The Use of Disopyramide in Resistant Cardiac Arrhythmias Due to Acute Ischaemic Heart Disease

1977 ◽  
Vol 5 (5) ◽  
pp. 369-373 ◽  
Author(s):  
G Sandler

Disopyramide, a new anti-arrhythmic drug, has been assessed in twenty-one episodes of cardiac arrhythmia secondary to acute ischaemic heart disease which failed to respond to more conventional suppressive therapy with lignocaine and other standard drugs. The intravenous administration of 100 mg of disopyramide resulted in suppression of two out of seven episodes of supraventricular arrhythmia, and eleven out of fourteen episodes of ventricular arrhythmias. Successful suppression correlated with blood levels of disopyramide in most cases of ventricular arrhythmias but not in the supraventricular arrhythmias. There were no adverse effects on blood pressure or cardiac function. There were minimal effects on conduction in the electrocardiogram. It is concluded that disopyramide, which probably acts by direct depression of myocardial irritability, is a useful new anti-arrhythmic drug in acute myocardial infarction, especially in those patients with ventricular arrhythmias resistant to more conventional anti-arrhythmic therapy.

BMJ ◽  
1982 ◽  
Vol 284 (6323) ◽  
pp. 1148-1151 ◽  
Author(s):  
L Harris ◽  
H J Dargie ◽  
P G Lynch ◽  
C J Bulpitt ◽  
D M Krikler

1967 ◽  
Vol 5 (5) ◽  
pp. 19-20

Complete heart block can occur in ischaemic heart disease, and can acutely complicate myocardial infarction. Most other cases are associated with fibrosis of the bundle of His of unknown cause, or are congenital. In some patients with chronic heart block, especially the congenital type, adequate output is maintained. In other patients chronic or intermittent heart block may cause Stokes-Adams attacks, or heart failure may not respond to digitalis and diuretics until the heart rate is increased. These require treatment by drugs or, when this fails, by use of anartifical pacemaker.


ESC CardioMed ◽  
2018 ◽  
pp. 2836-2840
Author(s):  
Martha Gulati

The more atypical presentation of women makes the diagnostic evaluation of symptomatic women challenging and results in more frequent referral for diagnostic testing to improve the precision of the ischaemic heart disease likelihood estimate. The classification of ischaemic heart disease and myocardial infarction has moved beyond the diagnosis of obstructive coronary artery disease and encompasses ischaemia that can occur in the presence and absence of obstructive coronary artery disease. Consideration of the different pathophysiology of ischaemia that may occur in women needs to be considered in the evaluation and treatment of ischaemic heart disease in women.


Author(s):  
Bernhard L Gerber ◽  
Mouaz H Al-Mallah ◽  
Joao AC Lima ◽  
Mohammad R Ostovaneh

Chronic ischaemic heart disease (IHD) is one of the most common cardiac conditions worldwide and is generally caused by the consequences of coronary atherosclerosis, including myocardial infarction. Clinical challenges in chronic IHD include detection of myocardial ischaemia in symptomatic patients with suspected coronary artery disease (CAD), evaluation of myocardial viability in patients with established IHD and poor left ventricular ejection fraction (LVEF) when revascularization is considered, as well as risk stratification and identification of patients with chronic IHD at high risk of complications. Cardiovascular magnetic resonance (CMR) can provide vital answers to all three of these challenges. Stress CMR is now increasingly used to detect ischaemia by means of vasodilator stress perfusion or dobutamine stress contractile reserve stress imaging. For viability assessment, late gadolinium enhancement is currently the method of choice to detect myocardial infarction, and low-dose dobutamine stress magnetic resonance can provide additional information to determine viability and guide therapy. Cardiovascular risk in patients with chronic IHD is mainly determined by left ventricular function, most commonly utilizing LVEF, as well as infarct size, infarct characteristics, and ischaemic burden, which can all be measured reliably with CMR. This chapter will review the role of CMR for the detection of myocardial ischaemia, viability, and risk.


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