scholarly journals DISORDERS OF CARDIAC RHYTHM IN PATIENTS WITH PRE-EXCITATION SYNDROME OF VENTRICLES AND THEIR PHARMACOLOGICAL CORRECTION

2020 ◽  
Vol 24 (1-2) ◽  
pp. 24-29
Author(s):  
R.V. Lutsenko ◽  
Yu. A. Kapustnick ◽  
A. H. Sydorenko

The aim of the research was to analyze the possibility of using different antiarrhythmic agents in patients with pre-excitation syndrome and disorders of cardiac rhythm. Most typical disorders of cardiac rhythm in patients with pre-excitation syndrome are orthodromic reciprocating supraventricular tachycardia, antidromic supraventricular tachycardia, atrial fibrillation and atrial fibrillation. During attack of tachycardia in patients with syndrome of pre-excitation, different clinical symptoms can be observed. They can range from mild palpitation to syncope. This tachycardia can be even reason of sudden cardiac death. Main its mechanism is macroreentrant circuit involving the AV-node, the additional pathway, the atria, the ventricles. To arrest the attacks of atrioventricular reciprocating tachycardia in patients with WPW syndrome and with narrow complexes QRS, calcium channel blocker verapamil has efficacy in 95% of patients. However, for treatment this arrhythmia with wide complexes QRS verapamil is contraindicated. Besides, it should be taken in account that treatment with this type of cardiac arrhythmia cardiac glycosides is also forbidden. Verapamil and cardiac glycosides are contraindicated for termination of arrhythmia in patients with WPW syndrome and such disorders of cardiac rhythm as atrial fibrillation (flutter). For therapy of atrial fibrillation (flutter) in patients with WPW syndrome antiarrhythmic agents of agents of І A subclass (quinidine, procainamide, disopyramide, propafenone) and ІІІ class (amiodarone, sotalol) can be useful. For interruption of paroxysmal tachycardia in patients with pre-excitation syndrome antiarrhythmical preparations of plant origin (gilurytmal and allapinin) have high efficacy. Termination of paroxysmal tachycardia in patients with premature excitation of ventricles can be achieved after administration of antiarrhythmic agents of ІС subclass, in particular after using of propafenone and encainide. However, treatment with the help of these agents quite often leads to appearance of arrhythmogenic action. In pre-excitation syndrome and cardiac arrhythmias, it is impossible to use drugs, which cause the acceleration of conductivity of nerve impulses in additional pathways (cardiac glycosides, β-blocker agents, for example propranolol). In patients with paroxysmal atrioventricular reciprocating (circular) tachycardia digitalis and calcium channel blockers should be avoided. Such agents as digoxin and verapamil in this arrhythmia can turn out to be dangerous in WPW syndrome, since they raise the conductivity through additional conductive pathways.

2019 ◽  
Vol 2019 ◽  
pp. 1-5
Author(s):  
Mohammed Abdullahi Talle ◽  
Faruk Buba ◽  
Aimé Bonny ◽  
Musa Mohammed Baba

Syncope is a common manifestation of both hypertrophic cardiomyopathy (HCM) and Wolff-Parkinson-White (WPW) syndrome. The most common arrhythmia in HCM is ventricular tachycardia (VT) and atrial fibrillation (AF). While preexcitation provides the substrate for reentry and supraventricular tachycardia (SVT), AF is more common in patients with preexcitation than the general population. Concurrence of HCM and WPW has been reported in many cases, but whether the prognosis or severity of arrhythmia is different compared to the individual disorders remains unsettled. We report a case of HCM and Wolff-Parkinson-White (WPW) syndrome in a 28-year-old male Nigerian soldier presenting with recurrent syncope and lichen planus.


2015 ◽  
Vol 48 (5) ◽  
pp. 861-866 ◽  
Author(s):  
Frida Sandberg ◽  
Valentina D.A. Corino ◽  
Luca T. Mainardi ◽  
Sara R. Ulimoen ◽  
Steve Enger ◽  
...  

2014 ◽  
Vol 48 (12) ◽  
pp. 1570-1579
Author(s):  
Vibha C. A. Desai ◽  
Christina M. L. Kelton ◽  
Anne H. Metzger ◽  
Teresa M. Cavanaugh ◽  
Jeff J. Guo ◽  
...  

1984 ◽  
Vol 247 (4) ◽  
pp. F650-F655 ◽  
Author(s):  
M. Cruz-Soto ◽  
J. E. Benabe ◽  
J. M. Lopez-Novoa ◽  
M. Martinez-Maldonado

The inhibition of renin secretion and the vasoconstrictive action of cardiac glycosides may be attributed to increases in cytosolic calcium as a result of inhibition of Na+-K+-ATPase. These studies examined in the dog in vivo the role of calcium on the renal actions of ouabain as assessed from the modifying effects of calcium channel blockers. Since vanadate, another Na+-K+-ATPase, inhibitor, enhances in vitro the binding of ouabain to Na+-K+-ATPase, we examined the capacity of vanadate to modify the renal effects of ouabain in vivo. Infusion of ouabain (1 microgram X kg-1 X min-1) into the renal artery decreased RBF, GFR, and renin secretion, and produced diuresis and natriuresis. When ouabain was infused in dogs receiving the calcium channel blocker verapamil (100 microgram/min), it failed to suppress renin secretion or cause renal vasoconstriction. In addition, verapamil produced diuresis and natriuresis, which were greatly enhanced by ouabain (e.g., verapamil FENa 12.0 +/- 1.1----34.2 +/- 5.1%). The data strongly suggest that calcium entry into cells is a major mediator of the renin inhibitory effect and of the renal vasoconstriction induced by cardiac glycosides. The natriuresis observed during the calcium channel blocker infusion suggests that this drug may have a direct tubular effect on sodium reabsorption. Superimposition of vanadate (0.5 mumol/min) on ouabain infusion led to massive natriuresis (FENa, 5 +/- 1----35 +/- 4%), renal vasodilation (RBF 90 +/- 12----170 +/- 15 ml/min), and an increase in renin secretion (delta, 100%).(ABSTRACT TRUNCATED AT 250 WORDS)


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