Kapusnyk Yu. O.

DIAGNOSTIC AND DRUG THERAPY ASPECTS OF ARRHYTHMIAS AND CONDUCTION DISORDERS IN PATIENTS WITH SSS


About the author:

Kapusnyk Yu. O.

Heading:

LITERATURE REVIEWS

Type of article:

Scentific article

Annotation:

The main disorders of rhythm and conduction in patients with sinus node weakness are: 1) persistent sinus bradycardia; 2) bradysystolic form of atrial fibrillation; 4) migration of atrial rhythm driver; 5) stoping of the sinus and replace it with other ectopic rhythms; 6) sinoauricular blockade; 8) tachycardia-bradycardia syndrome, for which tachycardia and bradycardia are typical. The most important methods for the diagnosis of sinus syndrome are load tests (bicycle ergometry, treadmill test), tilt test (passive orthostatic test) and vaginal tests, Holter ECG monitoring and esophageal electric cardiac stimulation. Pharmacotherapy of sinoatrial blockade does not always lead to a positive result. It is more effective in sinoatrial-blockade of functional origin. Patients with sinus node weakness syndrome are contraindicated prescribing class I antiarrhythmic agents (quinidine, novocainamide, disopyramide, etmosin, etacizine, propafenone, diphenin, lidocaine, trimecaine, β-adrenergic blocker agents, amiodarone and sotalol). In patients with sinoatrial blockade of grade II with rare loss of PQRST complexes, treatment can be started from using cholinolytic agents. In case of persistent sinoatrial blockade of II-III centuries in ineffectiveness of therapy with help cholinolytic agents, β-adrenergic simulative agents are prescribed: isoproterenol (isadrin) or orciprenaline sulfate (alupent). Beside of euphiline (theophylline) can be administered. M-cholinolytic agents, β-adrenergic simulative agents and euphiline should be used for correcting of conductivity disorders in patients with sinus node weakness. Adrenaline and glucocorticoid hormones are prescribed for sinoauricular blockade of II and III centuries, especially in the presence of arterial hypotension. The drug of choice for treating of brady-dependent forms of atrial fibrillation is allapinin, because this antiarrhythmic agent has β1 -adrenergic simulative effect. For the treatment of frequent and stable ventricular extrasystolic arrhythmia developed on the background of bradycardia, it is effective using of combine therapy, which includes allapinin, riboxin, panangin and bellataminal. In case of a brady-tachyarrhythmia syndrome it is very difficult to choose a drug for the treatment of the patient. Cardiac glycosides, which slow the frequency of ventricular contractions, maintain sinus rhythm, and also cause stopping of atrial paroxysmal tachycardia or atrial flutter, are used for both emergency care and routine therapy.

Tags:

cardiac arrhythmias, heart block, sinus weakness, extrasystolic arrhythmia, beard-tachyarrhythmia syndrome.

Bibliography:

