allapinin and Arrhythmias--Cardiac

Antiarrhythmic drug allapinin has been used in clinical practice for a long time but data of investigation of its effects and mechanism of action are scanty. The aim of this review is to summarize results of clinical studies of allapinin supplementing them with personal unpublished data. The review embraces pharmacokinetics and pharmacodynamics of the drug, its efficacy in the treatment of various cardiac rhythm disturbances and side effects. The conclusion is made that clinical application of allapinin as class 1C antiarrhythmic drug according to Vaughan-Williams classification should be guided by general recommendations concerning indications and contraindications for this class of antiarrhythmic drugs. Special feature of allapinin is its high efficacy for prevention of attacks of paroxysmal atrial fibrillation.

Topics: Aconitine; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Clinical Trials as Topic; Humans; Treatment Outcome

Topics: Aconitine; Amiodarone; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Disopyramide; Electrocardiography; Humans; Moricizine; Phenothiazines; Procainamide; Propranolol

Topics: Aconitine; Aconitum; Arrhythmias, Cardiac; Biological Availability; Clinical Trials as Topic; Humans; Tablets

Topics: Aconitine; Aconitum; Administration, Oral; Arrhythmias, Cardiac; Clinical Trials as Topic; Dose-Response Relationship, Drug; Humans; Injections, Intravenous; Placebos

The results of the trial point to a potent and protracted antiarrhythmic effect of allapinin equally pronounced with both intravenous and oral administration to patients with ventricular and supraventricular premature beats. The side effects of the drug in acute tests and during short-term course therapy are not significant.

Topics: Aconitine; Adolescent; Adult; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Clinical Trials as Topic; Electrocardiography; Female; Heart Rate; Humans; Injections, Intravenous; Male; Middle Aged; Monitoring, Physiologic; Tablets; Time Factors

Intravenous glialin in a dose of 7 mg/kg suppressed the number of ectopic contractions caused by double ligature of the left coronary artery by the method of Harris and almost 2-fold prolonged animal life-span in comparison with the control. The maximum antiarrhythmic effect of glialin developed after 180 min and persisted for 5 h. Glialin injected intravenously (10 mg/kg) after myocardial infarction under conditions of programmed electrical stimulation inhibited conduction of evoked impulse in the atria, Purkinje fibers, and ventricular myocardium and did not modify the effective refractory periods of the atria and ventricles.

Topics: Aconitine; Animals; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Dogs; Electrophysiology; Glycyrrhizic Acid; Heart Conduction System; Myocardial Infarction

Antiarrhythmic activity of oral allapinin was studied in 64 patients with ischemic heart disease. 27 of the patients had undergone coronary artery bypass grafting 2 to 12 months before, 19 patients had postinfarction cardiosclerosis, 38--arterial hypertension, 30--circulation insufficiency stage I. Arrhythmia presented as ventricular extrasystole (n = 28), paroxysmal atrial fibrillation (n = 18), paroxysmal atrial tachycardia (n = 11), frequent supraventricular extrasystole (n = 7). Arrhythmia continued from 6 months to 8 years. An effective single dose was defined with acute pharmacological test. The treatment course lasted for 21 days. Allapinin proved to be highly effective: ventricular ectopic activity was suppressed in 71.4% patients, atrial tachycardia paroxysms were prevented in 72.7%, paroxysms of atrial fibrillation--in 77.8%. Allapinin tolerance was good. Extracardiac side effects occurred most frequently, but dose lowering was necessary only in 6.2%. The drug was discontinued because of cardiac side effects in 4.7% cases. ECG monitoring is a highly informative method of the treatment efficacy control.

Topics: Aconitine; Aged; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Coronary Artery Bypass; Drug Tolerance; Electrocardiography; Humans; Hypertension; Male; Middle Aged; Monitoring, Physiologic; Myocardial Ischemia; Time Factors

The antiarrhythmic effects of allapinine were studied in 57 patients with chronic circulatory failure (CCF) and cardiac arrhythmias by employing 48-hour Holter monitoring. Allapinine was found to suppress premature ventricular contraction, group premature ventricular contraction and 'runs' of ventricular tachycardia by 82.5, 88.6, and 93.1%, respectively. The antiarrhythmic activity of the agent was more pronounced in patients with coronary heart disease, Stages I-IIA CCF and left ventricular ejection fraction greater than 40%. In addition, in Stages I-IIA CCF allapinine increased myocardial contractility and left ventricular ejection fraction, whereas in Stages IIB-III CCF it showed a slight cardiodepressive effect. Thus, when given in the course therapy in patients with CCF, allapinine has a high antiarrhythmic activity and, to a lesser extent, affects central hemodynamics.

Topics: Aconitine; Adult; Aged; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Cardiomyopathy, Dilated; Coronary Disease; Electrocardiography, Ambulatory; Female; Heart Diseases; Heart Valve Diseases; Hemodynamics; Humans; Male; Middle Aged

Out of 85 patients with cardiac arrhythmias in the presence of chronic coronary heart disease, 28 who were resistant to ethacisine and allapinine were included into the study. They had frequent and persistent arrhythmias. The patients were divided into 2 groups: (1) the patients receiving intravenous He-Ne laser therapy in combination with one of the above drugs; (n = 17) and (2) those taking He-Ne laser therapy alone (n = 11). The efficacy of the therapies were controlled by 24-hour monitoring. An antiarrhythmic effect was more frequently observed when He-Ne laser was combined with one of the above drugs than when it was given alone (67.4 and 36.3%, respectively).

