiac Complexes, Premature; Digoxin; Disopyramide; Electrophysiology; Humans; Lidocaine; Mexiletine; Myocardial Infarction; Phenytoin; Quinidine; Tachycardia; Tachycardia, Paroxysmal; Verapamil

Topics: Age Factors; Ajmaline; Electrocardiography; Humans; Infant; Male; Procainamide; Quinidine; Sex Factors; Tachycardia, Paroxysmal; Whooping Cough; Wolff-Parkinson-White Syndrome

Topics: Administration, Oral; Ajmaline; Arrhythmias, Cardiac; Atrial Fibrillation; Biotransformation; Cardiac Complexes, Premature; Drug Hypersensitivity; Heart; Heart Conduction System; Humans; Hypotension; Injections, Intramuscular; Injections, Intravenous; Tachycardia, Paroxysmal

Topics: Adolescent; Adult; Aged; Ajmaline; Child; Child, Preschool; Clinical Trials as Topic; Female; Humans; Male; Middle Aged; Tachycardia, Paroxysmal; Tachycardia, Supraventricular; Verapamil

Topics: Adolescent; Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Cardiac Complexes, Premature; Clinical Trials as Topic; Electrocardiography; Female; Humans; Male; Middle Aged; Prajmaline; Tachycardia, Paroxysmal

Topics: Adult; Aged; Ajmaline; Cardiac Glycosides; Clinical Trials as Topic; Drug Combinations; Female; Humans; Male; Meprobamate; Middle Aged; Phenobarbital; Procainamide; Quinidine; Tachycardia, Paroxysmal; Theophylline

The aim of this study was to assess the response of refractoriness in normal and diseased human bundle branches to changes in cycle length, as well as during a long period of continuous overdrive pacing.. The anterograde refractory period of the bundle branches in patients with functional bundle branch block shortens as the rate is increased. The rate-dependent response of refractoriness in diseased bundle branches is quite different. However, this difference has not been precisely delineated, and its physiologic meaning is uncertain.. Refractoriness of the bundle branches was measured by the extrastimulus technique in 16 patients with tachycardia-dependent bundle branch block and 10 patients with functional bundle branch block, both after basic trains of 8 atrial-paced impulses at different cycle lengths and during a 10-min period of continuous overdrive pacing.. The baseline refractory period in the bundle branches of patients with functional bundle branch block measured 430 +/- 32 ms (mean +/- SD) and shortened to 368 +/- 30 ms at the shortest cycle length. The maximal effect was reached within the 1st min of overdrive pacing. The baseline refractory period of the bundle branches was significantly longer in patients with tachycardia-dependent bundle branch block (611 +/- 184 ms) and demonstrated a cumulative overdrive prolongation in 15 (83%) of 18 studies with typical manifestations of fatigue. In two other studies, this occurred only after ajmaline administration.. A rate- and time-dependent prolongation of refractoriness frequently occurs in diseased human bundle branches. When absent, this response may be induced under the effects of sodium channel blockers. This would suggest that an abnormality in the recovery from inactivation of the sodium channel might underlie the early stages of bundle branch disease.

Topics: Adult; Aged; Ajmaline; Bundle of His; Bundle-Branch Block; Cardiac Pacing, Artificial; Electrocardiography; Female; Heart Conduction System; Humans; Male; Middle Aged; Tachycardia, Paroxysmal; Tachycardia, Supraventricular

Topics: Adult; Ajmaline; Exercise Test; Humans; Male; Tachycardia, Paroxysmal; Tachycardia, Supraventricular; Wolff-Parkinson-White Syndrome

Electrophysiologic effects of 50 mg iv ajmaline were evaluated in 10 patients with atrioventricular nodal reentrant paroxysmal supraventricular tachycardia (PSVT) utilizing the slow pathway for antegrade and the fast pathway for retrograde conduction. Ajmaline terminated the PSVT in all 10 patients in 17 to 165 sec (mean 94 +/- 49 sec): by ventriculoatrial block in eight, AH block in one, and intra-atrial reentry in one patient. The predrug mean PSVT cycle length of 289 +/- 44 msec (range 240 to 350) increased significantly to 373.5 +/- 60 msec (range 263 to 464; p less than .01) before the tachycardia was terminated. The increase in cycle length was a function of both AH and HA prolongation. In all 10 patients ajmaline depressed conduction through the retrograde fast pathway, as evidenced by the increase in mean ventricular paced cycle length producing ventriculoatrial block from less than or equal to 280 +/- 40 to 438 +/- 93 msec (p less than .001), and the increase in the effective refractory period of the ventriculoatrial conduction system from less than or equal to 241 +/- 42 to less than or equal to 298 +/- 62 msec (p less than .05); the drug abolished ventriculoatrial conduction in four cases. The effective refractory period of the antegrade fast pathway was unchanged after ajmaline (less than or equal to 281 +/- 31 vs less than or equal to 275 +/- 38 msec; p = NS), but conduction through the antegrade slow pathway was depressed (atrial paced cycle length producing AH block 269 +/- 30 msec before and 312 +/- 44 msec after drug; p less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)

