By Dennis Krikler (auth.), Professor Dr. M. Schlepper, Dr. B. Olsson (eds.)
Asked to prepare a global assembly on Propafenone (Ryt monorm) we needed to query ourselves, no matter if to simply accept this supply simply as physicians or in our capability as chairmen of the research team on arrhythmias and intracardiac electrography of the eu Society of Cardiology. Considerung the "pros and contras" and good conscious that you can actually simply be considered as "product promoter" we, however, decide to set up the Symposion in organization with the research team. We felt justified to take action for a few purposes: Arrhyth mias and their therapy in addition to the instruments to discover the 1st and to regulate the latter are good in the scope of the research team. a world symposion supplied the chance to have the "state of the paintings" in arrhythmias and antiarrhythmic remedy completely reviewed by means of the world over popular investigators, hence serving an academic objective. additionally it used to be the purpose and goal of the assembly to have what's recognized a few quite new drug provided in a serious demeanour and to show what's no longer recognized, yet can be identified. it's in that context the shows of the loose consultation can be judged. To the cautious reader it is going to turn into obvious that a lot which was once now not stated, will be learn "between the lines".
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Additional info for Cardiac Arrhythmias: Diagnosis Prognosis Therapy
Am J Med 61: 192 Vismara LA, Anderson EA, Mason OT (1975) Relation of ventricular arrhythmias in the late hospital phase of acute myocardial infarction to sudden death after hospital discharge. Am 1 Med 59: 6 Winkle RA (1980) Ambulatory ECG and the diagnosis, evaluation and treatment of chronic ventricular arrhythmias. Prog Cardiovasc Dis 23: 99 Efficacy of Oral Propafenone in Supraventricular and Ventricular Arrhythmias: Experience with 47 Cases P. - F. Leclercq Our experience with propafenone (P) extends over a 2Y2-year period; we initially designed a double-blind crossover study comparing P with quinidine, but in fact, P quickly appeared as such an interesting, particular, and powerful drug that the problem was not really to prove its efficacy, but to detail all the aspects of its activity and hence, its indications according to arrhythmia mechanism and resistance to conventional therapies.
8. Cardiac tolerance to quinidine, propafenone, and disopyramide (case no. 34). The left upper panel shows the runs of ventricular tachycardia in a 57-year-old patient with a congestive cardiomyopathy. Quinidine treatment (right uper upper panel) is indeed effective in suppressing the arrhythmia but induces four attacks of torsades de pointes in the 24-h period, two of which degenerate into ventricular fibrillation requiring electrical countershock. Propafenone does not have this toxicity at the ventricular level but induces a sinoatrial block (left lower panel).
The ideal parameter would be one that can easily be detected by noninvasive methods, that shows no spontaneous variability, and that is as closely linked to the inherent mechanism of ventricular tachyarrhythmias as possible. Recently, ventricular late potentials that probably result from regional slow ventricular activation [15-21] have emerged as a new noninvasive parameter [22-32]. Whether these late potentials as recorded from the body surface are a better indicator of an increased risk of ventricular tachycardia or ventricular fibrillation in coronary patients than Holter monitoring has not yet been settled.
Cardiac Arrhythmias: Diagnosis Prognosis Therapy by Dennis Krikler (auth.), Professor Dr. M. Schlepper, Dr. B. Olsson (eds.)