Showing papers on "Sinus tachycardia published in 1990"
TL;DR: This study evaluated the prognostic utility of several risk factors in the 3,339 patients enrolled in Phase II of the Thrombolysis in Myocardial Infarction (TIMI) trial and found that eight risk factors can be easily remembered and assessed in patients with myocardial infarction who are candidates for thrombectomy therapy and can be used to estimate short-term mortality.
140 citations
TL;DR: It is concluded that sinus tachycardia, SVE, and VPBs are common among patients with theophylline toxicity; however, sustained ventricular or supraventricular tachyarrhythmias that require antiarrhythmic therapy are uncommon.
54 citations
TL;DR: It is concluded that esmolol effectively controls the hyperdynamic response to ECT and reduces the length of seizures.
Abstract: We evaluated the clinical effectiveness of esmolol, an ultra-short-acting beta 1-adrenergic receptor blocking drug, to control the sinus tachycardia and increase in arterial blood pressures induced by electroconvulsive therapy (ECT). Each of 20 patients, ASA physical status I-III, participated in a double-blind, randomized study, involving four match-pair trials (placebo versus esmolol) during ECT. Each patient acted as his or her own control (total number of ECT procedures, 160). We administered a 4-min infusion of either placebo or esmolol at the rate of 500 micrograms.kg-1.min-1. We then induced anesthesia with methohexital and succinylcholine. After administration of electrical stimulation for ECT, the rate of infusion decreased to 300 micrograms.kg-1.min-1 for three additional minutes and was then discontinued. Statistically significant reductions in mean heart rate from minute 2 until minute 15 and in maximum heart rate (the mean of each patient's maximum heart rate after seizure changed from 152 +/- 23 to 115 +/- 24 beats/min) occurred in patients given esmolol. During and immediately after infusion, arterial blood pressure also decreased. Finally, the length of seizures decreased, as manifested clinically from 48 +/- 18 to 39 +/- 14 s and on electroencephalogram from 86 +/- 41 to 67 +/- 28 s. We conclude that esmolol effectively controls the hyperdynamic response to ECT and reduces the length of seizures. The significance of the latter to the overall effectiveness of ECT is not known.
40 citations
Journal Article•
TL;DR: The present study concluded that 57 per cent of patients of snake bite were in 2nd and 3rd decades of life and all these patients had bleeding manifestations and abnormal electrocardiograms.
Abstract: The present study was conducted in 30 cases of snake bite to understand fully the intricacies of the cardiac profile and to render help in the management of the problem arising out of them. All were subjected to routine and specific investigations (ECG, X-ray Chest, SGOT). The present study concluded that 57 per cent of patients of snake bite were in 2nd and 3rd decades of life. Viperine snake bite occurred in 93 per cent and elapide snake bite in 7 per cent of cases. Cardiotoxicity was seen in only 25 per cent patients with viperine bite. Seventy-six per cent of the patients presented within 24 hours of the bite. Seventy per cent of patients had haemorrhagic manifestations and 30 per cent had cardiotoxicity. The disturbance in heart rate was seen in 47 per cent, rhythm disturbance in 6.7 per cent, tachycardia in 36.7 per cent and bradycardia in 10 per cent cases. Hypertension was found in 6.7 per cent, hypotension in 16.7 per cent. Thirty per cent of patients had gallop rhythm and it persisted in 16.6 per cent patients till discharge. One patient had evidence of pulmonary edema and one had basal congestion. Cardiomegaly on chest X-ray was found in one patient and elevated SGOT titres were found in ten per cent. Common electrocardiographic changes were sinus tachycardia, sinus arrhythmia (6.6%), sinus bradycardia (10%), tall T-wave in V2 (3.3%), pattern suggestive of acute anterior wall infarction with reciprocal changes (3.3%), myocardial ischemia (10%), non-specific ST-T changes (16.7%) and atrioventricular block (3.3%). The mortality rate was 10 per cent and all these patients had bleeding manifestations and abnormal electrocardiograms.
37 citations
TL;DR: The P wave could not be signal averaged and thereby improve on the signal-to-noise ratio if one assumed a single basic morphology, and three or more different P waves in a single normal subject were reported.
27 citations
TL;DR: In this paper, the sinus node regions showing earliest activation during catecholamine stimulation successfully limits maximum heart rate without causing significant bradycardia, and the effects are long lasting, while the remaining pacemaker behaves like the sinoatrial node.