Topics: Adolescent; Adult; Ajmaline; Atrioventricular Node; Electrocardiography; Female; Heart Conduction System; Humans; Injections, Intravenous; Male; Middle Aged; Tachycardia, Paroxysmal

Potentialities of the non-invasive method of trans-esophagus electrostimulation of the heart were studied with regard to the selection and assessment of the effectiveness of antiarrhythmic therapy in 16 patients with paroxysms of supraventricular reciprocal tachycardia. The antiarrhythmic therapy selected by this method proved effective in 13 patients following a prolonged course of treatment. The method was highly informative in predicting the efficacy of the systemic course treatment of patients with supraventricular tachycardia paroxysms.

Topics: Adolescent; Adult; Ajmaline; Amiodarone; Anti-Arrhythmia Agents; Digoxin; Drug Evaluation; Electric Stimulation; Female; Humans; Male; Middle Aged; Procainamide; Propranolol; Quinidine; Tachycardia, Paroxysmal; Verapamil

In Wolff-Parkinson-White (WPW) syndrome, the two most commonly occurring arrhythmias are circus movement tachycardia (CMT) and atrial fibrillation (AF). In 70% of patients with clinically documented CMT in whom the arrhythmia could be initiated by programmed electrical stimulation of the heart, the same CMT could still be initiated after long-term oral amiodarone administration. Spontaneous clinical recurrence of the arrhythmia was, however, observed in only 10% of patients. This finding suggests that the beneficial effect of amiodarone on CMT is primarily based on the prevention of the CMT-initiating premature beat. This may also apply to atrioventricular nodal reentrant tachycardia, in which amiodarone is also extremely effective in preventing relapses. The role of amiodarone in other forms of reentrant, or ectopic, supraventricular tachycardias is less well defined. During AF in WPW syndrome, the ventricular rate is related to the duration of the anterograde refractory period of the accessory pathway. Amiodarone prolongs this value, resulting in the reduction of ventricular rate during AF. Unfortunately, in the presence of a short anterograde refractory period of the accessory pathway, amiodarone results in only a small amount of lengthening of this value. In these patients the beneficial effect of amiodarone may primarily be related to the prevention of episodes of AF. We also found that the effect of oral amiodarone on the duration of the anterograde refractory period of the accessory pathway can (1) be abolished by sympathetic stimulation with isoproterenol and (2) be predicted from the effect of ajmaline or procainamide given intravenously. These observations clearly have practical clinical implications.

Topics: Ajmaline; Amiodarone; Atrial Fibrillation; Benzofurans; Electrophysiology; Heart; Humans; Isoproterenol; Procainamide; Tachycardia, Paroxysmal; 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: Adolescent; Adult; Ajmaline; Arrhythmias, Cardiac; Atrial Fibrillation; Cardiac Complexes, Premature; Female; Humans; Male; Middle Aged; Prajmaline; Tachycardia, Paroxysmal

Electrophysiologic studies were performed in a 41 year old man for analysis of paroxysmal tachycardias appearing in various electrocardiographic patterns of supraventricular and ventricular bigeminy, junctional and ventricular tachycardia and atrial fibrillation, among others. All these arrhythmias were due to dual atrioventricular (A-V) nodal pathways with simultaneous dual fast and slow conduction of single atrial beats at a normal basic sinus rate. Moderate changes in sinus rate and in fast or slow pathway conduction times, or both, changed the position of the slowly conducted beats between the neighboring two fast conducted beats and resulted in various electrocardiographic manifestations of the conduction disturbance. Different blocks, such as second degree type 1, 2:1, 3:1 and possibly also type II, in one of the two pathways and occasionally aberrant conduction induced even more unusual tracings. After intravenous injection of 25 mg of ajmaline, unexpected lengthening and shortening of the A-H interval occurred, suggesting variable shifts between fast and slow pathway conduction. The incidence of dual A-V nodal pathways is discussed; it was documented in 17 (4.2 percent) of 405 patients studied. A theoretical model of A-V nodal conduction is proposed to explain its normal properties and abnormal patterns.

