EFFECTIVENESS OF PHARMACOLOGICAL CORRECTION OF HEART RHYTHM DISORDERS IN PATIENTS WITH ISCHEMIC HEART DISEASE

Cardiovascular diseases (CVD) have the first place among causes of death and disability of adults in developed countries and have a tendency to increasing of disease and death. The main cause of capacity loss of patients with IHD is angina pectoris. Therefore, the coronary blood flow becomes inadequate to the metabolic needs of myocardium by exercise and stress. Due to these changes, progress of IHD is getting complicated by different disorders of heart rhythm among those extrasystoles are most frequent. The most serious concern is caused by developing ventricular extrasystoles. The ventricular extrasystoles are bound with the risk of fatal ventricular fibrillation. A timely use of potassium drugs by the basic therapy allows preventing different complications. A new medication containing К+ and Мg++ ions and influencing cell metabolism is Rhythmocor drug. Мg++ increases a therapeutic effect of К+ ions. Metabolic activity of Rhythmocor is stimulated by activation of oxidation-reduction enzymes, stabilization of functioning ion channels of sodium-potassium-ATPase that increases stability of electrophysiological properties of cardiomyocytes. On the condition of ischemia and hypoxia, one of influence mechanisms of Rhythmocor on cells is inhibition of intensiveness of free-radical oxygenation of proteins and lipid peroxidation, expressed activation of antioxidant enzymes: superoxide dismutase and catalase. By acute and chronic myocardial ischemia, Rhythmocor decreases volume of lactic acid in cardiomyocytes. By chronic coronary insufficiency, these mechanisms limit damaging influence of oxidative stress. Quite often course of IHD and angina is complicated with different heart rhythm disorders. Ventricular extrasystoles occur in 90% of such patients. This rhythm disorder develops due to primary electrical instability of myocardium caused by ischemia and reperfusion, or is secondary relatively to disorders of cardiac hemodynamics. It was proved that ionic disorders occur unidirectional by ventricular extrasystoles, and by hypokalemia hypomagnesemia develops that plays a significant role in development of these rhythm disorders. Magnesium deficiency is observed in 40% of patients treated in general therapeutic departments and in 70% of patients with acute myocardial infarction. Magnesium is a natural and physiologic calcium agonist. A main role of magnesium is proved by its cofactor influence in activity of more than 300 fermentation reactions providing energetic and other needs of a cell. By potassium deficit, changes in different organs and systems occur in the body that are manifesting as seizures, development of paralyses and paresthesias, quite often comas, decreasing blood pressure. Using of Rhythmocor in states bound with activation of free-radical processes provides decreased permeability of a cell membrane. Thanks to its properties and К+ та Мg++ ions, Rhythmocor manifests its antiarhythmic action and potentiates clinical effectiveness of other antiarhythmic medications. Magnesium ions included into the drug are natural calcium agonists, defense cells from their excessive transferring seen by a pathologic process in general, and also by arrhythmias. Magnesium ions have significance for normal generation and providing of electrical impulse. While slowing atrioventricular conduction, they can prevent reciprocal arrhythmias. By blocking of calcium channels, they suppress a ventricular tachycardia of type “pirouette”. Magnesium ions modulate activity of numerous receptors, including cardiac ones. As a cofactor they participate in more than 300 different biochemical reactions. They have a tranquilizing action on central nervous system. Potassium ions have non-specific antiarrhythmic action bound with changes of potassium permeability of a membrane. These ions inhibit ectopic automatism not influencing the sinus node function, which cells are less sensitive to their inhibiting influence.