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Severe poisoning with cardiotropic drugs in children, accompanied by pronounced rhythm disorders and low cardiac output syndrome, is quite rare, but sometimes they can end fatally.The objective was to demonstrate the successful use of electrocardiostimulation in acute propafenone poisoning in a child of three years old.Materials and Methods. A retrospective analysis of the features of the course of severe propafenone poisoning in a three-year-old child who required pacing was carried out. Special attention was paid to the analysis of rhythm disorders that led to cardiac arrest by the type of electrical activity without a pulse, high efficiency of timely electrocardiostimulation in order to relieve bradyarrhythmia. Against the background of the therapy, a stable recovery of the correct sinus rhythm was achieved six hours after the connection of a temporary electrocardiostimulator.Conclusion. The presence of persistent bradyarrhythmia-type rhythm disorders in acute poisoning with antiarrhythmic drugs in children is an indication for the emergency use of electrocardiostimulation.

Background. Clinical search for modern, more hemodynamically efficient areas for placing endocardial electrodes with constant cardiostimulation. Our aim is to study electrophysiological parameters and clinical results of His bundle direct stimulation, analyze traits of compromised electrode removal from the given heat area.Materials and Methods. We examined 36 patients divided into two groups (18 patients in each group) according to the signs of transatrial (first) or transventricle (second) stimulation of His bundle. Up to 12 months from the implantation moment we analyzed electrocardiostimulation parameters, data of body-surface ECG, ultrasound dynamics of heart cavity sizes, life quality according to MOS SF-36 scale.Results. In the first group time for electrical systole of ventricle myocardium (width QRS) was authentically less – 111 ± 13 ms comparing to the second – 134 ± 19 which corresponded to physiological pattern for myocardial ventricle activation, excluded dyssinchrony, left ventricle diastolic dysfunction, development of arrhythmogenic chronic cardiac insufficiency. Life quality in the first group was authentically higher – 71 ± 8,5 vs 63 ± 9,9 points in patients from the second group. Four electrodes (2 electrodes in each group) were removed due to exit-block development.Conclusion. Implantation of transatrial electrode in the bundle of His area ensures stable fixation, lower risk of dislocation in the early postoperative period and eases its removal if coinciding indications occur. Clinical application of this medical approach is an impact for creating a peculiar endocardial electrode in native industry, supplying device and stimulator type DDD(R), with a spare ventricle canal which is rather timely regarding conditions for import substitution plan.

Aim. To study clinical and psycho-pathological features of anxiety disorders (AD), as well as quality of life (QoL) in the patients with implanted pacemakers (PM). Material and methods. In total, 75 patients underwent psychological testing with the Hospital Anxiety and Depression Scale (HADS) before and after the PM implantation. QoL was assessed with a short-form health survey instrument MOS-SF-36. Results. In 70,7% of PM patients, various AD forms were observed. Their prevalence and severity correlated with the duration and regimen of electrocardiostimulation (ECS), age, somatic pathology, and ECS complications. The highest summary QoL scores were registered in the patients with heart rate-adapting ECS, no manifested chronic heart failure, and those aged under 50 years. Conclusion. PM patients require additional psychological rehabilitation measures.

So far, electrocardiostimulation (ECS) problems, and their regional solutions, have been inadequately described. Therefore, the aim of this study was to investigate short- and long-term ECS results in patients of Saransk City and Mordovia Republic regions; to search for methods improving end-points in these patients. The study included 51 ECS individuals who underwent pacemaker implantation at Saransk City Clinical Hospital No. 4 (1996-2004). Questionnaire survey and clinical follow-up methods were used; ECS concept was reviewed: intervention indications, short- and long-term complications, their diagnostics, treatment and prevention; recommendations for controlling the problems identified were developed. Unfortunately, Russian standards of diagnostics, treatment (including surgery), and out-patient follow-up of such patients have not been created yet. Organizing a Saransk branch of Research Institute of Transplantology and Artificial Organs, including a modern telemedicine complex, might be an optimal regional-level solution for these problems.

One hundred fifty-four patients with artificial pacemaker (АРМ) and diagnosed CHD with effort angina, functional class II-IV, were included into the trial. The influence of electrocardiostimulation (ECS) on CHD clinic was surveyed. The symptoms had improved in 72 (46, 8 %) patients (Group 1), with decreased frequency of anginal episodes, quantity and doses of antianginal drugs taken, and increased exercise capacity. The opposite was observed in another 30 (19. 5 %) patients (Group 2), with more frequent anginal episodes, changed pain type, localisation and duration, and modified reaction to nitroglycerin. It was explained by electrostimulation associated with 1. 5-2-fold increase in heart rate, raising myocardial О2 demand, as well as by psychocardial syndrome. In remained 52 patients (33. 8 %) (Group 3), the character of anginal episodes did not react to ECS. Coronary reserve optimisation requires the flexible programming of electroimpulse frequency, according to angina and/or chronic heart failure functional class, and to ECS regimen. In particular, for patients with low coronary reserve, the frequency of 55-56 impulses per min is optimal, and individuals with congestive heart failure need 75-85 impulses per min.