Abstract: This study tested the feasibility of neodymium:YAG laser photocoagulation of selected sinus node areas to depress sinus rate responsiveness. In 14 open-chest dogs, origin of the sinus impulse (O point) was electrically mapped from the epicardium before and during isoproterenol infusion. Epicardial laser photocoagulation was applied to the O point observed during isoproterenol infusion and stepwise to remapped new O points until a 30 +/- 5% decrease in heart rate occurred. Long-term effects were assessed by Holter monitoring and electropharmacologic testing preoperatively and up to 10 weeks or 6 months. Mean (+/- SEM) percent decreases were observed at 10 weeks in the following parameters: average 24-hour heart rate, 17.4 +/- 5.0%; maximum heart rate on Holter, 30.5 +/- 3.5%; heart rate during pharmacologic autonomic blockade, 32.7 +/- 3.5%; and maximum heart rate on isoproterenol, 23.1 +/- 4.6% (all p less than 0.01). Curves with pacemaker recovery time plotted against control cycle length remained unchanged. Holter monitoring did not show excessive bradycardic episodes even after administration of propranolol. In three control dogs (sham operation), sinus node function remained unchanged. Histologic study of the irradiated area showed replacement by inflammatory cells, fibrosis, and cartilage formation with surrounding normal cells and occasional cells resembling pacemaker-like cells at the caudal end of the sinoatrial node. This study suggests that 1) map-guided graded laser photocoagulation of sinus node regions showing earliest activation during catecholamine stimulation successfully limits maximum heart rates without causing significant bradycardia, 2) the effects are long lasting, and 3) the remaining pacemaker behaves like the sinus node. Laser modification of sinus node function could become a form of nonpharmacologic heart rate control in patients with coronary artery disease undergoing surgery and in the syndrome of inappropriate sinus tachycardia.
25 citations
TL;DR: Sinus node ablation by high-frequency current (HFC) was induced in seven thoracotomized dogs under autonomic blockade and acute histological findings showed coagulation necrosis of the endocardium, extending to the muscle fibres and affecting the sinus cells.
Abstract: Sinus node ablation by high-frequency current (HFC) (0.7 MHz. 5-10 W), delivered through the distal electrode of a conventional endocavitary catheter, was induced in seven thoracotomized dogs under autonomic blockade. The HFC was delivered for variable periods of time under ECG monitoring, while sinus tachycardia was produced or after attaining sinus arrest. The procedure was repeated until a stable non-sinus rhythm was obtained. Sinus rhythm was abolished in all seven dogs after a variable number (7-20) of discharges. The escape rhythm obtained after the last discharge, characterized by means of epicardial electrodes and analysis of P-wave morphology, length of PR interval and the rate, showed an atrial activation pattern different from sinus rhythm in all cases. The P-wave was retrograde in two cases, and in one case no atrial activity was detected after the last discharge; however, atrial activity recovered after 35 min, the activation pattern being different from the controls. After 2 h, sinus rhythm had not returned in any case. In no case was there perforation of the atrial wall. Acute histological findings showed coagulation necrosis of the endocardium, extending to the muscle fibres and affecting the sinus cells.
24 citations
TL;DR: It is speculated that atrial ectopic focus tachycardia may have different etiologies: multiple foci may be due to extensive atrial disease such as that found in primary cardiomyopathy or after myocarditis, whereas single foci might be a developmental aberration.
