antiarrhytmic

BACKGROUND: Mothers requiring the antiarrhythmic agent flecainide are often advised not to breastfeed, because of the lack of data concercing neonatal effects and flecainide plasma concentrations following maternal exposure as well as via lactation. This is the first report on combined maternal, fetal, neonatal and breastmilk flecainide concentrations in a breastfed infant of a mother requiring flecainide treatment. CASE PRESENTATION: A 35-year old Gravida 2 Para 1, known with ventricular arrhythmia, was referred to our tertiary center at 35 + 4 weeks of gestation...

Class IC antiarrhythmic drugs (AADs) currently represent a cornerstone in the therapy of atrial fibrillation, both for the restoration of sinus rhythm and for the prophylaxis of long-term relapses. They also play an important role in the treatment of idiopathic ventricular arrhythmias. Following the results of the Cardiac Arrhythmia Suppression Trial study, flecainide and by extension the other Class IC AADs were contraindicated in patients with ischaemic and structural heart disease, due to their pro-arrhythmic effect and the consequent increase in mortality observed in the study...

PURPOSE: In the pathogenesis of severe COVID-19 complications, derangements of renin-angiotensin-aldosterone system (RAAS), vascular endothelial dysfunction leading to inflammation and coagulopathy, and arrhythmias play an important role. Therefore, it is worth considering the use of currently available drugs to protect COVID-19 patients with cardiovascular diseases. METHODS: We review the current experience of conventional cardiovascular drugs [angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers, anticoagulants, acetosalicylic acid, antiarrhythmic drugs, statins] as well as some other drug classes (antidiabetic drugs, vitamin D and NSAIDs) frequently used by older patients with cardiovascular diseases...

The surface charge of brain endothelial cells forming the blood-brain barrier (BBB) is highly negative due to phospholipids in the plasma membrane and the glycocalyx. This negative charge is an important element of the defense systems of the BBB. Lidocaine, a cationic and lipophilic molecule which has anaesthetic and antiarrhytmic properties, exerts its actions by interacting with lipid membranes. Lidocaine when administered intravenously acts on vascular endothelial cells, but its direct effect on brain endothelial cells has not yet been studied...

Vitamin D and parathormone (PTH) are hormones regulating calcium and phosphorus homeostasis. The aim of the article is to summarize the current knowledge in the field and to assess its impact on heart failure (HF) pathogenesis. PTH serum concentration being frequently elevated in patients with HF has negative impact on circulatory system stimulating myocardial fibrosis, wall thickening and reninangiotensin-aldosterone system (RAAS) activity. PTH reacts with smooth muscle cells receptors mediating adrenergic and chronotropic activation resulting in increased oxidative stress, endothelial dysfunction, intracellular calcium overload and has negative influence on prognosis in chronic HF patients...

To investigate risk factors for incident seizures among adult patients with depression. We conducted a nested case-control analysis in adult patients with newly diagnosed depression, using data from the U.K.-based Clinical Practice Research Datalink. Among cases with incident seizures and matched controls, we estimated odds ratios (ORs) with 95 % confidence intervals (CIs) of potential risk factors for seizures as reported from data of the general population: underweight (body mass index <18.5 kg/m2 ), smoking, alcoholism, drug abuse, psychiatric or neurologic comorbidities, and concomitant use of drugs...

Tetralogy of Fallot (ToF) is the most common cyanotic congenital heart defect. The actual treatment relies on cardio-surgery--complete correction within the infant age. Without surgery only 10% of subjects survived 3rd decade and only 3-5% of subjects were able to survive until their 40th. This particular paper is dedicated to case of a 69-years old male subject with positive history of uncorrected ToF due to his refusal of surgery, ischemic cardiac disease NYHA III-IV and chronic kidney failure. This subject was hospitalized within the department of internal medicine due to several days of chest pain connected with lower extremities oedemas and dyspnoeic syndrome after minimal physical load...

UNLABELLED: Rivaroxaban, a selective inhibitor of active factor X, is metabolized by cytochrom P450 3A4 (CYP3A4) and is a substrate for transporter protein--P-glycoprotein (P-gp). Amiodarone, an antiarrhytmic agent, is classified as moderate CYP3A4 and P-gp inhibitor. A CASE REPORT: A 75-year-old male, who underwent lobectomy for bronchiectasis many years ago, is presented. For one year the patient was treated with rivaroxaban (20 mg/d) due to venous thromboembolism and recurrent episodes of atrial fibrillation...

Stimulation of β-adrenergic receptors in the heart is the most effective endogenous way to increase the mechanical performance of cardiac tissues to meet the requirements of a fight-or-flight situation or stress. On the other hand, sustained activation of cardiac β-receptors initiates maladaptive remodeling of the myocardium leading to cardiomyopathies and heart failure. Since both acute and chronic stimulation of β-adrenoceptors are arrhythmogenic, the application of β-receptor blockers exerts effective antiarrhytmic actions at both short and long time scale...

BACKGROUND: Protein-losing enteropathy (PLE) is a disorder characterized by abnormal and often profound enteric protein loss. It's relatively uncommon complication of Fontan and other complex congenital heart disease (CCHD) procedures. Because of the complexity and rarity of this disease process, the pathogenesis and pathophysiology of protein-losing enteropathy remain poorly understood, and attempts at treatment seldom yield long-term success. AIM OF PRESENTATION: is to describe single centre experience in diagnosis, evaluation, management and treatment of children with protein-losing enteropathy after Fontan and other CCHD procedures in the current era and in centre with limited human and technical resources, follows with a comprehensive review of protein-losing enteropathy publications, and concludes with suggestions for prevention and treatment...

