[Algorithm for the management of patients with ventricular arrhythmias].

The paper proposes an original algorithm for the management of patients with ventricular arrhythmia from its first registration to choice of treatment policy. Using modern diagnostic methods, much attention is paid to the identification of myocardial structural and ischemic changes and also to the involvement of the autonomic and central nervous systems in ventricular arrhythmogenesis. The diagnostic problems are solved step-by-step. The role of psychological diagnosis is accentuated. Longitudinal electrocardiogram monitoring with telemetric data transmission can promptly initiate treatment of patients in an outpatient setting and, in a number of cases, without discontinuing work. The key point of the algorithm proposed is to prevent sudden cardiac death.

[A case of effective psychogenic ventricular arrhythmia treatment with the anxiolytic Adaptol].

There is a presents a clinical case of idiopathic ventricular arrhythmia developing in a 27-year-old young woman with anxiety neurosis successfully treated with the anxiolytic Adaptol used in daily dosage 1500 mg during a month.

[In search of optimal treatment for nonischemic ventricular arrhythmia in patients with anxiety disorders].

AIM: To assess whether arrhythmias may be corrected with the anxiolytic Adaptol in subjects with anxiety disorders. SUBJECTS AND METHODS: On the basis of the data of psychological and mental testing (Stroop test) and the results of Holter monitoring, the authors selected among 59 patients with non-coronarogenic ventricular arrhythmias (VA) and an inadequate response to antiarrhythmic therapy 21 patients with manifest anxiety disorders, in whom a psychogenic factor had played a significant role in the genesis of VA, which served as an indication for Adaptol use. Reexaminations were made 30 days after initiation of therapy with Adaptol 500 mg t.i.d. RESULTS: Adaptol used to treat VA in patients with high anxiety, unlike the controls, exerted a significant antiarrhythmic effect: the average daily and average hourly number of ventricular ectopic complexes significantly decreased while there were no changes in the control group (untreated with Adaptol). In 95% of the patients, the positive Stroop mental test became negative, i.e. it failed to provoke arrhythmia (p < or = 0.01), made test performance easy, and diminished a blood pressure response to the test. The number of patients with moderate and high situational anxiety decreased by 3 times (p < or = 0.01); the general condition improved in the majority of patients. CONCLUSION: The psychogenic factor plays a significant and sometimes determining role in the genesis of non-coronarogenic VA. When used alone and in combination with antiarrthythmics, Adaptol proved to be effective in treating non-coronarogenic VA in patients with higher anxiety.