[A combination of kordaron with ritmilen: its effect on the electrophysiology of the heart and its clinical effectiveness]. / Kombinatsiia kordarona s ritmilinom: vliianie na élektrofiziologiiu serdtsa i klinicheskaia Teffektivnost'.

Combined effect of cordarone and ritmilen on myocardial electrophysiology was assessed in an acute medicated test, on the basis of electrophysiologic studies and transesophageal pacing test, in patients with resistant paroxysmal supraventricular tachycardia. The cordarone-ritmilen combination has proved efficient in 82.4% of cases and caused a significant change of the P-Q interval and effective refractory period (ERPav, ERPrv, ERPiv). The Q-T interval increased but never resulted in ventricular arrhythmias. Good antiarrhythmic effect was seen in 70.4% after 12 months. There were side effects in 10.7% of cases.

[Clinical use and late results of transvenous endocardial destruction of the atrioventricular junction by the bipolar method]. / Klinicheskii opyt i otdalennye rezul'taty transvenoznoi éndokardial'noi destruktsii atrioventrikuliarnogo soedineniia serdtsa bipoliarnym sposobom.

Transvenous endocardial destruction of the AV junction, using an original bipolar technique, was carried out in 32 patients with supraventricular tachyarrhythmias, resistant to medication. The procedure was effective in 29 (91%) of 32 patients. Stable and complete AV block was achieved in 23 of 30 patients, with subsequent implantation of a pacemaker, while in 4 patients, clinical improvement was achieved with intact AV conductivity. Two patients with re-entry tachycardia of the AV junction were subjected to low-energy contusion of the AV junction, and the results were good. Major hemodynamic and myocardial contractility parameters were basically unchanged at long-term follow-up; spontaneous heart rate was significantly decreased in patients with implanted pacemakers, and some of those developed pacemaker dependence.

[Reproducibility of reciprocal atrioventricular tachycardia during intracardiac and transesophageal electric stimulation]. / Vosproizvodimost' retsiproknykh atrioventrikuliarynkh takhikardii pri vnutriserdechnoi i chrespishchevodnoi elektro-kardiostimuliatsii.

A feasibility to provoke reciprocal atrioventricular tachycardias was examined in 23 patients with atrioventricular nodal tachycardia and 17 with orthodromal tachycardia in the presence of the Wolff-Parkinson-White syndrome with endocardiac and transesophageal diagnostic pacing. Atrioventricular nodal tachycardia could be induced in all 23 (100%) patients both by endocardiac and transesophageal pacing. Orthodromal tachycardia was provoked only in 9 (53%) of 17 patients by transesophageal pacing. It was generally noted that tachycardia induction required more "aggressive" regimens of transesophageal pacing than endocardiac one. Endocardiac diagnostic pacing is now a more informative technique, but transesophageal pacing requires further development.

[Evaluation of the possibility of selection of individual anti-arrhythmia therapy]. / Otsenka vozmozhnosti individual'nogo podbora antiaritmicheskoi terapii.

Antiarrhythmic therapy was chosen for 3-7 days by modified chronic electrophysiological study at three stages: (1) the efficacy of a drug, its action onset and termination were defined; (2) a dosage was chosen on an individual basis and the duration of drug potency was specified; (3) the dosage regimen of a drug given as a course therapy was confirmed by the results of trials. Its choice was made on the basis of the oral administration of a tested drug and multiple programmed electric cardiostimulation. In late periods (3-37 months), the therapy was effective and safe in 51 (86%) of 59 patients. The drug regimens and doses were in poor agreement with conventional ones in 49% of the patients. The method proposed makes it possible to choose antiarrhythmic therapy on an individual basis and reduce the number of complications.

[First experiences with the effect of low-energy electric impulse on the atrioventricular junction in various types of paroxysmal supraventricular tachycardia]. / Pervyi opyt nizkoénergeticheskogo élektroimpu'lsnogo vozdeistviia na atrioventrikuliarnoe soedinenie serdtsa pri nekotorykh paroksizma'lnykh nadzheludochkovykh takhikardiiakh.

Efficient treatment of paroxysmal supraventricular reciprocal tachycardias (nodal and orthodromal) was studied in 29 patients by applying low-energy discharges (mean 2.3 +/- 0.1 kV) to the area of the atrioventricular junction. Late results of the treatment were assessed 7-22 months later. Cessation of tachycardia paroxysms was observed in 10 patients, their lower frequency (by more than 50%) was seen in 14 cases. The value of discharge energy, their numbers, relations between potential amplitudes produced by atria and His' bundle, feasibility of paroxysm induction, presence or absence of bundle-branch block were not prognostic criteria for efficiency of this mode of therapy in the present investigation. In the authors' opinion, the method is promising in the treatment of atrioventricular nodal and orthodromal paroxysmal tachycardias.