Adenosine is an endogenous purine nucleoside that plays an important role in many biochemical processes. It acts through the four types of adenosine receptors: A1, A2A, A2B, A3 which are located i.a. in the immune, nervous, circulatory, respiratory or urinary system. Adenosine is used as an antiarrhythmic agent in the treatment of paroxysmal supraventricular tachycardia. However, due to a very short blood half-time other clinical applications are limited. In order to overcome this obstacle many analogues and conjugates of adenosine with better pharmacokinetic properties have been synthesized...

AIM: To provide insights into the characteristics and management of outpatients when their atrial fibrillation (AF) was first detected: diagnosis, treatment and follow-up in the context of the public health system. DESIGN: AFABE is an observational, multicentre descriptive study with retrospective data collection relating to the practice patterns, management and initial strategies of treatment of patients with diagnosed AF in the context of primary care, emergency and cardiologists of the public health system...

The aims of this survey was to provide insight into treatment activity, the strategy of treatment, and risk stratification of patients with asymptomatic and symptomatic ventricular pre-excitation across Europe. Fifty-eight centres, members of the European Heart Rhythm Association EP research network, covering 20 countries answered the survey questions. All centres were high-volume ablation centres. A younger person with asymptomatic Wolff-Parkinson-White (WPW) pattern has a higher likelihood of being risk-stratified or receiving ablation therapy compared with an older subject...

Features of dynamics of arterial hypertension and rhythm disorders within 3 years after the termination of alcohol intake were studied. The study included 260 patients with alcoholic dependence at the age from 22 to 74 years (mean age 46±6.6 years). The functional state of the cardiovascular system was evaluated. It has been shown that within 1 month after the termination of alcohol intake, 73.1% of patients develop arterial hypertension that needs treatment. Cardiac rhythm disorders were registered in 23...

OBJECTIVE: To assess the dynamics of non-invasive electrophysiologic (ventricular arrhythmias, HRV, HRT, mTWA) and humoral (red blood cells ω-3 index) SCD predictors at the background of therapy with ω-3 PUFA in patients with iscemic heart disease and ventricular arrhythmias. MATERIALS AND METHODS: The study included 80 patients. Inclusion criteria were: documented IHD (history of myocardial infarction, stable angina, previous surgical intervention on coronary arteries (coronary artery bypass grafting [CABG], percutaneous coronary intervention [PCI]), positive stress tests, signs of IHD in coronary angiography or computer tomography of coronary arteries; ventricular arrhythmias, according to registered Holter monitoring (PVCs in the number of 250 or more per day and /or intermittent ventricular tachycardia paroxysms); continuous antiarrhytmic therapy for at least 1 month before inclusion (ω-blockers and /or amiodarone), 4) informed consent to participate in the study...

Sustained ventricular tachycardia (VT) is an important cause of morbidity and sudden death in patients with dilated cardiomyopathy. Although ICD effectively terminate VT episodes and improve survival, shocks reduce quality of life, and episodes of VT predict increased risk of heart failure and death despite effective therapy. Patients suffering recurrent VT episodes remain a challenge. Antiarrhytmic therapy reduces VT episodes, but it is associated with serious adverse events, and disappointing efficacy. Catheter ablation has emerged as an important option to control recurrent VT, but major procedure-related complications, and even death, are still issues to concern...

Ca(2+) has been largely recognized as an essential messenger in all eukaryotes, from mammals to parasites. The disruption of Ca(2+) homeostasis in any cell usually drives to lethal effects resulting in cell death by apoptosis or necrosis. This appears also to be the case in human trypanosomatids, such as Trypanosoma cruzi, the causative agent of Chagas' disease, Trypanosoma brucei, which produces "sleeping sickness" and Leishmania sp, responsible for leishmaniasis. The aim of this review is to describe the intracellular Ca(2+) regulation and the cytotoxic effect of new drugs regarding the disruption of Ca(2+) homeostasis in these parasites...

AIM OF STUDY: To assess direct in-patient cost and length of stay in the intensive care unit (ICU) and the standard cardiology unit in acute heart failure (AHF) readmissions. RESULTS: Out of 1 759 patients hospitalized with acute heart failure, 223 patients were readmitted to Faculty Hospital Brno-Bohunice (Czech Republic) during study period (61.4% male; mean age 71.2 years) with mean total cost CZK 85 120 (Euro 3 095) per length of stay 9.2 days and interventions...

Normal heart function and repolarization of the cardiac action potential (AP) is to a high extent subjective to synchronized activity of sarcolemmal K(+) channels, expressed in both ventricular and atrial myocardium, largely contributing to regulation of the resting potential, the pacemaker activity, and the shape and duration of the AP. Clinical observations and experimental studies in cardiomyocytes and multicellular preparations provided firm evidence for the sensitivity of some major outward K+ currents and the corresponding ion channels to shifts in intracellular Ca(2+) concentration ([Ca(2+)](i))...

Lidocaine is a class I antiarrhytmic drug that blocks Na(+) channels and exists in both neutral and charged forms at a physiological pH. In this work, a mathematical model of pH and the frequency-modulated effects of lidocaine has been developed and incorporated into the Luo-Rudy model of the ventricular action potential. We studied the effects of lidocaine on Na(+) current, maximum upstroke velocity, and conduction velocity and demonstrated that a decrease of these parameters was dependent on pH, frequency, and concentration...