prajmaline and Arrhythmias--Cardiac

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; Arrhythmias, Cardiac; Cardiac Complexes, Premature; Clinical Trials as Topic; Humans; Middle Aged; Prajmaline

The antiarrhythmic efficacy of tocainide, a new antiarrhythmic substance, has been compared with that of prajmalium bitartrate, a drug in clinical use for many years in the German speaking countries. The investigation was performed as a double-blind cross-over study in 20 patients with ventricular arrhythmias (VA) of various origin. The efficacy was assessed by serial Holter monitoring. Plasma levels were measured to study the dose-effect relationship. Applying to the criterion of a reduction of VA of more than 75% or an improvement according to the Lown grading 8 pts. under tocainide and 7 under prajmalium bitartrate were responders. Side effects were few and under tocainide only 2 pts. had to discontinue the therapy. From the present findings tocainide and prajmalium bitartrate have the same efficient antiarrhythmic effects in the majority of patients.

Topics: Adult; Aged; Ajmaline; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Clinical Trials as Topic; Double-Blind Method; Electrocardiography; Female; Heart Diseases; Humans; Lidocaine; Male; Middle Aged; Prajmaline; Tocainide

24-h ECG recordings were used to assess the efficacy of prajmalium bitartrate (PB) in reducing the incidence and the severity of premature ventricular complexes (PVCs), and to compare its antiarrhythmic action with that of Disopyramide. 13 patients with frequent PVCs were distributed randomly into 2 groups. The first group of 7 patients received PB 80 mg/day for 4 days as their first treatment, and disopyramide 400 mg/day for a further 4 days as the second therapy. The succession of the drugs was reversed in the other group of 6 patients. Analysis of the Holter recordings showed that PB and disopyramide reduced PVC frequency to a similar extent as compared to the corresponding wash-out period, viz. by 56.7% (p less than 0.05) and 62.1% (p less than 0.01), respectively. Thus, PB appears to be an effective antiarrhythmic drug and comparable to disopyramide. It may be used to prevent premature ventricular complexes and runs of ventricular tachycardia.

Topics: Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Disopyramide; Drug Evaluation; Electrocardiography; Female; Humans; Male; Middle Aged; Prajmaline; Pyridines

Prajmalium rarely causes idiosyncratic liver injury. Author describes the case of cholestatic hepatitis occurring in three weeks after cessation of short-term treatment with prajmalium. Eighteen months later, despite of good general status, physical and biochemical features of cholestasis were present. Pathologic examination of liver biopsy specimen revealed the chronic intracellular cholestasis with lymphocytic infiltration. Presented case indicate that even short-term treatment with potentially weekly hepatotoxic drug may cause the long-term intrahepatic cholestasis.

Topics: Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Chemical and Drug Induced Liver Injury; Cholestasis, Intrahepatic; Female; Humans; Middle Aged; Prajmaline

40 patients with various type of arrhytmia with stable angina were treated with 3 x 20mg Prajmalin (Neo-Gilurytmal) over 6-day period. A positive antyarhytmic response was observed in 30 patients (75%). In the remaining 10 patients considering the lack of adequate response after 6 days on 60 mg the trial was continued at a dose of 100 mg/day (5 x 20mg). With this dose bringing on the desired results. In 32 patients with VE'e and SVE's Neo-Gilurytmal was used in mono therapy. While in other types of arthymia it was used as previously as a first treatment and also in cases where other antiarhytmic drugs (e.g. Propahenone, Mexitil or Beta-blockers) were unsuccessful. Antiarhytmic effects were verified using 24-hour Holter monitoring before introduction of Neo-Gilurytmal, during the first fourth and seventh day of administration and also the eleventh day of observation (in 30 patients three days after cessation of treatment and in 10 cases three days after commencing on 100 mg daily). The results, as mean of the 24-hour observation was statistically analysed using the Wilcoxon test. We analysed the mean from the first day (H1), fourth day (H2), seventh day (H3) i.e. 6 days after administration and in 10 patients three day after increasing the dose to 100 mg/day (H4). We compared this to a base value (Ho) obtained before drug administration. The results obtained showed the Neo-Gilurythmal is an effective drug significantly reducing meanly VE's and SVE's and also gigemini, trigemini, coupled, runs. It was concluded that Neo-Gilurythmal did not significantly effect the heart rate and QT intervals and also QT adjusted to the heart rate. It was also noticed that these was a lack of therapeutic effect 3 days after cessation of treatment, which was suggested that constant therapy is required. Neo-Gilurythmal was find to be effective even in the case where other previously used antiarhymics were ineffective. We also observe a positive result in treatment of paroxismal tachycardia, in treatment of WPW Syndrome and also in prophylactic againts its recurrence. In our study no adverse effects (e.g. cardiac muscle depression, hypotensive episodes or noted in other studies gepatotoxicity or cholestatic episodes) were observed.