Topics: Adult; Ajmaline; Atrial Fibrillation; Atrioventricular Node; Atropine; Bundle of His; Cardiac Pacing, Artificial; Electrocardiography; Heart Block; Heart Conduction System; Humans; Lidocaine; Male; Metoprolol; Models, Biological; Tachycardia, Paroxysmal; Verapamil

Three patients with reentrant tachycardia are described who had an accessory pathway with a very long conduction time that was incorporated in the tachycardia circuit. The accessory pathway was able to conduct in one direction only, in retrograde manner in two patients and in anteriograde manner in the remaining patient. Evidence is presented that reveals that in the first two patients the accessory pathway was septally located, had completely bypassed the normal atrioventricular (A-V) conduction system, had properties of decremental conduction, and had an atrial exit close to the coronary sinus and a ventricular exit relatively far from the atrioventricular A-V ring. In the third patient, who manifested wide QRS complex during tachycardia, the ventricular end of the accessory pathway seemed to be located close to the right ventricular apex. The atrial end of the pathway could not be localized exactly.

Topics: Adult; Ajmaline; Atropine; Bundle-Branch Block; Cardiac Pacing, Artificial; Child; Electrocardiography; Female; Heart Conduction System; Humans; Male; Physical Exertion; Tachycardia; Tachycardia, Paroxysmal; Time Factors; Wolff-Parkinson-White Syndrome

Topics: Adult; Ajmaline; Electrocardiography; Female; Humans; Tachycardia, Paroxysmal; Wolff-Parkinson-White Syndrome

Topics: Ajmaline; Arrhythmias, Cardiac; Cardiac Complexes, Premature; Cardiac Pacing, Artificial; Carotid Sinus; Digitalis Glycosides; Humans; Massage; Tachycardia, Paroxysmal; Valsalva Maneuver; Verapamil

Topics: Ajmaline; Coronary Disease; Electrocardiography; Female; Heart Conduction System; Heart Defects, Congenital; Humans; Male; Tachycardia, Paroxysmal; Wolff-Parkinson-White Syndrome

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

The paper substantiates the necessity of using a set of antiarrhythmic drugs for the prevention of supraventricular tachysystoles. In the development of supraventricular tachysystoles an important role is attributed to the disorders in automatic regulation of the sinus node. Cases are described in which the development of paroxysmal cardiac fibrillation with approximately equal intervals of time was caused by an inhibition of the sinus node activity. The set of antiarrhythmic drugs included beta-adrenergic blockers, isocholinic-type drugs, cardiac glycosides, Rauwolfia serpentina preparations, parasympatholitic drugs.

Topics: Adult; Aged; Ajmaline; Anti-Arrhythmia Agents; Barbiturates; Drug Combinations; Female; Humans; Middle Aged; Phenobarbital; Sparteine; Sulfates; Tachycardia, Paroxysmal

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

Topics: Ajmaline; Electrocardiography; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Tachycardia, Paroxysmal; Wolff-Parkinson-White Syndrome

Topics: Adult; Ajmaline; Cholecystitis; Deslanoside; Electric Countershock; Electric Stimulation; Female; Hernia, Hiatal; Humans; Hyperthyroidism; Male; Middle Aged; Pacemaker, Artificial; Tachycardia, Paroxysmal

Having briefly touched upon the problem of terminology and classification of arrhythmias the authors consider the diagnosis and clinical evaluation of some disorders, including the extrasystole (the significance of the extrasystolic interval), ectopic arrhythmias from the region of the atrio-ventricular junction (with simultaneous consistent or transent disruption of the intraventricular conduction), isolated atrial tachycardia, some variants of auricular fibrillation, flutter paroxysms, paroxysms of ventricular tachycardia, with continued auricular fibrillation in particular, and also the earlier described electrocardiographic phenomenon tentatively interpreted as sinistroatrial fibrillation with dextraatrial tachycardia, as well as major types of disrupted condution. The authors give a brief exposure of their views as to the principles of the treatment. Emphasis is placed on the importance of a comprehensive clinical approach to the diagnostic matters and to the evaluation of arrhythmias, as well as to the fundamental need to define more precisely the pathogenesis of the disturbed rhythm in a concrete patient so as to adopt an effective treatment.

