Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UNIPROT:Q96S42 (nodal)
 22,877 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Eight patients with the Siemens Elema "Tachylog" generator implanted for management of paroxysmal reentrant tachycardia were studied to assess the safety and efficiency of three antitachycardia programs. The programs investigated were burst overdrive, self-searching, and adaptive table scanning. There were five males and three females aged 19-62 years. Seven had Wolff-Parkinson-White syndrome, and one had dual atrioventricular nodal pathways. Four had right atrial electrodes and four had right ventricular electrodes. Patients were studied lying, standing, and exercising in all three modes, and the appropriate long-term programs were chosen. The generator remained in a program for 1 month, it was interrogated and the memory was read, and then it was reprogrammed to a different antitachycardia mode. Burst overdrive was unsuitable for long-term use in four patients, producing atrial fibrillation in one and ventricular arrhythmias in three. In this group, self-searching and adaptive table scanning were safe and equally effective (mean number of attempts/tachycardia 6.97 and 6.3, respectively). In the four patients in whom all three programs could be used, burst overdrive proved to be most efficient, the mean number of attempts/tachycardia were 2.4 (cf 9.6 and 9.0 for self-searching and adaptive table scanning). Thus, burst overdrive was only suitable for long-term use in 50% of our patients, but when safe it was more efficient than the other two programs, especially in those with narrow termination windows on exercise.
 ...
PMID:Antitachycardia pacing: a comparison of burst overdrive, self-searching and adaptive table scanning programs. 242 66

Two hundred and eight patients underwent operative therapy of supraventricular tachycardia between June 1984 and June 1986. There were 196 patients with Wolff-Parkinson-White syndrome, one with AV nodal reentry, two with atrial flutter, one with ectopic atrial tachycardia, three with paroxysmal sinus tachycardia, and five with atrial fibrillation. Map guided or direct surgery was performed in all patients except the three with atrial fibrillation. Direct surgery was generally successful with failures including one patient with Wolff-Parkinson-White syndrome, one with atrial flutter, and the three patients with paroxysmal sinus tachycardia. There was no mortality. Major complications were uncommon and included three resternotomies for bleeding, one chylopericardium. Six patients required reoperation.
 ...
PMID:Surgical treatment of supraventricular tachycardia: a five-year experience. 243 65

The effect of intravenous (1.5 to 2.0 mg/kg body weight) and oral (300 to 375 mg/d) diprafenone was studied in 15 patients with the Wolff-Parkinson-White syndrome and symptomatic supraventricular tachycardia. Intravenous application of diprafenone significantly increased atrioventricular nodal conduction time as well as the effective refractory periods of the right ventricle and the accessory pathway in both the antegrade and retrograde directions. Antegrade conduction block in the accessory pathway occurred in two patients after the dose was increased to 2.0 mg/kg body weight. Intravenous diprafenone suppressed the inducibility of supraventricular tachycardia in two patients, but the tachycardia cycle length was significantly increased in all other patients. Fourteen patients were treated with oral diprafenone, and 11 were asymptomatic during a 17-month follow-up, two of these after the dose had been increased to 375 mg/d. Oral therapy had to be withdrawn in two patients because of adverse gastrointestinal side effects and in one because of recurring bronchospasm.
 ...
PMID:Diprafenone for treatment of Wolff-Parkinson-White syndrome. 248 25

Twenty patients with recurrent symptomatic supraventricular tachycardia were studied to estimate the efficacy of flecainide in the long-term treatment of these arrhythmias and to evaluate the prognostic value of programmed electrophysiologic stimulation. All patients had their arrhythmia inducible at baseline evaluation. Nine patients had a Wolff-Parkinson-White (WPW) syndrome, five had a concealed bypass tract, and two had dual atrioventricular (AV) nodal pathways. In the remaining patients there was an intraatrial reentry circuit. Previous medication was no to five antiarrhythmic drugs (mean 2.4 drugs). At baseline, a circus movement tachycardia was induced in 12, AV nodal tachycardia was induced in two, atrial tachycardia was induced in three, atrial fibrillation was induced in five, and a flutter was induced in two patients. After flecainide, 2 mg/kg intravenously in 10 minutes, six patients no longer had their arrhythmia inducible. In the WPW patients, atrial fibrillation was no more inducible. In 65% of the patients there was no recurrence during a follow-up period of 11 +/- 10 months. None of the six patients who no longer had their arrhythmia inducible had a recurrence of the tachycardia over a period of up to 3 years. Seven of the other 14 patients (who still had their arrhythmia inducible) had a recurrence of the tachycardia. Positive and negative predictive values are 50% and 100%, respectively. We conclude that flecainide prevents recurrences of supraventricular tachycardias in 65% of patients with inducible supraventricular tachycardias during a mean follow-up of 11 months. Programmed electrical stimulation has a high negative predictive value in this setting. Flecainide is especially effective in preventing atrial fibrillation in patients with WPW syndrome.
 ...
PMID:Flecainide acetate in the treatment of supraventricular tachycardias: value of programmed electrical stimulation for long-term prognosis. 249 38

