DIFFERENTIATED THERAPY OF ATRIAL-FIBRILLATION AND FLUTTER IN PATIENTSWITH CORONARY HEART-DISEASE DEPENDING ON ARRHYTHMIA PAROXYSM DURATIONBEFORE TREATMENT

Aim, To ascertain optimal antiarrhythmic therapy (AAT) in paroxysms of atrial fibrillation (AF) and atrial flutter (AFl) basing on their pre treatment duration. Materials aad methods. A total of 2851 coronary he art disease (CHD) patients with AF and Am paroxysms aged 40-75 years w ere treated from 1982 to 1996. The patients received sublingual or ora l drugs (anaprilin, ethacizine, quinidine, etc.) or intravenous antiar rhythmic drugs (ritmilen, isoptin, novocainamide, etc). Results. In pr etreatment 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 effectiven ess occurred in the use of intravenous antiarrhythmic drugs or quinidi ne, quinidine+verapamil. In the paroxysm duration from 7 days to sever al months, positive effect was achieved only in administration of quin idine or quinidine+verapamil. Conclusion. The principle of differentia ted therapy of AF and AFl in CBD patients depending on the paroxysm du ration before treatment allows choice of adequate therapy by enhancing ifs antiarrhythmic and weakening arrhythmogenic effects.