[The agreed experts' position of the Eurasian Association of Therapists on tactics of management of patients with comorbid pathology infected with SARS-Cov-2].

The agreement of experts of the Eurasian Association of Therapists (EAT) discusses pathogenesis and treatment of COVID-19. Modern data on the characteristics of cardiovascular, kidney, respiratory damage in SARS-infected CoV-2 are presented. The tactics of managing patients initially having cardiovascular diseases, diabetes mellitus, chronic obstructive pulmonary disease, bronchial asthma, chronic kidney disease are discussed in detail. The article presents data on drug interaction of drugs.

[Anticoagulants in the prevention of complications in patients with atrial fibrillation].

This review presents new data on the comparative effectiveness and safety of treatment with oral anticoagulants warfarin, dabigatran, rivaroxaban, apixaban for prevention of thromboembolism in patients with atrial fibrillation.

[Romano-Ward syndrome initially diagnosed as epilepsy]. / Sindrom Romano-Uorda, pervonachal'no diagnostirovannyi kak épilepsiia.

A report of a case of Romano-Ward syndrome presenting as epilepsy is accompanied with discussion of symptoms characteristic of the syndrome and possible causes of erroneous primary diagnosis.

[Protective electrophysiological effects of somatostatin in patients with paroxysmal atrioventricular reciprocal tachycardias]. / Kupiruiushchee deistvie i élektrofiziologicheskie éffekty somatostatina u bol'nykh s paroksizmal'nymi atrioventrikuliarnymi retsiproknymi takhikardiiami.

Within 30 seconds after intravenous injection of somatostatin (sandostatin, 0.1 mg) we observed restoration of sinus rhythm in patients with atrioventricular (AV) junctional or orthodromic reciprocal tachycardias. This action was associated with interruption of re-entry on anterograde direction of AV conductivity. Somatostatin elicited pronounced cardiac electrophysiological effects which were due to activation of parasympathetic nervous system. Besides, it evoked transient elevation of systolic (+12.6%) and diastolic (+13.5%) blood pressures. High efficacy and good tolerance of somatostatin allow to consider this peptide as an alternative to adenosine and verapamil in the treatment of AV reciprocal tachycardias.

[Effect of regulatory peptides on the effect of cardiorespiratory synchronization in patients with heart diseases]. / Deistvie reguliatornykh peptidov na éffekt kardiorespiratornyi sinkhronizatsii u bol'nykh s patologiei serdtsa.

A long-acting somatostatin analogue (sandostatin) and synthetic opioid dalargin were examined for the effect on the heart rhythm under the cardiorespiratory synchronization test in patients with heart disease. In high-frequency respiration synchronized with photostimulator flashes the patients exhibited cardiorespiratory synchronism when heart rate corresponds exactly to respiration rate. A spontaneous change of the respiration rate entailed corresponding changes in the heart rate. This allowed regulation of the heart rhythm. Intravenous injection of sandostatin or dalargin extended the range of the cardiorespiratory synchronization. The latter points to involvement of peptides in mechanisms of heart taking of the control signals coming from the central nervous system.

[Possibilities of correcting adverse effects of anti-arrhythmia agents]. / Vozmozhnosti korrektsiii neblagopriiatnykh éffektov antiaritmicheskikh preparatov.

A hundred and twenty two patients with premature ventricular contractions and paroxysmal tachycardias were comprehensively studied prior to and following treatment regimen with ethacizin, befol, sodium succinate and their combinations. Besides its significant antiarrhythmic activity, ethacizin displayed a number of adverse cardiac effects, such as excessive negative inotropic and dromotropic ones. Befol and sodium succinate in combination with ethacizin can reduce or even eliminate these side effects in rest and during simulated mental stress and graded exercise. The antiarrhythmic effect of the combined therapy preserved or even became stronger. This therapy may be long performed for arrhythmias even in patients with circulatory insufficiency and cardiac conduction disturbances caused or redoubled by ethacizin.

[New pharmacodynamic effects of gidazepam and befol in patients with cardiac arrhythmias]. / O novykh farmakologicheskikh éffektov gidazepama i befola u bol'nykh s aritmiiami serdtsa.

The new Russian drugs gidazepam, a tranquilizer, and befol, an antidepressant, show not only their psychotropic action, but change cardiac electrophysiological function and produce antiarrhythmic effects, which allows them to be used in the treatment of various cardiac arrhythmias. The antiarrhythmic effect of the psychopharmacological agents is largely shown in patients with ventricular premature contraction and paroxysmal tachycardias in the presence of neurocirculatory dystonia, as well as with great deviations of the electrophysiological properties of the cardiac conduction system from the their mean values, by promoting their normalization. The antiarrhythmic effect of gidazepam is higher than that of befol in both patients with neurocirculatory dystonia and those with coronary heart disease.

[The clinico-hemodynamic effects of the activator of the GABA-ergic stress-limiting system sodium valproate (acediprol) and etatsizin in patients with cardiac arrhythmias]. / Kliniko-gemodinamicheskie éffekty aktivatora GAMK-ergicheskoi stress-limitiruiushchei sistemy val'proata natriia (atsediprola) i étatsizina u bol'nykh s aritmiiami serdtsa.