In this study of surgical procedures for various tachyarrhythmias, Wolff-Parkinson-White syndrome comprised most of the cases. An endocardial approach was used to ablate accessory pathways. Additional use of cryocoagulation after surgical incision of the atrium, previously routinely performed, is at present only done occasionally for septal accessory pathways. Ventricular tachycardia (VT) was the next most frequent condition. The surgical procedures for ischemic and nonischemic VTs are completely different, although both are based on the principle of complete electrophysiologic mapping. For ischemic VT, surgery consists of resection of the left ventricular aneurysm and excision or cryocoagulation of the endocardium, or both. For nonischemic VT, either excision of the entire thickness of the myocardium (2.0 X 2.5 cm on average) at the earliest excitation site of the right ventricle and cryocoagulation of the area of delayed potential or only incision and cyrocoagulation of the left ventricle were performed to avoid reduction of the left ventricular cavity. Ectopic atrial tachycardia was cured by excision of the earliest excitation site without use of a heart-lung machine, when the focus was located in the atrial free wall. Other successful treatments were of reentrant atrial tachycardia by cryocoagulation, atrial flutter by cryocoagulation of impulse pathways at the coronary sinus and around the atrioventricular node, and a new surgery for atrial fibrillation and flutter, which retained sinus rhythm. Johnson's procedure was used for surgical ablation of atrioventricular nodal reentrant tachycardia.
 ...
PMID:Surgical management of tachyarrhythmias. 259 17

Since Sealy's pioneering surgical intervention for Wolff-Parkinson-White syndrome, surgical electrophysiologic interventions have been developed for all supraventricular arrhythmias. The surgical rationales are based on the site of origin of the arrhythmic mechanism and the associated pathology that characterizes the "arrhythmogenic substrate." The Wolff-Parkinson-White syndrome is characterized by an accessory atrioventricular (AV) connection distinct from the AV node-His bundle system. It is associated with AV reentrant tachycardia or atrial fibrillation, or both, with fast ventricular responses through the accessory pathway. The current surgical management involves ablation of the accessory pathway using either an endocardial or an epicardial approach. Surgical ablation is associated with high efficiency and low morbidity. Epicardial dissection of the accessory pathway on the beating heart has helped to localize variant accessory pathways associated with Coumel's tachycardia or the Mahaim fiber. AV nodal reentrant tachycardia can be cured using direct AV nodal dissection (or perinodal cryoablation). Atrial flutter can be interrupted by cryoablation of the arrhythmogenic substrate located in the coronary sinus orifice region. The chronotropic atrial function, abolished by incessant or paroxysmal idiopathic atrial fibrillation, can be restored using the corridor operation (sinus node-AV node insulation). The success of surgical intervention in atrial tachycardias is uncertain, but it may be an option in selected patients with resistant atrial tachycardias.
 ...
PMID:Surgical alternatives for supraventricular tachycardias. 259 18