Topics: Ajmaline; Arrhythmias, Cardiac; Atrial Fibrillation; Cardiac Complexes, Premature; Cardiac Glycosides; Electric Countershock; Electrocardiography; Humans; Lidocaine; Pacemaker, Artificial; Procainamide; Propranolol; Quinidine; Reserpine; Tachycardia, Paroxysmal

Topics: Administration, Oral; Adult; Aged; Ajmaline; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Atrial Fibrillation; Cardiac Complexes, Premature; Electrocardiography; Female; Humans; Male; Middle Aged; Quaternary Ammonium Compounds; Tachycardia, Paroxysmal; Tartrates; Ventricular Fibrillation; Wolff-Parkinson-White Syndrome

Topics: Administration, Oral; Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Atrial Fibrillation; Cardiac Complexes, Premature; Electrocardiography; Female; Humans; Lidocaine; Male; Middle Aged; Phenytoin; Procainamide; Tachycardia, Paroxysmal; Tartrates

Topics: Aged; Ajmaline; Electric Countershock; Electrocardiography; Glucagon; Humans; Male; Procainamide; Quinidine; Shock, Cardiogenic; Tachycardia, Paroxysmal; Xylenes

Topics: Adult; Aged; Ajmaline; Electric Stimulation; Electrocardiography; Heart Atria; Heart Block; Heart Conduction System; Humans; Male; Tachycardia, Paroxysmal; Wolff-Parkinson-White Syndrome

Topics: Ajmaline; Apgar Score; Arrhythmias, Cardiac; Cesarean Section; Digoxin; Electrocardiography; Extraction, Obstetrical; Female; Fetus; Heart Block; Humans; Infant; Infant, Newborn; Lanatosides; Pregnancy; Prenatal Diagnosis; Tachycardia; Tachycardia, Paroxysmal; Ventricular Fibrillation; Verapamil; Wolff-Parkinson-White Syndrome

Topics: Administration, Oral; Aged; Ajmaline; Arrhythmia, Sinus; Arrhythmias, Cardiac; Cardiac Complexes, Premature; Female; Humans; Male; Middle Aged; Tachycardia, Paroxysmal; Tartrates

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; Digitalis Glycosides; Electric Countershock; Humans; Magnesium; Male; Middle Aged; Nitriles; Potassium; Procainamide; Tachycardia, Paroxysmal

Topics: Ajmaline; Digoxin; Electrocardiography; Furosemide; Humans; Infant, Newborn; Infant, Newborn, Diseases; Male; Phytotherapy; Plants, Medicinal; Potassium; Rauwolfia; Tachycardia, Paroxysmal; Wolff-Parkinson-White Syndrome

Topics: Ajmaline; Atrial Fibrillation; Cardiac Complexes, Premature; Female; Humans; Male; Phytotherapy; Plants, Medicinal; Rauwolfia; Tachycardia, Paroxysmal

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: 1-Propanol; Ajmaline; Female; Humans; Male; Middle Aged; Phytotherapy; Plants, Medicinal; Quinolizines; Rauwolfia; Tachycardia, Paroxysmal; Tartrates; Wolff-Parkinson-White Syndrome

Topics: Ajmaline; Cardiac Glycosides; Female; Heart Defects, Congenital; Humans; Infant; Infant, Newborn; Male; Nasal Decongestants; Neostigmine; Procainamide; Quinidine; Tachycardia, Paroxysmal

Topics: Aged; Ajmaline; Alkaloids; Drug Therapy; Female; Geriatrics; Humans; Injections; Rauwolfia; Tachycardia; Tachycardia, Paroxysmal

Topics: Ajmaline; Alkaloids; Humans; Rauwolfia; Tachycardia; Tachycardia, Paroxysmal; Tachycardia, Ventricular

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

Topics: Ajmaline; Cardiac Complexes, Premature; Humans; Hypnotics and Sedatives; Rauwolfia; Tachycardia; Tachycardia, Paroxysmal

Topics: Ajmaline; Pacemaker, Artificial; Procainamide; Rauwolfia; Tachycardia; Tachycardia, Paroxysmal; Tachycardia, Ventricular; Therapeutics

Topics: Ajmaline; Arrhythmias, Cardiac; Cardiac Complexes, Premature; Drug Therapy; Emergency Treatment; Humans; Rauwolfia; Tachycardia; Tachycardia, Paroxysmal

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

Topics: Ajmaline; Myocardial Infarction; Rauwolfia; Tachycardia; Tachycardia, Paroxysmal; Tachycardia, Ventricular

Topics: Ajmaline; Electrocardiography; Humans; Niacin; Nicotinic Acids; Rauwolfia; Tachycardia; Tachycardia, Paroxysmal