Hemodynamic and antiarrhythmic effects of acediprol and ethacizine were examined in 51 patients with premature ventricular contraction concurrent with neurocirculatory dystonia and coronary heart disease. It was ascertained that acediprol exerted a positive inotropic action and ethacizine lowered myocardial contractility. Acediprol therapy prevents or attenuates the hypokinetic and arrhythmogenic effects of stimulated stress in patients with ischemic and non-ischemic arrhythmias. The preventive antiarrhythmic effect of acediprol is the most pronounced in patients with neurocirculatory dystonia. Ethacizine fails to improve hemodynamic supply of the stress test and enhances stress-related hypodynamia in some patients.

[Comparative analysis of antiarrhythmic action and electrophysiological effects of a new benzodiazepine derivative gidazepam and ethacizin in arrhythmias of various genesis]. / Sravnitel'nyi analiz antiaritmicheskogo deistviia i élektrofiziologicheskikh éffektov novogo proizvodnogo benzodiazepina gidazepama i étatsizina pri aritmiiakh serdtsa razlichnogo geneza.

The antiarrhythmic and electrophysiological effects of the new benzodiazepine tranquilizer gidazepam versus ethacizin were examined in patients with cardiac arrhythmias. The antiarrhythmic effect of the agent was found during 24-day monitoring and simulated psychoemotional stress in 81% of patients with neurocirculatory dystonia and in 61% of patients with coronary heart disease. The antiarrhythmic effects developed with gidazepam-induced changes in electrophysiological properties of the cardiac conduction system. The preventive antiarrhythmic effect of gidazepam was demonstrated to be higher than that of ethacizin during stress in patients with arrhythmias of extra-ischemic genesis.

[Comparative anti-arrhythmia effectiveness of activators of body stress-limiting systems in patients with arrhythmia]. / Sravnitel'naia antiaritmicheskaia éffektivnost' aktivatorov stress-limitiruiushchikh sistem organizma u bol'nykh s narusheniiami ritma serdtsa.

The antiarrhythmic effects produced by activators of the body's stress-limiting systems were comparatively evaluated in patients with cardiac arrhythmias of ischemic and non-ischemic etiology. Acediprol, gidazepam, and befol were found to be beneficial in ventricular premature contraction when psychoemotional stress was simulated, as evidenced by 24-hour monitoring. The most pronounced protective therapeutical effect of the drugs was observed in patients with arrhythmias of extracoronary origin and in individuals with a marked arrhythmogenic effect of stress. Gidazepam was shown to suppress the provocative arrhythmogenic effect of the stress test.

[First experience in clinical trials of the new domestic drug acediprol used in the treatment of cardiac arrhythmias]. / Pervyi opyt klinicheskogo issledovaniia novogo otechestvennogo preparata atsediprola v lechenii narushenii ritma serdtsa.

The antiarrhythmic effect of sodium valproate (acidoprol) on the degree of arrhythmic manifestations was examined in 18 patients with neurocirculatory dystonia (NCD) and 19 with coronary heart disease (CHD). A 24-hour ECG monitoring and recording were performed on emotional stress and exercise. The antiarrhythmic effect of the agent was evaluated by the blind method and placebo. The course of its therapy was found to reduce the frequency of ventricular premature contractions in 14 patients with NCD and to substantially limit or eliminate the arrhythmogenic effect of emotional stress and exercise. In CHD, the antiarrhythmic effect of acedoprol was less, it being shown only by 6 patients, but the effect failed to occur during exercise. However, the arrhythmogenic effect of emotional stress in CHD was significantly limited. Thus, the GAMA-ergic, stress-limiting system activator acedoprol has antiarrhythmic activity in cardiac patients, but its activity is drastically pronounced in NCD and less marked in CHD.

[Use of cardiorespiratory synchronization in the differential diagnosis of arrhythmia]. / Primenenie kardiorespiratornoi sinkhronizatsii dlia differentsial'noi diagnostiki aritmii.

A method was proposed for differential diagnosis of functional and organic cardiac arrhythmias. It is based on the concept that the nervous system produces a trigger impact on the heart. Cardiorespiratory synchronization is one of the manifestations of the impact. The advantage of the method is that it takes only several minutes and requires no expensive equipment. In fact it may be used at any medical institution. It is particularly effective in mass surveys of persons with cardiac rhythm disturbances of unknown etiology, which are identified for the first time.

[Differential psychopharmacotherapy of heart rhythm disorders]. / Differentsirovannaia psikhofarmakoterapiia narushenii ritma serdtsa.

Antiarrhythmic activity of psychotropic agents, such as phenibut, eglonyl, azaphen, grandaxin, fali-lepsin, is demonstrated for the first time ever in patients with paroxysmal supraventricular tachycardia, atrial fibrillation and ventricular extrasystole. It is dependent on the nature of the underlying heart disease, the psychopathologic syndrome and vegetative cardiac rhythm regulation type. Different trends of cardiac and hemodynamic change are produced by different psychopharmacologic agents. Differential long-term intermittent psychopharmacotherapy is proposed for the control of heart rhythm disorders.

[Experience with the clinical use of lithium oxybutyrate in patients with cardiac rhythm disorders]. / Opyt klinicheskogo ispol'zovaniia litiia oksibutirata u bol'nykh s narusheniem ritma serdtsa.

An antiarrhythmic effect of lithium oxybutyrate was demonstrated in 81% of patients with ventricular extrasystole in the presence of affective disturbances, those with hypersympathicotonus in particular. In arrhythmic cases, lithium oxybutyrate was shown to have a hypokinetic effect on central hemodynamics and contribute to peripheral vasodilatation without causing clinically apparent circulatory disorders. The drug inhibits platelet aggregation and moderately increases blood procoagulation activity in the presence of greater erythrocyte deformability and improved bulbar conjunctival microcirculation.