Abstract: Multiple Atrial Ectopic Foci. Atrial ectopic focus is a common mechanism for chronic incessant supraventricular tachycardia in children. The majority of patients require treatment because of symptoms or tachycardia-induced cardiomyopathy. Management with traditional drugs fails to restore sinus rhythm and surgery has heen thought to be curative. We have had 54 patients with atrial ectopic focus tachycardia; 40 right atrial (36 with normal P waves simulating sinus tachycardia), and 14 left atrial. Surgical treatment of tachycardia was performed in 28 patients; all 28 had a single abnormal P wave axis before surgery, had mapping in the electrophysiology lab, and were thought to have a single focus. However, in 14/28 (50%) after surgical removal of this focus, additional foci became apparent. In 11/14, the next focus appeared during surgery; between 3–15 additional foci were identifled and surgically treated. This resulted in cure in 9/11, but 2/11 despite almost total atrial disconnection, continued to have atrial ectopic focus tachycardia. The other three patients with multiple foci had atrial ectopic focus tachycardia recur with a diflPerent P wave axis from 1 week to 2 months postoperatively. Since the overall initial success rate for multiple foci was different from single foci, patients with multiple foci and single foci were compared to try to predict multiple foci. Patients with multiple foci had: (1) the same incidence of cardiomyopathy (78%); (2) faster maximum atrial rate on Holter (89% of multiple foci had a rate faster than 160/min vs 43% of single foci, (P < 0.05); (3) faster minimum atrial rate on Holter (89% of multiple foci had a minimum rate faster than 70/min vs 0% single foci, (P < 0.05); and (4) different preoperative electrocardiogram (0% multiple foci had left atrial P waves vs 44% of single foci, (P < 0.025). In conclusion: (1) approximately half the patients with atrial ectopic tachycardia had multiple foci; (2) surgical treatment of multiple foci was less successful than single foci, although with improvement in surgical techniques, even multiple foci were successfully eliminated by surgery, and surgery was successful in 100% of the last 10 cases; (3) multiple foci were unlikely with left atrial P waves and slower atrial rates. We speculate that atrial ectopic focus tachycardia may have different etiologies: multiple foci may be due to extensive atrial disease such as that found in primary cardiomyopathy or after myocarditis, whereas single foci may be a developmental aberration. (J Cardiovasc Electrophysiol, Vol. J, pp. 132–138, April 1990)
22 citations
TL;DR: It is suggested that cardiac P2 receptors may be coupled to prostaglandin synthesis via an IAP-insenstive stimulation of phospholipase C and not lipoxygenase metabolites of arachidonic acid, e.g. prostag landins, may be involved in the generation of tachycardia.
Abstract: Effects of adenosine 5′-triphosphate (ATP) and adenosine on cardiac sinus pacemaker activity were examined in the rabbit heart. Electrocardiograms of hearts were recorded while using the Langendorff perfusion method. Both adenosine and ATP, added to the perfusate, slowed the sinus pacemaker activity in a concentration-dependent manner. But in about 40% of the cases, ATP higher than 300 μM initially accelerated and then slowed the heart. The sinus slowing caused by adenosine and ATP was blocked by theophylline (a p1 receptor antagonist) and disappeared in the hearts pre-treated with islet-activating protein (IAP). In contrast, the ATP-induced sinus acceleration was not affected by either theophylline or IAP. In about 75% of the IAP-treated hearts, ATP persistently accelerated the sinus pacemaker. In the remaining 25% of the hearts, ATP caused junctional tachycardia, which may have masked the ATP-induced sinus acceleration. Apamin specifically blocked the ATP-induced sinus acceleration, suggesting that P2 receptors are involved. Among various adenine nucleotide analogues, the order of potency in inducing tachycardia in IAP-treated hearts is adenosine-5′-[γ-thio]triphosphate > adenylyl imidodiphosphate > adenosine 5′-[α, β-methylene]triphosphate = ATP > adenosine diphosphate = adenosine 5′-[β, γ-methylene]triphosphate. ATP-induced acceleration was partially blocked by indomethacin and aspirin (cyclooxygenase inhibitors), but not by nordihydroguaiaretic acid (a lipoxygenase inhibitor). These results suggest that cyclooxygenase and not lipoxygenase metabolites of arachidonic acid, e.g. prostaglandins, may be involved in the generation of tachycardia. Consistent with this notion, exogenously applied cyclooxygenase metabolites, prostaglandin E2 and 6-keto-prostaglandin F1α, which are known to be produced by extracellular ATP in the rabbit heart [Schwartzman et al. (1981) Eur J Pharmacol 74: 167–173], accelerated the sinus rate. We also observed that the ATP-induced tachycardia was almost completely blocked by neomycin (a phospholipase C inhibitor). We suggest, therefore, that cardiac P2 receptors may be coupled to prostaglandin synthesis via an IAP-insenstive stimulation of phospholipase C.
22 citations
TL;DR: It is concluded that noninvasive studies can help identify RAET among patients with poor functioning hearts and right atrial tachycardia.
20 citations
TL;DR: In conclusion: sinus function may be abolished by closed chest radiofrequency ablation of the sinoatrial node with radiofrequency energy in dogs under fluoroscopic monitoring and autonomic blockade.
