Prenatal diagnosis and management of fetal Long QT syndrome.

This report describes a fetus presenting with second-degree atrioventricular block, sinus bradycardia, and transient ventricular tachycardia with ventriculoatrial dissociation. Long QT syndrome (LQTS) was suspected due to the association of heart rhythm disturbances and very short transmitral early deceleration time. This impaired relaxation of the left ventricle was explained by the extreme prolongation of the refractory period caused by the prolonged relaxation time. The infant was treated successfully with beta-blockers and implantation of a pacemaker. The prognosis is poor when LQTS presents utero or during the first week of life. To date, only a few case reports of a fetus with LQTS have been published.

[Study of antiarrhythmic activity and duration of action of quaternidine]. / Issledovanie protivoaritmicheskoi activnosti i prodolzhitel'nosti deistviia kvaternidina.

The results of experiments on dogs showed that quaternidine, a quaternary ammonium derivative of trimecaine, produces a significant antiarrhythmogenic effect in cases of rhythm disorders in the late stage of a model myocardial infarction. For drugs administered in a single isotoxic dose, the therapeutic effect of quaternidine in animals with acute myocardial ischemia considerably exceeds the duration of action of lidocaine and trimecaine.

[Laboratory and clinical study of therapeutic efficacy of medicinal films for surgical procedures]. / Laboratorno-klinicheskoe issledovanie terapevticheskoi éffektivnosti lekarstvennykh plenok khirurgicheskogo naznacheniia.

An analysis of the experimental data showed that anesthetic medicinal films (AMFs) offer an effective medicinal form for the treatment of suppurative inflammatory disorders(SIDs) of soft tissues. The results of preclinical experiments with AMFs showed evidence of anesthetic, antimicrobial, and hemostatic effects. The therapeutic effect was established in the course of clinical investigations and confirmed by the results of cytological, histological, morphological, and bacteriological testing. The experimental data indicate that AMF application offers a promising means of SID treatment. Further development of this medicinal form must lead to an increase in the therapeutic efficacy, decrease the drug dose, and reduce the probability of side effects during the treatment of SIDs in soft tissues of various localization.

[The anti-arrhythmia activity of amino acid-containing trimecaine derivatives on models of early occlusive and reperfusion arrhythmias in cats]. / Protivoaritmicheskaia aktivnost' aminokislotsoderzhashchikh proizvodnykh trimekaina na modeliakh rannikh okkliuzionnykh i reperfuzionnykh aritmii u koshek.

Experiments were conducted on models of early occlusion and reperfusion arrhythmias in cats to study the antiarrhythmic activity of trimecain, its morpholine analogue (MPT), and MPT derivatives containing glycine, magnesium salt of aspartic acid, and N-acetylglutaminic acid. All the compounds were injected in doses of 5% of LD50. A 22.5 mg/kg dose of trimecain prevented cardiac rhythm disorders after occlusion of the coronary arteries as well as after restoration of the coronary blood flow. Replacement of the diethyl group in the structure of trimecain by the morpholine ring led to diminution of antiarrhythmic activity, and MPT in a dose of 28.0 mg/kg, in distinction from the former, had no effect on the frequency of the occurrence of early occlusion arrhythmias and the duration of reperfusion arrhythmias. Introduction of amino acids as an anion into the MPT structure raised the antiarrhythmic activity of the last named.

[The antiarrhythmic activity of the polymeric forms of quinidine, trimecaine, etatsizin, propranolol and verapamil]. / Antiaritmicheskaia aktivnost' polimernykh form khinidina, trimekaina, étatsizina, propranolola i verapamila.

The antiarrhythmic activity and acute toxicity of polymeric formulations of quinidine, trimecaine, ethacizine, propranolol, verapamil which had been immobilized on a cellulose carrier (monocarboxylcellulose) and low molecular analogues were studied in various experimental animals (rats, mice, dogs). The polymeric formulations of trimecaine and verapamil were found to have a higher antiarrhythmic activity in different arrhythmia models than trimecaine and verapamil. The toxicity of all new compounds was no more than the values of conventional antiarrhythmic drugs.

[The effect of a combination of N-propylajmaline bromide and trimecaine on heart arrhythmias of different origins and on the electrophysiological parameters of the myocardium]. / Vliianie kombinatsii N-propilaimalinbromida i trimekaina na aritmii serdtsa raznogo geneza i élektrofiziologicheskie parametry miokarda.

