Clinical course of acute atrial fibrillation treated with rapid digitalization

Weiner, P; Bassan, Mayer; Jarchovsky, J; Iusim, Samuel; Plavnick, L

doi:10.1016/0002-8703(83)90517-3

Cited by 63 publications

(17 citation statements)

References 3 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The present study demonstrates, moreover, for the first time, a relation between the inotropic actions of cardiac glycosides and an inhibitory effect on atrial fibrillation. Such findings might have implications for the clinical observation that atrial fibrillation may terminate after administration of digitalis [3,4], especially when heart failure improves [4]. A reduced tendency to induce nonsustained atrial fibrillation after digitalis administration has also been demonstrated in apparently normal atria [8].…”

Section: Discussionmentioning

confidence: 79%

“…Experimental studies suggest that cardiac glyscosides may actually enhance atrial fibrillation, through vagally mediated actions, but such studies also demonstrate direct electrophysiologic effects that could ameliorate this arrhythmia [2]. Clinical experience suggests, moreover, a favorable effect [3,4] and some clinicians have related such action to the inotropic properties of digitalis [4]. Accordingly, to clarify this controversy, the effects of acetyl strophanthidin (AS) on the duraAbdel Malec Mokraoui, Howard S. Friedman, Lawrence A. Melniker, Thach N. Nguyen Section of Cardiology and the Department of Medicine, Brooklyn Hospital and SUNY Health Science Center, Brooklyn, New York tion of electrically-induced atrial fibrillation were determined in intact and neurohumoral blockaded dogs.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Effects of acetyl strophanthidin on duration of atrial fibrillation in the neurally-intact and blockaded dog

Mokraoui

Frıedman

Melniker

et al. 1988

Cardiovasc Drug Ther

View full text Add to dashboard Cite

Although the inotropic and dromotropic effects of cardiac glycosides in atrial fibrillation (AF) are well recognized, their action on AF itself is not clear. Accordingly, to determine whether cardiac glycosides prolong AF, the duration of electrically induced AF, atrioventricular conduction, and left ventricular function were assessed for 30 minutes before and for 30 minutes following intravenous administration of acetyl strophanthidin (AS), 20 micrograms/kg, in neurally intact, beta-blocked, and beta-blocked and vagotomized dogs. In the intact dog, AS, 20 micrograms/kg, increased peak dp/dt by 132 +/- 35 mmHg.sec-1, p less than 0.05, and slowed ventricular response by 16 +/- 7 min-1, p less than 0.05, but had a variable effect on AF duration. While the increased left ventricular peak dp/dt persisted for 15 minutes after AS, an increased duration of AF was evident only at 20 minutes, when the effects of AS on left ventricular (LV) inotropy were no longer apparent. Moreover, the subset of dogs that did not demonstrate prolongation of average duration of AF after AS had a greater increment of peak dp/dt than those that showed prolongation, 237 +/- 52 versus 53 +/- 31 mmHg.sec-1, p less than 0.05. An additional 20 micrograms/kg, which produced ventricular extrasystoles, prolonged AF duration when compared to both control and 30-minute measurements. Acetyl strophanthidin, 20 micrograms/kg, had a variable effect on duration of AF with beta-blockade but prolonged duration by 114 +/- 34%, p less than 0.05, with both vagotomy and beta-blockade.(ABSTRACT TRUNCATED AT 250 WORDS)

show abstract

Section: Discussionmentioning

confidence: 79%

mentioning

confidence: 99%

Effects of acetyl strophanthidin on duration of atrial fibrillation in the neurally-intact and blockaded dog

Mokraoui

Frıedman

Melniker

et al. 1988

Cardiovasc Drug Ther

View full text Add to dashboard Cite

show abstract

“…Kalp hızını kontrol altına almakta etkili olabilirler. Digital ventrikül fonksiyonları depresse olan hastalarda hemodinaminin düzeltilmesinde yardımcı olur (8,9,10 Sonuç olarak; açık kalp cerrahisinden sonra ortaya çıkan akut atriyal fibrilasyonlu olgularda sinüs ritminin hızlı bir şekilde restorasyonunun sağlan-masında propafenon infüzyonunun etkili ve emniyetli bir tedavi yöntemi olduğu düşüncesindeyiz.…”

