enalapril and Tachycardia--Supraventricular

Topics: Aged; Antihypertensive Agents; Bisoprolol; Bundle-Branch Block; Cardiac Complexes, Premature; Catheter Ablation; Electrocardiography; Enalapril; Heart Conduction System; Heart Rate; Heart Ventricles; Humans; Hypertension; Male; Tachycardia, Supraventricular; Ultrasonography

The authors of the article studied potential of various drug combinations (atenolol + enalapril + indapamide, and celanid + enalapril + indapamide) in complex treatment of patients with heart failure (HF) and supraventricular arrhythmias. The subjects were 106 patients, of whom 74 had coronary heart disease, of whom 51 had old myocardial infarction, and 18 had undergone coronary artery bypass grafting. Dilatation cardiomyopathy was found in 8, aortomitral valvular disease--in 18, and combined mitral valvular disease--in 6 patients. 36 subjects had permanent atrial fibrillation, 48--a paroxysmal form of ciliary arrhythmia, 22--paroxysms of atrial tachycardia. NYHA functional class (FC) II HF was diagnosed in 64 patients, NYHA FC III HF--in 42 patients. According to what treatment regimen was applied, the patients were divided into two groups, comparable in the main clinical and functional characteristics. Two-month therapy resulted in improvement of hemodynamics, increase of activity tolerance and improvement of life quality in both groups. The combination celanide + enalapril + indapamide in individual doses was effective in FC II-III HF with supraventricular arrhythmias. The cost of treatment with celanid is lower.

Topics: Aged; Angiotensin-Converting Enzyme Inhibitors; Anti-Arrhythmia Agents; Atenolol; Blood Pressure; Cardiac Glycosides; Diuretics; Drug Therapy, Combination; Echocardiography; Electrocardiography; Enalapril; Follow-Up Studies; Heart Failure; Heart Rate; Humans; Indapamide; Lanatosides; Male; Middle Aged; Tachycardia, Supraventricular; Treatment Outcome

Two women, both aged 54 years, were admitted because of supraventricular arrhythmias of recent onset. Patient 2 was also in heart failure. Male family members of both patients were known to have Duchenne's muscular dystrophy, of which one had died.. The electrocardiogram of patient 1 demonstrated atrial fibrillation. Patient 2 had a raised serum creatine kinase concentration and increased pulmonary marking in the chest radiogram. Patient 1 had normal findings on left heart catheterization, but immunohistochemical analysis of a myocardial biopsy revealed dystrophin mosaic with 20% dystrophin-negative fibres. Patient 2 had a reduced ejection fraction and 80% dystrophin-negative fibres.. Myocardial involvement in the carrier state for Duchenne's muscular dystrophy having been demonstrated in both women, patient 1 received antihypertensive treatment while patient 2, who was in cardiac failure, was given diuretics, ACE-inhibitor and beta-receptor blockers.. Cardiomyopathy in carriers of Duchenne's muscular dystrophy is a rare cause of supraventricular arrhythmias. The cause can be confirmed by immunochemical analysis of an endomyocardial biopsy.

Topics: Angiotensin-Converting Enzyme Inhibitors; Anti-Arrhythmia Agents; Antihypertensive Agents; Atrial Fibrillation; Creatine Kinase; Diuretics; Drug Therapy, Combination; Dystrophin; Electrocardiography; Enalapril; Female; Heart; Heart Failure; Heterozygote; Humans; Immunohistochemistry; Male; Metoprolol; Middle Aged; Muscular Dystrophies; Myocardium; Nicardipine; Pedigree; Tachycardia, Supraventricular