Combined Medical and Non-Medical Arrhythmia Correction Together with Metabolic, Neurohumoral and Hemodynamic Violations in Them

Metabolic disorders in neurohumoral regulation lead to heart rhythm disturbances and can cause the syndrome of endogenous intoxication. From this perspective it becomes necessary to include active methods of detoxification (hemosorption, plasmosorption, plasmapheresis, etc.) in the complex therapy. Ultraviolet irradiation of blood, which has a wide spectrum of long-term therapeutic effect (restorative, detoxifying, anti-inflammatory) is widely spread nowadays. It is well-known fact that antiarrhythmic drugs are most effective in 50-60% of cases, but, in addition, they are also able to cause arrhythmogenic effect. Thus, quantum hemotherapy, autotransfusion with ultraviolet irradiated blood can help to overcome the resistance to antiarrhythmic drugs and prevent their arrhythmogenicity. Clinical comparative study of the alapinin action with autotransfusion ultraviolet irradiated blood was conducted on 41 patients with chronic ischemic heart disease with arrhythmias, 23 of them patients who had no or complete alapinin monotherapy effect, and 18 patients with satisfactory effect. Of the 41 patients, there were 21 males and 20 females aged 35 to 80 years, with an average age of 65 years. Against the background of hypertension, arrhythmias occurred in 30 patients, without hypertension – in 11 patients, with stable angina pectoris II functional class – in 8, III functional class – in 16, IV functional class – in 10, unstable angina pectoris in 7 patients, with atherosclerotic cardiosclerosis – in 26, with postinfarction – in 15 patients. Circulatory disturbance of the 1st stage was observed in 2 patients, stage IIA in 34, stage IIВ in 3 patients, stage III in 2 patients. The use of alapinin with autotransfusion with ultraviolet irradiated blood was performed in 10 patients with supraventricular extrasystole, in 20 patients with flicker and atrial flutter, in 11 patients with ventricular extrasystole. Oral usage of alapinin was started at a dose of 0,05 g 2 times per day 30 minutes before meals, first grinding it and washing it with water of room temperature. With good tolerability, the dose was increased to 3 tablets per day (0,05 g 3 times). When the antiarrhythmic effect was achieved, they switched to a maintenance dose (0,05 g of 1-2 reception) for 7-10 days. Intramuscularly, alapinin was given at a dose of 20 mg (4 ml of a 0,5% solution) 2-3 times a day. Thus, comparing the therapeutic, metabolic, neurohumoral and hemodynamic efficacy of alapinin, alapinin and autotransfusion with ultraviolet irradiated blood, the most pronounced therapeutic effect in patients with arrhythmias was obtained with the use of alapinin in combination with autotransfusion with ultraviolet irradiated blood. The action of alapinin is accompanied by positive significant changes in the adrenaline content, noradrenaline, free fatty acids, acetylhydroperoxide, malonic dialdehyde, peroxide hemolysis of red blood cells, electrolytes and their ratios, especially in ventricular extrasystole without negative inotropic effect in the above doses.