Abstract: UNLABELLED Transcatheter ablation of the sinoatrial node with radiofrequency energy (0.6 MHZ, 2.5-5 watts) was performed in 10 dogs under fluoroscopic monitoring and autonomic blockade. Sinus function was previously studied in terms of cycle length, recovery time and atrial activation pattern by catheter mapping. Several discharges (8-22) were applied for variable periods of time (maximum 1 minute). Sinus tachycardia and/or sinus arrest during ablation confirmed correct catheter position. Sinus rhythm was abolished in eight dogs. The ectopic rhythm was atrial in six and AV nodal in two dogs. Ectopic atrial cycle length and recovery time were longer than the baseline sinus values: 724 +/- 321 versus 509 +/- 147, P less than 0.05; 1103 +/- 775 versus 618 +/- 151, P less than 0.05 (values in msec). The study was repeated 10-14 days later in six dogs; three maintained the same atrial rhythm, one persisted in sinus rhythm, and one dog changed from atrial to sinus rhythm, whereas another changed from sinus to atrial rhythm. Gross findings revealed transmural lesions in all dogs, without perforation. Histology in chronic dogs showed sinus cell necrosis and its replacement by granulation tissue. IN CONCLUSION sinus function may be abolished by closed chest radiofrequency ablation.
TL;DR: It is suggested that a normal dietary component can induce serious cardiac arrhythmias, and that a low‐tyramine diet may be of value for patients who are susceptible to cardiac arrHythmias.
Abstract: Five out of 12 physically healthy patients with depression undergoing a tyramine pressor test developed cardiac arrhythmias. These arrhythmias occurred in drug-free patients in three out of 12 infusions following as little as 0.03 mg/kg of tyramine and after moclobemide, a reversible inhibitor of monoamine oxidase-A, in four out of 14 tyramine infusions with as little as 0.04 mg/kg of tyramine. The arrhythmias seen were independent of patient's age and occurred both before and after 30 mmHg elevations in systolic blood pressure. Electrocardiographic abnormalities and arrhythmias seen were a loss of p waves, sinus tachycardia, frequent atrial ectopic beats, atrial premature beats, Wenckebach phenomenon, junctional rhythm, ventricular ectopics, varying QRS configurations, and ventricular bigeminy. Tyramine, both oral and intravenous, caused similar reproducible changes in dogs, though not in rats, mice or guinea pigs. Practical implications are that tyramine pressor testing in humans should be performed cautiously and only with adequate cardiac monitoring and resuscitation facilities at hand. These findings suggest that a normal dietary component can induce serious cardiac arrhythmias, and that a low-tyramine diet may be of value for patients who are susceptible to cardiac arrhythmias.
TL;DR: This study suggests that maintenance digoxin may be withdrawn safely in elderly nursing home residents in sinus rhythm and without history of atrial dysrhythmia.
Abstract: Chronic use of digitalis is common amongst the institutionalized elderly. Associated with digitalis use is the potential for toxicity and/or adverse reactions. In this study maintenance digoxin was withdrawn from 14 elderly nursing home residents in sinus rhythm. Subjects were followed over 18 months for evidence of dysrhythmia or heart failure. One resident had an episode of supraventricular tachycardia which required digoxin to be restarted. One resident developed left heart failure, treated with oral diuretic. For 12 of the 14 residents, withdrawal of maintenance digoxin was achieved without deleterious effect. This study suggests that maintenance digoxin may be withdrawn safely in elderly nursing home residents in sinus rhythm and without history of atrial dysrhythmia.
TL;DR: Variability of the Intracardiac Electrogram is described as a method of high sensitivity to distinguish ventricular arrhythmias from sinus rhythm but the specificity of this algorithm has not been assessed.
Abstract: PAUL, V.E., ET AL.: Variability of the Intracardiac Electrogram: Effect on Specificity of Tachycardia Detection. Correlation has been described as a method of high sensitivity to distinguish ventricular arrhythmias from sinus rhythm but the specificity of this algorithm has not been assessed. Ten patients with a history of chronic ventricular tachycardia were studied. The ventricular endocardial electrogram was recorded during sinus rhythm at rest immediately following exercise and during their clinical ventricular tachycardia. Each complex recorded during these sample periods was correlated with a template constructed during sinus rhythm at rest. Although for each patient the range of correlation values obtained at rest were clearly separated from those obtained during ventricular tachycardia, in 69% of cases there was overlap of the range in sinus tachycardia and ventricular tachycardia.
Journal Article•
TL;DR: Four premature infants presenting with episodes of bradycardia in the first weeks of life were given diphemanil, and it was felt that this anticholinergic therapy may have caused a prolongation of the QT interval and, therefore, a partial A-V block in case of sinus tachycardia.