Section: Discussionunclassified

Açik Kalp Cerrahi̇si̇ Sonrasinda Atri̇yal Fi̇bri̇lasyon Geli̇şen Olgularda Propafenon'un Si̇nüs Ri̇tmi̇ Restorasyonundaki̇ Etki̇si̇

Eren¹,

Yazıcıoğlu²,

Taşöz³

et al. 1997

Ankara Üniversitesi Tıp Fakültesi Mecmuası

View full text Add to dashboard Cite

“…In spite of this, Weiner et al [85] reported successful cardioversion in 85% of 45 subjects with paroxysmal AF treated with rapid digitalization, although there was no indication of the severity of AF.…”

Section: Digitalis For Conversion To Sinus Rhythmmentioning

confidence: 99%

The pharmacologic treatment of atrial fibrillation

Bolognesi

1991

Cardiovasc Drug Ther

View full text Add to dashboard Cite

The pharmacologic treatment of atrial fibrillation (AF) is aimed at controlling the ventricular response, restoring sinus rhythm, and preventing or delaying relapses. In the control of ventricular response, digitalis maintains a primary role when the arrhythmia is accompanied by heart failure. In ischemic, hypertensive, and degenerative (whose number is increasing at present) cardiopathies without evident ventricular dilatation, treatments with calcium antagonists (such as verapamil, gallopamil, or diltiazem) or beta-blocking agents must be preferred. In order to control the ventricular response in patients with chronic AF during physical activity, the association of digitalis with beta-blocking agents or calcium antagonists seems to provide satisfactory results. The drugs of the IC class, especially flecainide, represent a certain therapeutical progress in the restoration of sinus rhythm in the treatment of paroxysmal atrial fibrillation affecting subjects without evident alterations of ventricular function, particularly in subjects with Wolff-Parkinson-White syndrome, with forms of vagal origin, or with atrial fibrillation alone. A therapeutic combination of digitalis and quinidine may produce resolution of the arrhythmia in the presence of altered ventricular function or when AF is of an uncertain onset. In patients with hypertensive, ischemic, and/or degenerative cardiopathy without evident ventricular or advanced heart failure, the verapamil-quinidine association may also be effective and even quicker. The combination of drugs of the I and III class for restoration of the sinus rhythm in particularly resistant forms of AF without evident structural heart alterations is promising but must be verified in a greater number of patients. In the prevention of relapses amiodarone appears to have the widest spectrum of advantages from an electrophysiologic point of view; however, because of its many side effects, amiodarone represents a late therapeutical choice. The promising results obtained with flecainide are disputed by the results of the CAST, which limit the possibilities of using this drug to a low number of cases (W.P.W. syndrome, AF of vagal origin, atrial fibrillation alone). In the past, quinidine and disopyramide have been the drugs most widely used in the prophylaxis of AF. These drugs have a similar efficacy, and both of them provided some positive results. However, because of untoward side effects (especially for quinidine) during chronic treatment, the use of these drugs has been questioned. Perhaps in the majority of patients, the less dangerous therapeutic choice after the termination of the fibrillation is a combination of drugs slowly down AV node activity (digitalis or calcium antagonists and beta blockers) with class IA antiarrhythmics.

show abstract

Clinical course of acute atrial fibrillation treated with rapid digitalization

Cited by 63 publications

References 3 publications

Effects of acetyl strophanthidin on duration of atrial fibrillation in the neurally-intact and blockaded dog

Effects of acetyl strophanthidin on duration of atrial fibrillation in the neurally-intact and blockaded dog

Açik Kalp Cerrahi̇si̇ Sonrasinda Atri̇yal Fi̇bri̇lasyon Geli̇şen Olgularda Propafenon'un Si̇nüs Ri̇tmi̇ Restorasyonundaki̇ Etki̇si̇

The pharmacologic treatment of atrial fibrillation

Contact Info

Product

Resources

About