New ECG criteria for differential diagnosis of wide QRS complex tachycardias with right bundle branch block pattern.

Aim: To evaluate standard 12-lead ECG indices for the differential diagnosis of wide QRS tachycardias with right bundle branch block (RBBB) pattern.

Materials And Methods: Study analyses the 244 ECG indices in 111 patients (79 males and 32 females, age 53±17 years) with RBBB tachycardias, who underwent electrophysiological studies. First step includes retrospective analysis of QRS characteristics in 20 patients with ventricular tachycardias (VT), 24 pts with aberrant supraventricular tachycardias (SVT+RBBB) and 14 pts with antidromic SVTs (WPW).

Role of electrocardiographic and echocardiographic types of left bundle branch block in prediction of response to cardiac resynchronization therapy.

Aim: To assess the value of the complex analysis of electrocardiographic (ECG) variants and echocardiographic (echo) manifestation of left bundle branch block (LBBB) in predicting the success of cardiac resynchronization therapy (CRT).

Materials And Methods: The study included 39 patients (mean age 61.49±9.

[Cardiac resynchronization therapy in patients with permanent atrial fibrillation].

Unlabelled: In our study we compared effect of cardiac resynchronization therapy (CRT) in chronic heart failure (CHF) patients with permanent atrial fibrillation (AF) and patients with sinus rhythm. Special feature of our work was that patients with permanent atrial fibrillation didnt have obligatory ablation of atrio-ventricular node but underwent aggressive rate control to achieve more than 90% of biventricular (BV) complexes. We used 24 hours Holter monitoring because there are data that this method is more accurate than CRT counters.

[Changes of parameters of hemodynamics and systems of neurohumoral regulation in patients with implanted cardiac pacemakers after switching from DDD to VVI pacing mode].

To study complex of pathogenetic changes arising during VVI mode single chamber ventricular pacing we temporarily (for 1 hour) switched pacing mode from dual (DDD) to single (VVI) chamber stimulation in 11 patients. Parameters studied were cardiac output (CO), total peripheral vascular resistance (TPVR), levels of precursors of atrial and inactive fragment of brain natriuretic peptides (pro-ANP and NT-pro-BNP, respectively), noradrenaline, aldosterone, and renin activity in blood plasma. Reprogramming of pacing mode was associated with 21.

[Stroke and other thromboembolic complications of atrial fibrillation. Part VII. Prevention of cardioversion related thromboembolism].

In part VII of a series of papers on epidemiology and drug prevention of stroke and other thromboembolic complications of atrial fibrillation the authors analyze data on frequency and contemporary approaches to prevention of thromboembolic complications related to cardioversion. The stress is made on importance of prescription of indirect anticoagulants to all patients with duration of atrial fibrillation exceeding 48 hours. International normalized ratio should be controlled during anticoagulant therapy and be kept between 2.

[Atrial fibrillation: choice of the method of pharmacological cardioversion].

The paper considers circumstances under which it is expedient or not expedient to perform cardioversion in patients with paroxysmal or persistent atrial fibrillation. It contains discussion of benefits, limitations and drawbacks of electrical and pharmacological methods of cardioversion. American College of Cardiology/American Heart Association/European Society of Cardiology Guidelines for the Management of Patients With Atrial Fibrillation are presented.

[Stroke and other thromboembolic complications of atrial fibrillation. Part VI. Choice of optimal approach and drugs for prevention of stroke].

In part VI of a series of papers on epidemiology and drug prevention of stroke and other thromboembolic complications of atrial fibrillation the authors analyze data of randomized trials comparing various approaches to the treatment of atrial fibrillation: cardioversion with subsequent use of antiarrhythmic drugs for maintenance of sinus rhythm and control of rate of ventricular rhythm with obligatory concomitant use of anticoagulants. Approach aimed at sinus rhythm maintenance by means of repetitive cardioversions and long term antiarrhythmic therapy has not been associated with lowering of mortality, rates of stroke or other thromboembolic complications. The use of antithrombotic drugs represent a sole reliable method of stroke prevention in patients with persistent and chronic AF.

[Stroke and other thromboembolic complications of atrial fibrillation. Part v. The use of drugs without antithrombotic or antiarrhythmic properties.].

