[Anesthesiology in the surgical treatment of supraventricular tachyarrhythmias].

Different anesthesias were used in 197 patients operated for supraventricular tachiarrhythmias through a transvenous access. Hypnoanalgesia based on preventive injection of a potent nonnarcotic antiinflammatory agent xefocame (lornoxicame), drip infusion of propofol (2-3 mg/kg/h), and bolus injection of dormicum under conditions of spontaneous respiration proved to be the best method.

[Experience with the implantation of sensory multiple programmable pacemakers of the Siemens firm].

The paper summarizes the experience on 27 implantations of sensory multiprogrammable pacemakers (two-chamber Synchrony-II and one-chamber Sensolog-III) produced by Siemens-Elema. The implantations were performed in the Moscow Cardiostimulation Center in 1993. Primary pacemaker implantation was performed in 19 patients, 8 patients needed the replacement of one-chamber pacemakers because of the power source exhaustion or circulatory insufficiency.

[Rhythmographic analysis of atrial extrasystole in patients with sick sinus syndrome].

The comparative analysis of 141 electrocardiograms showing premature atrial contraction from 43 patients with the sick sinus syndrome and 19 subjects with normal sinus nodal function revealed new electrocardiographic signs suggesting sinus dysfunction: an increase in the postextrasystolic pause by more than 135% of the preextrasystolic interval; greater full compensatory pause values; extrasystolic appearance of a full compensatory pause with the coupling interval of less than 68% of the presystolic interval; an increase in the sinus cycle followed the postextrasystolic pause by greater than 50 msec. The proposed criteria show a 5.7-fold increase in the informative value of ECG analysis in the diagnosis of the sick sinus syndrome in premature atrial contraction.

[Provocation of supraventricular arrhythmia in the diagnosis of sick sinus syndrome].

The diagnostic value of routine evaluations of sinus function and of analysis of sinus pause lengths were compared in 31 patients with a brady- and tachycardia types of the sick sinus syndrome after abolishing the tachyarrhythmic paroxysms provoked during an electrophysiological study. The study was performed by transesophageal electric stimulation. The sensitivity of the two modes of diagnosing the sick sinus syndrome was comparable: 55.

[Potential of the method of transesophageal stimulation of the left atrium].

The authors provide the results of examining the conduction system of the heart in 623 patients with different disorders of heart conduction and rhythm by means of transesophageal pacing (TEP). The non-invasive electrophysiological examination of patients with sick sinus syndrome with latent disorders of atrioventricular (AV) conduction, and with supraventricular tachyarrhythmias turned out to be of high diagnostic value, inducing no complications. Application of programmed TEP (scanning extrastimulus on basis pacemaking) employed by the authors for the first time during TEP considerably widens the diagnostic possibilities of the technique permitting the measurement of the refractory periods of the conduction system (the refractory periods of the sinus node, atria, and AV-conduction system along normal and additional pathways), the performance of the trigger and removal of supraventricular arrhythmias with diagnostic and treatment purposes in view.