Serial electrophysiological testing of multiple antiarrhythmic drugs was performed in 98 patients with paroxysmal supraventricular tachycardia (WPW syndrome 32, concealed WPW syndrome 46, atrioventricular nodal reentrant tachycardia 20). Of 32 patients with WPW syndrome, twelve patients had atrial fibrillation and atrioventricular reentrant tachycardia. Serial supraventricular tachycardia induction was attempted after chronic oral administration of verapamil (120-320 mg/day, 86 pts), diltiazem (180 mg/day, 10 pts), disopyramide (300-600 mg/day, 27 pts), propafenone (300-600 mg/day, 25 pts), flecainide (100-300 mg/day, 7 pts), SUN 1165 (150-300 mg/day, 10 pts), and combination therapy (18 pts) by using six polar electrode left in the heart in almost all patients. In 96 of 98 patients, one or more drugs prevented induction of SVT. Combination therapy alone was effective in 14 pts. The site of action of verapamil and diltiazem was antegrade and retrograde normal pathway AV conduction in circus movement. The site of action of disopyramide, propafenone, flecainide, SUN 1165 was antegrade and retrograde accessory pathway conduction and retrograde normal pathway conduction. Eighty two pts were successfully followed for 17.7 +/- 9.6 months. In 68 of these 82 pts, PSVT did not recur. Therefore, serial electrophysiological testing proved useful for the selection of prophylactic antiarrhythmic drugs.
 ...
PMID:[Electrophysiological testing of multiple antiarrhythmic drugs in patients with paroxysmal supraventricular tachycardia after chronic oral administration]. 260 48

In 17 patients aged 21-61 (mean 32) with WPW syndrome the transoseophageal stimulation was performed before and after intravenous administration of propranolol (0.1 mg/kg b.w.) and atropine (0.02 mg/kg b.w.). Pharmacological blockade of the autonomic nervous system resulted in statistically significant increase of heart rate (from 81 to 111/min), shortening of a-v nodal and atrial refraction (from 298 to 272 ms) as well as in shortening of stimuli cycle length revealing Wenckebach's point (from 324 to 291 ms). The Kent bundle refraction did not at the average change (333 and 324 ms), while in individuals great differences were observed. Generally, pharmacological blockade of the autonomic nervous system improves a-v nodal conduction, but in patients with WPW syndrome does not significantly effect on the accessory pathway.
 ...
PMID:[Effect of pharmacologic blockade of the autonomic nervous system on electrophysiologic properties of the accessory pathway and atrioventricular node in patients with Wolff-Parkinson-White syndrome]. 263 10

All forms of supraventricular tachycardia (SVT) are now potentially curable by surgery and we believe that patients should be offered surgery as an initial therapeutic option. At Westmead Hospital, 311 patients have undergone surgery for SVT, 13 having AV node ablation, a procedure now rarely performed, and 298 have had attempts at curative surgery. One hundred and ninety-nine patients were diagnosed primarily as having a Wolff-Parkinson-White syndrome (WPW) and 139 had free wall or anterior septal connections with a clinical cure rate of 98.0%. The failures were entirely due to unrecognised posterior septal connections. Sixty patients had primarily posterior septal connections with a clinical cure rate of 96%. Atrioventricular junctional re-entry tachycardia may now be cured, probably by dividing an extra nodal His-to-atrial connection. Seventy-eight patients have undergone surgery with a clinical cure rate of 92%. Fifteen patients with right atrial tachycardias, 4 patients with nodo-ventricular fibres and 2 with incessant AV tachycardia have undergone surgery. The overall clinical cure rate for all patients is 95% and 92% at late electro-physiological study (EPS).
 ...
PMID:Surgery for supraventricular tachycardia (SVT). 263 19

Propafenone is an investigational type Ic anti-arrhythmic agent that markedly slows conduction velocity in all cardiac tissues. Propafenone also possesses weak beta- and calcium-channel blocking properties. The bioavailability of propafenone is dose-dependent. Hepatic metabolism of this agent is polymorphic and appears to correlate with the ability of the liver to oxidize debrisoquin sulfate. Propafenone is effective in suppressing spontaneous ventricular ectopy; however, the drug may be less effective in patients with sustained ventricular tachycardia or ventricular fibrillation when evaluated using programmed stimulation. Propafenone is also useful in the treatment of supraventricular tachycardias including atrioventricular (AV) nodal reentrant tachycardia, AV reentrant tachycardia associated with the Wolff-Parkinson-White syndrome, and atrial fibrillation. Adverse reactions seen with propafenone affect the gastrointestinal, central nervous, and cardiovascular systems. Comparative studies with currently available type Ic agents are needed to better define propafenone's place in therapy.
 ...
PMID:Propafenone: a novel type Ic antiarrhythmic agent. 265 98


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>