Topics: Adult; Aged; Angina Pectoris; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Drug Administration Schedule; Electrocardiography, Ambulatory; Female; Humans; Male; Middle Aged; Prajmaline; Tachycardia, Paroxysmal; Treatment Outcome

A significant potentiation of antiarrhythmic effect was observed in 121 dogs with arrhythmias 24 and 48 hours after the coronary artery ligation when the following drugs were combined: N-propylajmaline bromide (1A class) and trimecaine (1B class), quinidine (1A class) and trimecaine, N-propylajmaline bromide and anaprilin (2 class). The potentiation is attributed to the different molecular mechanisms of action of the drugs.

Topics: Animals; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Dogs; Drug Therapy, Combination; Prajmaline; Propranolol; Quinidine; Trimecaine; Verapamil

The frequency-dependent block of cardiac sodium channels by class 1 antiarrhythmic drugs can be described by a periodical ligand binding process between drug molecules and channel binding sites. This predicts a linear relation between onset-rate constant of frequency-dependent block and diastolic interval as well as saturation of block with high stimulation rates. From both relationships, the binding kinetics (time constant, tau on) and saturation level of block (bdinf) can be estimated. This is exemplified for the frequency-dependent block (reduction of the maximal upstroke velocity of action potentials) induced by prajmaline (10(-6) M). In the same way, the frequency-dependent effects of 11 other class 1 drugs reported in the literature were analyzed and compared with each other. When the drugs are ranked with respect to their binding kinetics (tau on), there is a close relationship to the subclasses (1a, 1b, 1c), with 1b drugs exhibiting the fastest and 1c drugs the slowest kinetics. However, differences also exist in the saturation behavior of frequency-dependent block even within the same subclasses (1a and 1c). Thus, the class 1 drugs can also be subdivided in three other groups exhibiting clearly separated bands of block-frequency relations, with half-maximal saturation occurring at different stimulation rates. Our findings may have differential implications for the antiarrhythmic and proarrhythmic efficacy of class 1 drugs.

Topics: Animals; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Electric Stimulation; Guinea Pigs; Heart; Heart Rate; In Vitro Techniques; Kinetics; Lidocaine; Ligands; Membrane Potentials; Papillary Muscles; Prajmaline; Quinidine; Sodium Channels

Prajmalium bromide in combination with trimecaine was tested for effects on arrhythmias in the late period of canine experimental myocardial infarction. The combination given in subthreshold doses was found to restore sinus rhythm in 8 of 11 cases. It also decreased the maximum repolarization rate in rat papillary muscles to a greater extent than either drug given alone. The rate of spontaneous firing of Purkinje fibers from the ischemic zone was decreased by the combination of the drugs.

Topics: Animals; Arrhythmias, Cardiac; Dogs; Drug Therapy, Combination; Myocardial Infarction; Papillary Muscles; Prajmaline; Purkinje Fibers; Trimecaine

We studied the effects of prajmaliumbitartrate (PBT, Neo-Gilurytmal, Giulini Pharma, Hannover, FRG), an antiarrhythmic drug on some parameters of blood coagulation in patients. PBT, 20 mg given three times a day, significantly prolonged template bleeding time and ex vivo thrombus formation time in a modified Chandler's loop. Ex vivo platelet aggregation using different agonists and tests of the plasmatic coagulation system remained unchanged.