  1. Ardashev VN, Steclov VI. Lecheniye narusheniy serdrchnogo ritma. M.: Medpractica; 2000. 165 s. [in Russian].
  2. Chazov YeI, Karpov YuA. Ratsionalnaya pharmacoterapiya serdechno-sosudistich zabolevaniy. М.: «Literra»; 2016. 1056 s. [in Russian].
  3. Ken Grauer. ACLS-2013-Arrhythmias. KG/EKG Press: Florida; 2013. 287 р.
  4. Mandel VJ. Aritmii sertsa. Mechanizmi, diagnostika, lecheniye. Тom 1. М.: Meditsina; 1996. 510 s. [in Russian].
  5. Nikonov VV. Narusheniya ritma sertsa. Izbrannie lektsii po meditsine neotlozhnich sostoyaniy. Charkov: «CHIU»; 2005. s. 85-109. [in Russian].
  6. Brown Ruth Cardiac arrhythmias. New York: Hayle Medical; 2015. 338 р.
  7. Rasin MS. Vnutrishnya medicina. Rozdil 2. Chvorobi sistemi krovoobigu. Vinnitsa: Nova Kniga; 2015. s. 33-116. [in Ukrainian].
  8. Yakovlev VB, Makarenko AS, Kapitonov KI. Diagnostika i leceniye narusheniy ritma serdtsa. М.: Binom. Laboratoriya znaniya; 2003. 168 s. [in Russian].
  9. Kuschakovskiy MS. Aritmii serdtsa. Sankt-Peterburg: Gippokrat; 1992. 622 s. [in Russian].
  10. Brown Antony FT, Cadogan M. Emergency medicine: diagnosis and management. 5-th Ed. Hodder; 2005. 536 p.
  11. Bobrov VA, Yanovski AD. Sindrom slabosti sinusovogo uzla i supraventricularnii aritmii. Kiev: Naukova dumka; 1991. 143 s. [in Russian].
  12. Galen S. Wagner, David G. Strauss Marriot’s Practical Electrocardiography. Lippincot Gilliams & Wilkins. Philadelphia; 2013. 552 p.
  13. Christopher P, Steinberg AS. Evidenced-Based cardiology. Lippincot Williams & Wilkins. Philadelphia; 2015. 504 p.
  14. Kopecky SL, Litin SC. Clinical pearls in cardiology. Mayo Clin. Proc.; 2010;85:473-8.
  15. American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Care. Circulation. 2005;13:IV-203.
  16. Ma OJ, Cline DM. Emergency medicine: Just the facts. 2-nd Ed. McGraw; 2004. 624 p.
  17. Мoya A, Sutton, Ammirati F, Blanc J, Brignole M. Guideline for the diagnosis and management of syncope (version 2009) Eur. Heart J. 2004;30:2631-71.
  18. Malaya LT, Latoguz IK, Miklyaev IYu, Vizir AD. Ritmi serdtsa. Charkov: Osnova; 1992. 556 s. [in Russian].
  19. Dzhanashia PH, Shevchenko NM, Shlik SV. Narusheniey ritma serdtsa. M.: Overley; 2006. 320 s. [in Russian].
  20. Ruth Brown Cardiac arrhythmias. Hayle Medical. New York; 2015. 338 p.
  21. Douglas I, Zipes P. Braunwald’s heart disease. 10-th Ed. Philadelphia: Saunders; 2014. 2040 p.
  22. Sanborn TA, Feldman T. Management strategies for cardiogenic shock. Curr. Opin. Cardiol. 2004;19(6):608-12.
  23. Mann HJ, Nolan PEJ. Uptake on management of cardiogenic shock. Curr. Opin. Cardiol. 2006;12:431-6.
  24. Babak OY, Bilovol GD. Emergency management of internal diseases. Kyev: AUS Medicine Publishing; 2010. 447 p.
  25. Mazur NA, Ivanova DA, Pavlova TS. Rezultati clinicheskogo izucheniya novogo antiaritmicheskogo preparata allapinina. М.: Byul. VKNC AMN SSSR. 1986;2:30-4. [in Russian].
  26. Smetnev AS, Golitsin SP, Levin ER. Izuchenie sravnitelnoy antiaritmicheskoy effectivnosti allapinina, etacizina i mixetila u bolnich s zheludochcovimi narusheniyami ritma serdtsa. Ter. Archiv. 1988;60(8):34-8. [in Russian].
  27. Kapustnick YuO, Boyko MG, Latoguz IK, Kurochka YeO. Pharmakoterapiya aritmiy sertsa. Poltava: ASMI; 2002. 334 s. [in Ukrainian].
  28. Kapustnick YuO, Vlasova OV. Pharmakoterapiya nevidcladnich staniv v cardiologii. Poltava: Ukrpromtorgservis; 2013. 335 s. [in Ukrainian].
  29. Metelitza VI. Spravochnik po clinicheskoj pharmacologii serdechno-sosudistich lekarstvennich sredstv. Moskva, Sankt-Peterburg: Binom – Nevskij Dialect; 2002. 925 s. [in Russian].
  30. Gabriel Khan M. Cardiac Drug therapy. 8-th Ed. (Contemporary Cardiology. Human press; 2014. 334 p.
  31. Kapustnick YuA, Masoud Kiani, Lutsenko RV. Antiarrhythmical therapy Saarbrucken, Germany. Edition: LAP LAMBERT Academic Publishing GmbH&Co. KG; 2011. 264 p.
  32. Grauer K. ACLS-2013-Arrhythmias. KG/EKG Press, Florida; 2012. 287 p.
  33. Safar PYu, Bicher ND. Serdechno-legochnay i tcerebralnaya reanimatsya. M.: Meditsina; 1997. 535 s. [in Russian].
  34. Bozhenkov YuG, Stepankov YuP, Tkachenko TV, Govorova NV. Neotlozhnaya meditsinskaya pomosch. M.: Meditsiinskaya kniga. N. Novgorod: Izdatelstvo Nizhegorodskoy meditsinskoy akademii; 2001. 256 s. [in Russian].
  35. Zozulya IS. Meditsina neotlozhnich sostoyaniy: skoray i neotlozhnaya pomosch. Kiev: Meditsina; 2008. 695 s. [in Russian].
  36. Brown R. Cardiac arrhythmias. New York: Hayle Medical; 2015. 338 p.
  37. Roytberg GE, Strutinsky AV. Vnutrenniye bolezni. Serdechno-sosudistaya sistema. M.: Binom; 2007. 865 s. [in Russian].
  38. Acton QA. Cardiac Arrhythmias: Advances in Research and Treatment. Atlanta: Arrhythmias: Advances in Research and Treatment. Scholarly Edition; 2012. 760 p.
  39. Nedostup AV, Blagova OV. Kak lechit aritmii. Diagnostika i terapiya narusheniy ritma i provodimosti. 3-th Ed. М.: MEDpress–inform; 2008. 288 s. [in Russian].
  40. Gordienko AV, Kapustnick YuO, Kasakov YuM, Tomenko VV, Macharadze SA. Lecheniya nekotorich narusheniy ritma serdtsa metodom chrezpischevodnoy electrostimulyatsii levogo predserdiya. Aktualni pitannya ortopedichnoyi stomatologii. Zbirnik naukovich prats uchastnikiv naukopraktichnoyi konferentsii; 10 zhovtnya 1996. Poltava. s. 129-31. [in Russian].
  41. Naccarelli GV, Conti JB, Di Marco, Tracy CM. Task Force 6; Training specialized electrophysiology, cardiac pacing, and arrhythmia management: Endorsed by the Heart Rhythms Society. J. Am. Coll. Cardiol. 2008. p. 374-80.

Publication of the article:

«Bulletin of problems biology and medicine» Issue 4 Part 2 (154), 2019 year, 18-28 pages, index UDK 616.125.4 – 008.-071

DOI: