An unusual grayish brown discoloration of the synovium was found during a knee arthroscopy of a 72-year-old man. He also had similar pigmentation affecting the skin on the legs, arms, hands, and face. It was found he had been taking 400 mg of amiodarone hydrochloride daily for last 7 years. Amiodarone is known to cause a slate grey pigmentation of skin and cornea, but we believe this is the first report of amiodarone-induced pigmentation of the synovium. The arthroscopist should be aware of the possibility of drug-related synovial pigmentation and include this in differential diagnosis.
Aged ; Amiodarone/*adverse effects/therapeutic use ; Anti-Arrhythmia Agents/*adverse effects/therapeutic use ; Arrhythmias, Cardiac/complications/drug therapy ; Arthroscopy ; Diagnosis, Differential ; Humans ; Knee Joint/surgery ; Male ; Pigmentation Disorders/*chemically induced/*diagnosis ; Skin/pathology ; Synovial Membrane/*pathology

OBJECTIVETo observe the therapeutic efficacy and safety of amiodarone combined with Shenmai Injection (参麦注射液) on atrial fibrillation.

METHODSA total of 351 patients with atrial fibrillation caused by cardiovascular diseases and idiopathic atrial fibrillation were assigned to amiodarone group (control group, 128 cases) and amiodarone combined with Shenmai Injection group (treatment group, 223 cases). The patients in the control group received intravenous injection of 150 mg amiodarone in 10 min, followed by intravenous drip infusion at 1 mg /min and 6 h later at 0.5 mg /min until 48 h or cardioversion. The patients in the treatment group received the same treatment of amiodarone, while in addition, they received an injection of Shenmai Injection of 100 mL simultaneously. Blood pressure, ventricular rate, and cardioversion were observed.

RESULTSThe total efficiency rate was 98% (control group) and 99% (treatment group) (P>0.05). The mean ventricular rate decreased 23% and 31% in the control group and the treatment group, respectively (P<0.05). The mean cardioversion time of the two groups was 570±211 min and 351±123 min, respectively (P<0.05). Only mild side effects were observed in both groups.

CONCLUSIONCompared with amiodarone, amiodarone combined with Shenmai Injection takes effect more quickly with low side effects on the treatment of atrial fibrillation.

Aged ; Aged, 80 and over ; Amiodarone ; administration & dosage ; adverse effects ; therapeutic use ; Anti-Arrhythmia Agents ; administration & dosage ; adverse effects ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Drug Combinations ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; therapeutic use ; Female ; Humans ; Male ; Middle Aged

Anti-Arrhythmia Agents ; adverse effects ; therapeutic use ; Arrhythmias, Cardiac ; drug therapy ; Humans

Adolescent ; Anti-Arrhythmia Agents ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Child ; Female ; Follow-Up Studies ; Heart Valve Diseases ; complications ; Humans ; Male ; Quinidine ; adverse effects ; therapeutic use ; Rheumatic Heart Disease ; complications

OBJECTIVE: To investigate the effect of fructose-1,6-diphosphete(FDP) on myocardial preservation in pulmonary operations. METHODS: One hundred and six patients undergoing selective pulmonary lobectomy or segmentectomy were randomly divided into 2 groups with 53 patients each. FDP 200 mg/kg was infused intravenously before anesthesia in the FDP group, while 5% glucose with the same volume was given instead of FDP in the control group. ECGs were monitored from before the anesthesia to 72 h after the operation;the time and type of arrhythmia were recorded. Blood samples were taken before the operation (T0), immediately after the operation(T1), at 24 h(T2),48 h(T3)and 72 h(T(4)) after the operation to determine plasma creatine kinase isoenzyme MB(CK-MB) and cardiac troponin I(cTnI) concentrations. RESULTS: The incidence of arrhythmia in FDP group (35 times) was significantly lower than that in the control group(67 times). The incidence of all types of arrhythmia in the FDP group was also significantly lower than that in the control group. The concentrations of CK-MB and cTnI in the FDP group were significantly lower than those in the control group at T1, T2, T3, and T4. CONCLUSION FDP is effective for myocardial preservation in pulmonary operations.
Aged ; Anti-Arrhythmia Agents ; therapeutic use ; Arrhythmias, Cardiac ; etiology ; prevention & control ; Creatine Kinase, MB Form ; blood ; Female ; Fructosediphosphates ; therapeutic use ; Humans ; Male ; Middle Aged ; Pneumonectomy ; adverse effects ; Troponin I ; blood

Rapidly activating component of delayed rectifier potassium current (I(Kr)) plays a key role in the repolarization phase of cardiac action potential. Human ether-a-go-go-related gene (HERG) encodes the alpha subunit of this potassium channel. Mutations of HERG gene induce genetic long QT syndrome (LQTS). Furthermore, I(Kr)/HERG is the target of some drugs which may cause cardiac QT interval prolongation. Some other drugs with different chemical structures also may block the channel and prolong QT interval, which even developed into acquired arrhythmias. This review summarized the recent progress of structure, gating mechanisms and functions of I(Kr)/HERG channel, I(Kr)/HERG related arrhythmias, interaction between K+ channel and drugs, and strategies of grading-up the I(Kr)/HERG target.
Anti-Arrhythmia Agents ; adverse effects ; pharmacology ; therapeutic use ; Arrhythmias, Cardiac ; drug therapy ; metabolism ; Ether-A-Go-Go Potassium Channels ; antagonists & inhibitors ; chemistry ; genetics ; metabolism ; Humans ; Ion Channel Gating ; Long QT Syndrome ; drug therapy ; etiology ; genetics ; metabolism ; Mutation ; Potassium Channel Blockers ; pharmacology

Antiarrhythmic agents may increase capture threshold, but this is rarely of clinical significance. Flecainide acetate, a class IC agent, is reported to have a significant effect on the myocardial capture threshold. In this presentation, we report the case of a 72-year-old male, with a previously implanted VVI pacemaker due to sick sinus syndrome, who was treated with flecainide acetate for paroxysmal atrial arrhythmia control. During the fifteenth day of treatment, an abrupt rise in the ventricular capture threshold with ventricular pacing failure was noted. The capture threshold decreased two days after discontinuation of flecainide acetate.
Ventricular Function/*drug effects ; *Pacemaker, Artificial ; Male ; Humans ; Flecainide/*adverse effects/therapeutic use ; Electrocardiography ; Atrial Flutter/drug therapy ; Anti-Arrhythmia Agents/*adverse effects/therapeutic use ; Aged ; Action Potentials/*drug effects

OBJECTIVETo investigate the effectiveness and safety of various agents on paroxysmal atrial fibrillation in the elderly over 75 years old.

METHODSTotally 264 in-patients (75-91 years old, 185 males and 79 females) with atrial fibrillation history of less than 7 days were enrolled in this study. A total of 611 atrial fibrillation episodes were recorded, but 130 episodes (22.3%) of atrial fibrillation were auto-converted to sinus rhythm. The rest 481 episodes of atrial fibrillation were divided into six groups based on the drug used.

RESULTSThe cardioversion ratio of atrial fibrillation were 9.5%, 46.9%, 71.7%, 55.9%, 32.7%, and 73.6% in control, cedilanid, amiodarone, propafenone, verapamil, and quinidine groups, respectively. Ventricular rate control were 5.4%, 83.6%, 84.9%, 77.9%, 78.8%, and 11.3% in those groups, respectively. The total effective rates of amiodarone and cedilanid groups were the highest. When the ventricular rate was controlled to below 90 bpm, the patients would almost complain of no discomfort. No severe side-effect was observed in each group.

CONCLUSIONAmiodarone and cedilanid may be the proper drugs for the treatment of paroxysmal atrial fibrillation in the elderly. The above antiarrhythmics in each therapeutic group were relatively safe and effective.

Aged ; Aged, 80 and over ; Amiodarone ; adverse effects ; therapeutic use ; Anti-Arrhythmia Agents ; adverse effects ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Bradycardia ; chemically induced ; Cardiac Glycosides ; adverse effects ; therapeutic use ; Female ; Heart Rate ; drug effects ; Humans ; Lanatosides ; adverse effects ; therapeutic use ; Male ; Nausea ; chemically induced ; Propafenone ; adverse effects ; therapeutic use

OBJECTIVETo observe the clinical effect of the combined use of amiodarone and Wenxin Granule (WXG) in auricular fibrillation (AF) conversion and its safety.

METHODSTwo hundred and twenty-four patients, in whom AF lasted for less than 1 year, were enrolled and randomly assigned into two groups, 112 in each group. Patients in the treated group were treated with WXG and amiodorane and the others in the control group were orally administered with amiodarone alone. The accumulative conversion rate of AF and adverse reaction were monitored during the 6-month observation period.

RESULTSSix-month observation was completed in 109 cases in the treated group and 107 in the control group, while 3 cases and 5 cases in the two groups were dropped out respectively. The difference of accumulative AF conversion rates between the two groups become significant early after one month medication (P < 0.05), and was 65.1% and 47.7% respectively after 6-month of treatment (P < 0.05). Inter-group significant difference was also shown in the aspects of average conversion time, dosage of amiodarone required and the occurrence of adverse reaction (P < 0.05).

CONCLUSIONCombined use of WXG and amiodarone has a better effect in improving conversion rate of AF, shortening conversion time and decreasing the required dosage of amiodarone in treating AF as compared with the treatment with amiodarone alone, and by which the adverse reaction of long-term using amiodarone could be avoided.

Aged ; Amiodarone ; adverse effects ; therapeutic use ; Anti-Arrhythmia Agents ; therapeutic use ; Atrial Fibrillation ; drug therapy ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Phytotherapy ; Safety

No abstract available.
Aged ; Amiodarone/*adverse effects/therapeutic use ; Anti-Arrhythmia Agents/*adverse effects/therapeutic use ; Hepatitis, Alcoholic/diagnosis/etiology ; Hepatitis, Chronic, Drug-Induced/*diagnosis/etiology/pathology ; Humans ; Male