Topics: Ajmaline; Arrhythmias, Cardiac; Bleeding Time; Blood Coagulation Tests; Humans; Middle Aged; Platelet Aggregation; Platelet Count; Platelet Function Tests; Prajmaline

Topics: Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Female; Heart Ventricles; Humans; Male; Middle Aged; Prajmaline

Topics: Ajmaline; Arrhythmias, Cardiac; Chemical and Drug Induced Liver Injury; Cholestasis; Diagnosis, Differential; Humans; Male; Middle Aged; Prajmaline

Seven further cases with n-propyl-ajmaliumbitartrate (NPAB)-associated liver damage observed between 1976 and 1980 in two collaborating institutions are reported. The cause/effect relationship could be classified as probable in three cases and as potential in the remaining four patients. No drug rechallenge was carried out. In the clinical management, definite exclusion of biliary tract obstruction had a clear priority over histologic documentation of the degree of the transient liver damage. Follow-up data after 2 years 8 months to 5 years 9 months by personal reinvestigation of three patients and by questionnaire to family physicians and patients in the remaining four cases gave no clinical or serologic indication of persisting or relapsing liver damage. Liver biopsies were not considered to be warranted in the follow-up of these asymptomatic patients with normal liver function tests.

Topics: Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Chemical and Drug Induced Liver Injury; Female; Follow-Up Studies; Humans; Liver Function Tests; Male; Middle Aged; Prajmaline

Topics: Adult; Aged; Ajmaline; Arrhythmias, Cardiac; Cholestasis, Intrahepatic; Diagnosis, Differential; Female; Humans; Male; Middle Aged; Prajmaline

The present study was designed to assess the antiarrhythmic Prajmalium Bitartrate (PB) efficacy in the long term treatment of 22 patients with recent myocardial infarction and persistent, frequent, polimorphous, repetitive (two or more in a row) ventricular premature complexes (VPCs). VPCs were exposed by means of 24-hours ambulatory monitoring. The acute drug testing with a single dose of PB (30 mg) was followed by multiple maintenance therapy with a dose decreasing from 60 to 40 mg every day. Than, the long term antiarrhythmic action was evaluated by both monitoring and exercise stress testing (EST), symptom self-limited, in a 7 months and 28 days follow-up. A favorable therapeutic effect, with a reduction of VPCs frequency greater than 85% and the suppression of their greater Lown degrees, was obtained in 13 cases (59.2%) using PB alone and in 6 cases (27.2%) using PB associated with Amiodarone in 5 patients and with Metoprololo in one. No VPCs were present or they were less than 2 every 3 minutes during EST. Fourteen patients reported a recurrence of VPCs when the drug was stopped for 24-28 hours, after 3-5 months of the treatment. In 3 patients (13.6%) the PB was uneffective. In a case there was, during the acute drug testing, a paradox increasing of the arrhythmias, and in the other two an abnormal lengthening of QTc interval, while arrhythmia was unchanged. PB, alone or associated with other antiarrhythmic drugs, appears a well tolerated, handy and effective agent and it can be proposed as a drug of first choice for controlling VPCs.

Topics: Adult; Aged; Ajmaline; Ambulatory Care; Amiodarone; Arrhythmias, Cardiac; Drug Therapy, Combination; Electrocardiography; Female; Humans; Male; Metoprolol; Middle Aged; Monitoring, Physiologic; Myocardial Infarction; Prajmaline

Topics: Adult; Aged; Ajmaline; Anti-Arrhythmia Agents; Arrhythmias, Cardiac; Female; Humans; Male; Middle Aged; Prajmaline

Topics: Adolescent; Adult; Ajmaline; Arrhythmias, Cardiac; Atrial Fibrillation; Cardiac Complexes, Premature; Female; Humans; Male; Middle Aged; Prajmaline; Tachycardia, Paroxysmal