Topics: Aconitine; Adult; Aged; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Coronary Disease; Drug Resistance; Helium; Humans; Laser Therapy; Middle Aged; Neon; Phenothiazines

Data are reported of a study of the efficacy of membrane-stabilizing antiarrhythmic agents--ethmosin, ethacisin, allapinin. The latter was used in the treatment of 85 patients with arrhythmias of different etiology and proved more effective as compared with ethmosin and ethacisin. In ventricular extrasystole the effect was favourable in 86%, in supraventricular--in 70% of patients.

Topics: Aconitine; Aged; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Dose-Response Relationship, Drug; Drug Evaluation; Electrocardiography; Humans; Middle Aged; Moricizine; Phenothiazines; Remission Induction

The authors summed up the practical experience gained in long-term maintenance treatment with allapinine, a new Soviet antiarrhythmic agent, given to 65 patients with various cardiac arrhythmias in the outpatient setting. The long-term allapinine use yielded good results: its efficacy was proved to be approximately equal (63% and 60%) in patients with ventricular or supraventricular extrasystoles, respectively, but it was 77% in those with paroxysmal atrial fibrillation. There were no decreases in antiarrhythmic activity of allapinine during its long-term therapy. The agent produced no significant effects on heart rate, blood pressure, and myocardial contractility. Its side effects were recorded in 17 (26.2%) patients, however, withdrawal of the agent was required only in 6 cases.

Topics: Aconitine; Adult; Aged; Aged, 80 and over; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Cardiac Complexes, Premature; Female; Humans; Male; Middle Aged; Time Factors

Topics: Aconitine; Adult; Aged; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Electrocardiography; Exercise; Heart; Humans; Male; Middle Aged

Topics: Aconitine; Adult; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Cardiac Complexes, Premature; Drug Evaluation; Drug Therapy, Combination; Female; Humans; Male; Mexiletine; Middle Aged; Moricizine; Phenothiazines; Propranolol

The effect of allapinin on atrioventricular conductivity was assessed at intracardiac electrophysiologic investigation in 11 patients with various heart rhythm disorders. The effect of a 30 mg intravenous dose of the drug was evaluated 60 min after the injection. Allapinin significantly lengthened the P-Q interval and expanded the QRS complex. The effect was associated with a 24% increment in the P-A interval, a 7% increment in the A-H interval and a 31% increment in the H-V interval, suggesting that allapinin can be regarded as belonging to the first class of antiarrhythmic agents by Vaughan Williams' classification. Allapinin also shortened effective refractory time of the atrium and the atrioventricular node, as well as the total refractory period of the His-Purkinje system. Ventricular refractory periods were also shortened insignificantly. The drug is therefore assumed to have a vagolytic or, perhaps, sympathomimetic action.

Topics: Aconitine; Aconitum; Adolescent; Adult; Arrhythmias, Cardiac; Atrioventricular Node; Drug Evaluation; Electric Stimulation; Female; Heart Conduction System; Humans; Male; Middle Aged

The effect of antiarrhythmic drugs, ritmilen and allapinin, on endogenic prostanoid and cyclic nucleotide levels was examined in patients with heart rhythm disorders. Intravenous administration of antiarrhythmic agents is shown to be accompanied with increased release of prostacyclin that has antiarrhythmic properties into myocardial outflow. Both ritmilen and allapinin promoted the predominance of prostacyclin over thromboxane, with its intrinsic arrhythmogenic properties. Ritmilen- or allapinin-induced changes in prostaglandins E and F2 alpha consisted in that PGE prevailed, as compared to PGF2 alpha. There were no significant changes in cyclic nucleotide ratios (cAMP/cGMP) in response to treatment.

Topics: Aconitine; Adult; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Cyclic AMP; Cyclic GMP; Dinoprost; Disopyramide; Female; Humans; Male; Middle Aged; Nucleotides, Cyclic; Prostaglandins; Prostaglandins E; Prostaglandins F; Stimulation, Chemical

The effect of Ritmilen and allapinin, a new Soviet antiarrhythmic drug, on hemodynamics and myocardial contractility were evaluated in 36 patients with various heart rhythm disorders during diagnostic coronary angiography. Ritmilen has been shown to have an essential cardiodepressive effect. An intravenous 150 mg dose of Ritmilen results in a depression of dp/dtmax, Veragut's index, ejection fraction, mean standard circular fibre shortening rate, and increase in left ventricular systolic and end diastolic pressure, total peripheral resistance and mean arterial blood pressure. Allapinin (30 mg) has no marked cardiodepressive effect, as compared to Ritmilen.

Topics: Aconitine; Adult; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Depression, Chemical; Disopyramide; Drug Evaluation; Female; Hemodynamics; Humans; Male; Middle Aged; Myocardial Contraction