Abstract: Four premature infants presenting with episodes of bradycardia in the first weeks of life were given diphemanil. One of them received an overdose accidentally. Paradoxically, this induced a permanent bradycardia leading to the discovery of a grade II A-V block as well as a prolonged QT interval. Discontinuation of the drug resulted in a prompt normalization of these changes. It is felt that this anticholinergic therapy may have caused a prolongation of the QT interval and, therefore, a partial A-V block in case of sinus tachycardia. Thus, such a therapy should not be given to young premature infants without having checked the QT interval on a ECG tracing and having made sure that it is adapted to the actual heart rate. It is also advised to reduce usual doses.
TL;DR: An algorithm using the relative number of atrial vs ventricular beats and A‐V1 and V1‐V2 timing can provide automated dysrhythmia detection, without effect from lidocaine or isoproterenol infusion.
Abstract: WALSH, C.A., ET AL.: Differentiation of Sinus Rhythms from Supraventricular Tachydysrhythmias by Activation Sequence and Timing. Implantable device detection of tachydysrhythmias remains unreliable and inexact. False responses may occur because of misinterpretation of sinus tachycardia (ST) as a supraventricular tachydysrhythmia (SVTD). Timing of atrioventricular (AV) activation and ventricular dispersion identified and discriminated between ST and SVTDs in 11 dogs. Three bipolar epicardial electrodes recorded left atrial and left and right ventricular depolarizations simultaneously during normal sinus rhythm (NSRJ (mean of 5 beats in 11/11 dogs), ST produced by phlebotomy (50 beats in 10 episodes in 6/11) or isoproterenol infusion (105 beats in 21 episodes in 10/11), sinus bradycardia (SB) produced by vagal stimulation (140 beats in 29 episodes in 10/11), and during atrial flutter (AFL) (15 beats in 3 episodes in 3/11) and atrial fibrillation (AF) (152 beats in 31 episodes in 9/11) induced by programmed electrical stimulation. During lidocaine infusion, NSR (55 beats in 11 episodes in 10/11 dogs), SB (84 beats in 17 episodes in 7/11), AFL (10 beats in 2 episodes in 1/11], and AF (103 beats in 21 episodes in 7/11) were recorded. During isoproterenol infusion, SB (45 beats in 9 episodes in 5/11), AFL (15 beats in 3 episodes in 2/11), and AF (64 beats in 13 episodes in 5/11) were recorded in addition to ST. The interval between the left atrial and left ventricular intrinsic deflections (A-V1) and between the left and right ventricular intrinsic deflections (V1-V2) of each beat was measured. The mean value (msec) of A-V1 and V1-V2 in each episode was compared to NSR in the same dog. A difference of ≥ 16 ms was used for differentiation. In all cases except SB with first-degree AV block, V1-V2 in each episode was insignificant (0-14msec), categorizing the rhythms as supraventricular. During NSR, ST and SB without AV block, Δ A-V1 was small (0–15 msec). In contrast Δ A-V1 was ≥ 16 ms in 6/8 episodes of AFL. The remaining two episodes could be differentiated by the greater number of atrial versus ventricular beats. AF could be detected by the variability of A-V1. An algorithm using the relative number of atrial vs ventricular beats and A-V1 and V1-V2 timing can provide automated dysrhythmia detection, without effect from lidocaine or isoproterenol infusion.
01 Jan 1990
TL;DR: In old age, in case of occurrence of the symptoms of SSS, possibility of hyperthyrosis also should be considered, especially when indication of permanent pacemaker is established.
Abstract: Sinus tachycardia and atrial fibrillation are frequent features in hyperthyrosis while sinus node dysfunction is regarded as a rare complication Bradycardia may cause diagnostic problems mainly in atypical hyperthyrosis of the old age The authors analysed distribution and age related association of the rhythm disorders in hyperthyrosis In case of the appearance of Sick Sinus Syndrome (SSS), parameters representing the function of sinus node were studied by electrophysiological investigations Above the age of 50 years incidences of atrial fibrillation and SSS were significantly increased The abnormal sinus node function proved to be reversible in a portion of the cases In old age, in case of occurrence of the symptoms of SSS, possibility of hyperthyrosis also should be considered, especially when indication of permanent pacemaker is established
Journal Article•
TL;DR: This study discloses 28 percent presenting automatism disorders such as sinus tachycardia, 3 percent with excitability disorders and 1 percent with conduction disorders.
Abstract: Recording of the electrical activity of the heart is imperative in pregnant women. Our study discloses 28 percent presenting automatism disorders such as sinus tachycardia, 3 percent with excitability disorders and 1 percent with conduction disorders. Therefore, the study of the electrical waves permits correct, in time, any cardiac complication incompatible with the continuation of the pregnancy.