In part V of a series of papers on epidemiology and drug prevention of stroke and other thromboembolic complications of atrial fibrillation the authors analyze data of randomized trials exhibiting ability of long term use of beta-adrenoblockers, angiotensin converting enzyme inhibitors, angiotensin receptor antagonists and statins to prevent atrial fibrillation. They also discuss results of short term studies demonstrating improved efficacy of electrical and pharmacological cardioversion in patients with atrial fibrillation after pretreatment with verapamil, beta-adrenoblockers, and angiotensin receptor antagonists, and present data indicating that monotherapy with verapamil, beta-adrenoblockers, angiotensin receptor antagonists and statins can facilitate maintenance of sinus rhythm after cardioversion in patients with persistent atrial fibrillation.

[Stroke and other tromboembolic complications in atrial fibrillation. Part I. Prevalence and risk factors].

In a series of papers the authors discuss problems of epidemiology and drug prevention of stroke and other thromboembolic complications in patients with atrial fibrillation. Part I contains data on frequency of strokes in different categories of patients as well as review of main risk factors and mechanisms of development of stroke and other systemic embolic complications in various types of atrial fibrillation. Application of transthoracic and transesophageal echocardiography for assessment of risk of stroke and other systemic emboli is also discussed.

[Stroke and Other Thromboembolic Complications of Atrial Fibrillation. Part III. Prevention With Other Antithrombotic Agents.].

In part IV of a series of papers on epidemiology and drug prevention of stroke and other thromboembolic complications of atrial fibrillation the authors present data on clinical pharmacology of low molecular weight heparins, ximelagatran, indobufen, triflusal, dipyridamole, ticlopidine, and clopidogrel. Efficacy of direct thrombin inhibitor ximelagatran was found in randomized trials to be similar to efficacy of warfarin however the use of ximelagatran required no laboratory control of coagulation parameters. Preventive efficacy of indobufen, triflusal, dipyridamole, ticlopidine, and clopidogrel was assessed in trials on patients with cardiovascular diseases substantial number of whom had atrial fibrillation.

[Stroke and Other Thromboembolic Complications of Atrial Fibrillation. Part III. Prevention With Aspirin].

In part III of a series of papers on epidemiology and drug prevention of stroke and other thromboembolic complications of atrial fibrillation the authors present data on clinical pharmacology of aspirin as well as discussion of results of randomized trials in which cerebroprotective efficacy and safety of the use of aspirin for primary and secondary prevention of thromboembolism was studied in comparison with placebo and warfarin. According to cumulative data of 6 randomized studies average stroke risk lowering caused by aspirin was 22%. In primary prevention of stroke aspirin did not increase substantially frequency of serious bleedings.

[Stroke and Other Thromboembolic Complications of Atrial Fibrillation. Part II. Prevention With Warfarin].

In part II of a series of papers on epidemiology and drug prevention of stroke and other thromboembolic complications of atrial fibrillation the authors present data on clinical pharmacology of oral anticoagulants as well as discussion of results of randomized studies demonstrating high efficacy of warfarin in primary and secondary prevention of thromboembolism. According to cumulative data of 7 randomized trials average stroke risk lowering in patients with atrial fibrillation associated with the use of warfarin is 62%. Total bleeding rates during treatment with oral anticoagulants fluctuate between 5 and 10%; about half of these bleedings are serious.

[Antihypertensive drugs and malignant neoplasia].

Analysis of epidemiological, cohort and randomized studies of antihypertensive drugs containing reports of development of malignant neoplasms shows that long term use of some antihypertensive drugs while preventing cardiovascular complications has been associated with increased risk of malignancies. Most convincing evidence exists for association between the use of diuretics and renal cancer. Association between the use of reserpine and breast cancer in women, between atenolol and some types of cancer in elderly men also can not be ruled out.

[Calcium metabolism of the thrombocytes in ischemic heart disease].

Changes in Ca++ concentration were studied in platelets of patients with acute myocardial infarction, unstable or stable angina pectoris and those of healthy donors by means of fluorescent probe Quin-2 AM. Influence of aggregation inductors on the process of Ca++ level increase in these cells was also investigated. Intracellular Ca++ concentration increased in patients with acute myocardial infarction in the presence of PAF 2.