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Berlin Brandenburg

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  • 1
    Language: English
    In: International Journal of Cardiology, 5/1985, Vol.8(1), pp.67-76
    Description: This study was performed to ascertain whether intravenous amiodarone would revert supraventricular tachycardias to sinus rhythm, and if so, whether this effect depended upon the underlying mechanism of the arrhythmia. Fourteen patients were studied. Seven had Wolff-Parkinson-White (WPW) syndrome, 1 had dual atrioventricular nodal pathways and 1 an ectopic atrial tachycardia. Five patients had atrial fibrillation without accessory pathways. An atrial electrode was inserted to initiate tachycardias and record the electrogram. If tachycardias were stable for more than 5 min, amiodarone (5 mg/kg) diluted with dextrose saline was infused intravenously over 5 min. Two electrocardiographic leads and the right atrial electrogram were monitored. In 7 patients with atrial fibrillation (2 with accessory pathways), 6 did not revert to sinus rhythm, 1 reverted only after 1 hr. In 5 cases without accessory pathways the ventricular rate fell 5-10 min after commencing amiodarone. Four of the 5 patients with WPW syndrome and re-entrant tachycardias returned to sinus rhythm within 6 min of commencing the infusion (atrioventricular and ventriculoatrial times increased by 0-38% and 0-14% respectively). (Tachycardias terminated in the anterograde limb.) Three patients underwent intermittent right atrial stimulation for 1 hr. No tachycardias could be initiated for 30 min post amiodarone. The ectopic atrial tachycardia and that due to dual atrioventricular nodal pathways terminated within 7 and 2 min, respectively, of commencing intravenous amiodarone. Thus the use of intravenous amiodarone would be appropriate in the acute management of sustained supraventricular tachycardias.
    Keywords: Amiodarone -- Therapeutic Use ; Benzofurans -- Therapeutic Use;
    ISSN: 01675273
    E-ISSN: 18741754
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  • 2
    Language: English
    In: International Journal of Cardiology, 1/1986, Vol.10(1), pp.65-69
    Description: We have studied the relationship between age, daily dose, plasma concentration and clinical efficacy of disopyramide in a group of paediatric patients. Twelve children with ventricular and 3 with supraventricular arrhythmias were treated with oral disopyramide. The initial dose was 3-6 mg/kg per day. This was adjusted until a pre-dose plasma concentration greater than 2 mg/I was achieved. Seven patients were judged to have responded to the treatment on clinical criteria. No symptoms or signs of toxicity were observed. In some of the children the dose of disopyramide required to achieve a plasma concentration greater than 2 mg/l was greatly in excess of the normal adult dose. Generally the youngest children required the highest dose, but the variation was wide. The dose could not be predicted from the age, the body weight or the surface area of the patient. In children high doses of disopyramide may be needed to achieve effective plasma concentrations of the drug; such doses are not associated with adverse effects. Measurement of the plasma concentration is necessary to guard against premature termination of therapy.
    Keywords: Arrhythmias, Cardiac -- Drug Therapy ; Disopyramide -- Blood;
    ISSN: 01675273
    E-ISSN: 18741754
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  • 3
    Language: English
    In: European Heart Journal, 12/1988, 12/01/1988, Vol.9(12), pp.1284-1290
    Description: We treated 22 children, aged 3 days to 16 years 6 months (median 11 years 1 month), with flecainide for a variety of arrhythmias where a Class I agent was indicated. In 16, conventional antiarrhythmic treatment had failed. Structural heart disease was present in nine. The arrhythmia was paroxysmal re-entry atrioventricular tachycardia in nine; paroxysmal atrial tachycardia, flutter or fibrillation in five; paroxysmal ventricular tachycardia in five and frequent ventricular extrasystoles (with couplets) in three. Sinus rhythm was achieved in all four children who received flecainide during tachycardia (three received intravenous flecainide, one oral). During follow-up of 3-24 months (median 12 months), arrhythmia control was obtained in 13 children (59%). Combination therapy was used in seven of these; with digoxin in four and a beta blocker in three. Flecainide doses used in this study ranged from 1-11 mg kg-1 day-1 (median 4 mg kg-1 day-1), 25-297 mg m-2 day-1 (median 113 mg m-2 day-1). The median, pre-dose flecainide concentration in those responding to therapy was 225 micrograms l-1 and in those failing to respond was 417 micrograms l-1. An arrhythmogenic effect occurred in one child.
    Keywords: Medicine;
    ISSN: 0195-668X
    E-ISSN: 1522-9645
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