TL;DR: Based on hemodynamic data, alinidine seems to possess fewer negative hemodynamic side effects than esmolol, and in patients with a sinus tachycardia and concomitant hypertension, es Molol seems to be more advantageous.
Journal Article•
TL;DR: Administration of the beta blocking drugs propranolol and atenolol led to resolution of the clinical signs in a dog diagnosed with tachycardia, tachypnea, weakness, vomiting, and a history of exposure to the drug.
Abstract: Intoxication with metaproterenol, a mainly beta-2 selective agonist, was diagnosed in a dog with tachycardia, tachypnea, weakness, vomiting, and a history of exposure to the drug. Electrocardiography and echocardiography disclosed sinus tachycardia with episodes of ventricular tachycardia and exuberant systolic ventricular function, respectively. Administration of the beta blocking drugs propranolol and atenolol led to resolution of the clinical signs. Excessive sympathetic stimulation caused by metaproterenol is an unusual intoxication in dogs.
Journal Article•
TL;DR: The clinical course of neoplastic emboli can suggest acute pulmonary embolism, but the diagnosis can only be advanced after pulmonary angiography, especially if the patient is to have a cancer.
Abstract: In contrast to pulmonary parenchyma metastases or lymphangitic carcinomatosis, neoplastic emboli of small pulmonary arteries and capillaries frequently go unrecognized and are only discovered at autopsy. Five patients (48 +/- 12 years old) were admitted to 3 intensive care units for severe acute respiratory failure and died between the first and the tenth day following hospitalization. Each patient had a history of rapidly progressive dyspnea, and physical examination showed clinical evidence of right ventricular failure. The lungs were clear on chest X-rays and the ECG revealed sinus tachycardia with a right QRS axis. The mean partial pressures of oxygen (PaO2) and carbon dioxide (PaCO2) were, respectively, 50.8 +/- 9.1 mm Hg and 22.2 +/- 2.4 mm Hg. A swan-Ganz catheter, inserted into 4 patients, revealed pulmonary arterial hypertension (55, 43, 37, 28) with capillary wedge pressure within the normal limits and cardiac output normal or low (3.0, 3.8, 4.4, 5.0 l/min). Pulmonary angiograms from each patient showed decreased distal lung perfusion without any proximal defects suggestive of pulmonary embolism. The inferior vena cava always appeared clear. Malignant cells were found upon autopsy (4 cases) in the lumina of the pulmonary arterioles and the primary site of the cancer was determined in 3 patients (2 hepatomas and 1 pancreatic carcinoma). The last patient had a known breast cancer with bone marrow metastases and clinical, hemodynamic and angiographic evidence of neoplastic emboli. The clinical course of neoplastic emboli can suggest acute pulmonary embolism, but the diagnosis can only be advanced after pulmonary angiography, especially if the patient is to have a cancer.(ABSTRACT TRUNCATED AT 250 WORDS)
TL;DR: As with any antidepressant administered in a high therapeutic dose, caution and regular electrocardiographic monitoring of elderly patients with heart disease receiving lofepramine is recommended.
Abstract: Lofepramine at the upper limit of its therapeutic range (210mg/day), was associated with the development of sinus tachycardia with atrial ectopic beats and progression of right bundle branch block to trifascicular block in an 82 year old man with a history of heart disease. As with any antidepressant administered in a high therapeutic dose, caution and regular electrocardiographic monitoring of elderly patients with heart disease receiving lofepramine is recommended.
Journal Article•
TL;DR: Results are presented of 24-hour monitoring by Holter's method of ECG in 50 healthy seamen aged 29-55 years, in whom clinical examination, chest radiography, resting ECG records, and echocardiography confirmed normal condition of the cardiovascular system.
Abstract: Results are presented of 24-hour monitoring by Holter's method of ECG in 50 healthy seamen aged 29-55 years (mean 47.7 years), in whom clinical examination, chest radiography, resting ECG records, and echocardiography confirmed normal condition of the cardiovascular system. In 36% of the seamen premature beats of various origin were elicited. Supraventricular extrasystolic beats were demonstrated in 8%, atrioventricular-junction beats in 8%, and ventricular ectopic beats in 18%. In one case simultaneous occurrence of junction beats and ventricular beats was found. In 28% of the subjects sinus bradycardia was noted, and in 1 seaman two episodes of sinus tachycardia were recorded. The intensity of the observed arrhythmias was low.