Interventional and surgical arrhythmology: state of the art,problems and prospects for development

The paper considers the state-of-the-art, problems, and prospects for development of interventional and surgical arrhythmology in Russia, which is a multidisciplinary specialty which integrates present-day achievements of medicine and new technologies in the diagnosis and treatment of cardiac arrhythmias.     

New implanted electrodes for electric pacemakers

Requirements applicable to as well as the construction of electrodes to stimulate the cardiac function are presented in the article. The importance of pacemakers at a wide range of heart diseases is demonstrated.     

Evaluation of the results of epicardial electric pulse destruction of the bundle of Kent: immediate and late results

The authors assessed the outcomes of an epicardial electrical pulse destructive operation on Kent's bundle in 170 patients with the Wolff-Parkinson-White syndrome. The operation consisted in generating an electrical stimuli train of a power of 50-250 J along the fatty tenial margin of the atrioventricular sulcus, which damaged or isolated Kent's bundle. By refining the indications for application of the method, the authors succeeded in achieving 98% efficacy in abolishing the Kent bundle conduction in the absence of deaths in the latter group of patients. The technique was found to be indicated in lateral bundle localizations, except right anterolateral localizations when atrioventricular conduction disturbances may be present. Myocardial changes occurring after destruction caused no hemodynamic abnormalities and were not associated with coronary artery lesions. Increasing the force of intact myocardial contraction fully compensated a slight segmental ejection fraction deficiency at the site of destruction.     

Development of Noninvasive Technology of Stereotaxic Radioablation Using Linear Accelerators for the Treatment of Life-Threatening Ventricular Tachycardias in Experiment

Bulletin of Experimental Biology and Medicine - We developed a new technique of noninvasive stereotactic radioablation for the treatment of life-threatening tachyrhythmias. The study is performed...     

Dynamics of parameters of heart rate variability in patients with ischemic heart disease after direct myocardial revascularization

AIM: To study dynamics of parameters of heart rate variability (HRV) in patients with ischemic heart disease after direct myocardial revascularization. MATERIAL AND METHODS: Electrocardiography (ECG), 24 hour Holter ECG with spectral and temporal analysis of 24-hour HRV, as well as echocardiography (Echo) and stress-Echo were carried out in 24 patients with ischemic heart disease before, in 2-4 weeks and 2 months after surgery. Healthy persons of the same age (n=20) were used as controls. RESULTS: Prior to operation HRV in all patients was lower than in controls. In 2-4 weeks after coronary artery bypass grafting (CABG) further lowering of HRV parameters occurred. In 2 months after CABG HRV parameters in patients without complications were similar to preoperative values but remained lower than in controls.     

Evaluation of the anti-arrhythmic effect of intracardiac laser therapy by 24-hour electrocardiographic monitoring of patients with acute myocardial infarction

Ventricular arrhythmias were studied by Holter's 24-hour ECG monitoring in 215 acute myocardial infarction patients within the first day of the disease. Twenty-five minutes sessions of blood irradiation by a 2-4 mW helium-neon laser (HNL) through a light guide, introduced into the right atrium via the subclavian vein, were conducted for 3-5 days in 180 patients. The HNL therapy showed a marked antiarrhythimic effect in acute myocardial infarction, significant for the prevention and treatment of ventricular arrhythmias. High antiarrhythmic activity was noted in patients with frequent ventricular extrasystoles and high-grade arrhythmias. Control patients showed no significant spontaneous reduction of the rate of ventricular arrhythmias over a comparable period of time.     

Anatomical variants of sinoatrial and atrioventricular node arteries

The authors investigated on 70 hearts taken from deceased subjects of either sex, aged 19 to 75 years, anatomical variants of sinoatrial (SAN) and atrioventricular node (AVN) arteries. As regards the branching of the SAN artery from the right and left coronary artery (RCA, LCA), they found altogether 14 variants of connection with the anterior atrial sulcus and the orifice of the superior vena cava. As regards the branching of the AVN from the RCA and the LCA, they identified altogether 6 variants of connection with the venous sinus orifice and the base of the interventricular septum. Problems of surgical interventions on SAN and AVN arteries and mechanisms of possible traumatization in the course of these operations are discussed. Surgical lesions can be prevented by thorough analysis of coronarograms and by taking into account anatomical variants of SAN and AVN arteries.