[The differentiated therapy of paroxysms of atrial fibrillation and flutter in patients with ischemic heart disease in relation to the duration of the arrhythmia before the start of treatment].

AIM

To ascertain optimal antiarrhythmic therapy (AAT) in paroxysms of atrial fibrillation (AF) and atrial flutter (AFl) basing on their pretreatment duration.

MATERIALS AND METHODS

A total of 2851 coronary heart disease (CHD) patients with AF and AFl paroxysms aged 40-75 years were treated from 1982 to 1996. The patients received sublingual or oral drugs (anaprilin, ethacizine, quinidine, etc.) or intravenous antiarrhythmic drugs (ritmilen, isoptin, novocainamide, etc).

RESULTS

In pretreatment duration of AF and AFl up to 3 hours more pronounced effect was observed with sublingual and intravenous antiarrhythmic drugs. In the paroxysm duration up to 6 days, maximal antiarrhythmic effectiveness occurred in the use of intravenous antiarrhythmic drugs or quinidine, quinidine + verapamil. In the paroxysm duration from 7 days to several months, positive effect was achieved only in administration of quinidine or quinidine + verapamil.

CONCLUSION

The principle of differentiated therapy of AF and AFl in CHD patients depending on the paroxysm duration before treatment allows choice of adequate therapy by enhancing its antiarrhythmic and weakening arrhythmogenic effects.