In experiments on dogs and cats with disorders of the atrial and ventricular rhythms of various genesis the combination of N-propylaymalinebromide and trimecaine (the antiarrhythmic drugs of classes IA and IB) was found to potentiate the antiarrhythmic action. This effect was studied in electrophysiological experiments by using the microelectrode technique or on the dog and rat myocardium tissue. The combination of the antiarrhythmic drugs was shown to exert a more significant effect on some electrophysiological parameters determining the arrhythmic readiness of the myocardium.

Electrical instability of the heart in acute local myocardial ischaemia: pathogenesis and experimental prevention.

The pathogenesis of electrical instability of tissue in the earliest phase of ischaemia is well known. Convincing results in the prevention of ventricular fibrillation at this stage have been obtained only by agents inhibiting sympathetic activation of the heart, or by agents significantly prolonging the refractory period of heart cells. On the other hand, it was documented that sodium channel inhibitors are not suitable for prevention of electrical instability in the early phase of ischaemia and can, on the contrary, aggravate it. A question which is still unresolved and deserves further research is the effect of calcium channel inhibitors and of agents acting directly on the metabolism of ischaemic tissue.

[Therapeutic efficacy of trimecaine in cardiac rhythm disorders and ways of improving it]. / Terapevticheskaia éffektivnost' trimekaina pri narusheniiakh serdechnogo ritma i nekotorye puti ee povysheniia.

The efficacy of antiarrhythmic therapy with trimecain in 5 different regimens was studied in 87 patients, in 146 episodes of various disorders of the cardiac rhythm. On the basis of clinical and experimental (on 14 dogs with ventricular arrhythmia) studies, different schemes of trimecain treatment are compared. It was shown that combination of the intravenous and the subsequent intramuscular administration of trimecain to treat ventricular extrasystole complicating the course of acute myocardial infarction is as effective as prolonged instillation but exerts a longer action and is better tolerated by patients. Using tetrapolar chest rheography the effect of trimecain infused in the maximum single dose on the central hemodynamics and the ECG was studied in subjects without any cardiovascular pathology. It has been established that trimecain does not suppress myocardial contractility and has no hypotensive action.

[Clinico-electrophysiologic study of the anti-arrhythmic action of trimecaine]. / Kliniko-élektrofiziologicheskoe izuchenie antiaritmicheskogo deistviia trimekaina.

The antiarrhythmic activity of trimecaine hydrochloride administered orally and intramuscularly was studied in 58 patients with coronary heart disease accompanied by ventricular and supraventricular rhythm disorders. In 73.9% of the cases the drug exhibited antiarrhythmic action which was reflected in a longer period of the recovery of sinus node function, inhibited conduction in the atrioventricular node and a decreased time of intraatrial conduction. Side effects were observed in 17.3% of the cases mostly with the oral drug; they tended to abate spontaneously 2-4 h after trimecaine hydrochloride withdrawal.

[Pharmacological study of quaternary trimecaine derivatives]. / Farmakologicheskoe izuchenie nekotorykh chetvertichnykh proizvodnykh trimekaina.

It has been demonstrated in experiments on cats, rabbits, white rats and mice that the quaternary derivatives of trimecaine (QDT) produce a protective and antiarrhythmic action in atrial (acetylcholine and aconitine) and ventricular (aconitine and calcium chloride) fibrillation. The relationship has been found between the characteristics of the radical at the quaternary nitrogen atom and the antiarrhythmic activity of the QDT. The effect of the QDT on the electrophysiological parameters of the myocardium not on the hemodynamics have been examined. It has been shown that the QDT might be suggested for use as new antiarrhythmic agents.

[Comparative clinical study of the effectiveness of the new anti-arrhythmia agents, trimecaine and pyrromecaine]. / Sravnitel'noe klinicheskoe izuchenie éffektivnosti novykh antiaritmicheskikh preparatov trimekaina i piromekaina.

The antiarrythmic effects of trimecain and pyromecain were studied in 53 patients with frequent ventricular premature beats. Trimecain was given to 22 patients and pyromecain was given to 31. The efficiency of both intravenous and oral drug administration was considered. Comparative drugs--lidocain, mexityl, procainamid were parallely used. The efficiency criterion was the decrease in mean ventricular premature beats per hour by 50% or more during ECG-monitoring. A positive antiarrhythmic effect of intravenous trimecain was observed in 35.3% of the patients, that of pyromecain was in 18.2% and after administration of a related compound lidocain, it was seen in 30.0% and 26.7%, respectively. Trimecain in tablets proved to be efficacious in 15.4% of the patients in a single dose and in 18.2% after its long-term therapy, while mexityl, a comparative agent was efficacious in 63.6%. Pyromecain in tablets did not lead to decrease in ectopia either during an "acute" test or during the long-term therapy whereas procainamid was effective in 37.3% of the patients studied.