Zeitschrift für Kardiologie
-
The efficacy of beta adrenergic blocking agents has been observed in the treatment of a variety of cardiac arrhythmias. Electrophysiological experiments demonstrated that beta receptor blocking drugs prevent catecholamine-induced alterations of the transmembrane action potential. Clinically used beta blocking agents are effective in preventing arrhythmias provoked by sympathetic stimulation such as sinus tachycardia, paroxysmal junctional tachycardia, atrial, nodal, and ventricular premature contractions. ⋯ Beta blocking agents are--at least in our hands--most useful in combination with class I antiarrhythmic drugs with the intention to reduce the dosage--i.e. the side effects--of various antiarrhythmic drugs. In hyperthyroidism beta adrenergic blocking agents are effective complementary to the specific treatment. In cases of intoxication with beta blocking drugs complicated by myocardial depression and severe bradycardia glucagon must be regarded as a very useful compound.
-
To study the temporal relationship of occlusion and reperfusion we examined 16 patients (14 m, 2f) with variant angina for the occurrence and time course of arrhythmias with episodes of ST-elevation (n = 82). The patients underwent frequency-modulated ambulatory ECG recording, episodes of ST elevation were defined, and the arrhythmias were counted before, during and after each episode. In 10 patients (group A) no or only infrequent extrasystoles occurred. ⋯ There was a tendency towards a greater incidence of higher ST-elevations (greater than 2 mm) in group B (4 of 6 patients versus 2 of 10 in group A, p = 0.09). The relationship of arrhythmias and ST changes showed different patterns: the maximum of arrhythmias occurred during the episode in 3 patients, during and after the episode in 2 patients and only after the episode in 1 patient. Potentially dangerous arrhythmias are frequent in patients with variant angina and persist beyond the ST segment changes in one half of the affected patients.
-
The electrophysiological effects of sotalol, a beta-blocking drug with class III antiarrhythmic properties were assessed in 20 patients (mean age 33 +/- 14.3 years) with supraventricular tachycardias. Sixteen patients had Wolff-Parkinson-White syndrome (overt n = 9, concealed n = 7), three patients AV-nodal reentrant tachycardias and another patient atrial tachycardias. Sotalol was administered intravenously (n = 16) in a dose of 1.5 mg/kg over 15 min. ⋯ After intravenous application supraventricular arrhythmias were no longer inducible in 5 of 12 patients. In a further 4 patients only non-sustained supraventricular tachycardias (4-20 QRS complexes) were inducible. In 2 patients the supraventricular tachycardia terminated distal to the His bundle.(ABSTRACT TRUNCATED AT 250 WORDS)
-
One hundred and fifty-two patients underwent cardiac catheterization and coronary arteriography within 6.3 +/- 6.0 hours from onset of acute myocardial infarction. All had a standard 12-lead electrocardiogram recorded within 1.5 hours of cardiac catheterization. The electrocardiographic abnormalities present were correlated with the infarct related artery as determined by coronary arteriography. ⋯ Fifty-six percent of patients with CX artery as the infarct related artery presented with non-classical electrocardiographic abnormalities. The electrocardiographic pattern in patients with subtotal occlusions were similar to those of patients with total occlusions. Thus the electrocardiogram obtained in the first few hours of acute myocardial infarction is reliable in localizing the LAD as the infarct related artery.(ABSTRACT TRUNCATED AT 250 WORDS)