RU2110297C1 - Method for treating the patients possessing sinus node asthenia - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: method involves exposing precardial area to infrared laser radiation and permanent magnetic field at the same time. First of all, the III intercostal zone is exposed to treatment and then the radiator unit is moved in sequence to IV intercostal zone in parasternal position from the right side, to apex cordis, right interscapular region at the level of the fifth thoracic vertebra. The treatment is applied in daily mode under power density of at least 4 mW/cm², magnetic field induction of 10-14 mTesla with 15 procedures per course. EFFECT: enhanced effectiveness of treatment.

Description

 The invention relates to medicine, namely to physiotherapy and cardiology. It relates to a method of treating patients with sinus node weakness syndrome and cardiac conduction system in the form of pathological sinus bradycardia, atrial rhythm source migration, atrioventricular dissociation, and ventricular and supraventricular extrasystoles functioning at this background, paroxysms of atrial fibrillation and flutter.

 Complicated cardiac arrhythmias in the form of paroxysmal tachyarrhythmias and tachycardia, frequent polytopic extrasystoles, including allorhythmic extrasystoles, stable atrial fibrillation are serious restrictions on the appointment of physiotherapeutic procedures.

 We are not aware of the work and, accordingly, the recommendations on the use of physiotherapeutic methods for the treatment of complex cardiac arrhythmias and, in particular, those that are part of the syndrome of weakness of the sinus node and the cardiac conduction system.

 Virtually insurmountable difficulties for medical correction are cardiac dysrhythmias in patients with sinus node weakness syndrome.

 There is a method of treating extrasystolic arrhythmias in patients with coronary artery disease by intracardiac exposure to laser radiation and the paroxysmal form of atrial flutter in patients with coronary artery disease by intravenous irradiation of blood using a helium-neon laser.

 Closest to the proposed method is the treatment of arrhythmias in coronary artery disease in an experiment by introducing lidocaine, in which to prevent complications and completely restore the heart rhythm, they simultaneously affect the precardial region with 4 W pulsed laser radiation, a frequency of 4.5-5 Hz and continuous infrared radiation with a power of 50 mW in a constant magnetic field with an induction of 40 mT for 5 min (ed. St. USSR N 1816458, class A 61 N 5/06, 1993).

 The set of essential features of this method includes the use of physical factors against the background of the introduction of a drug - lidocaine, which is class 1B antiarrhythmic (Vidal Handbook "Medicinal Products in Russia", M., 1995, pp. 571-572) and may be isolated in some cases used to stop rhythm disturbances (ventricular extrasystoles, ventricular tachycardia).

 However, lidocaine is contraindicated (Metelitsa VN Handbook of a cardiologist in clinical pharmacology. M., 1987, p. 115) with weakness (dysfunction) of the sinus node in elderly patients. With severe bradycardia and with AV blockade of the II-III degree. Lidocaine is also not used for flutter and atrial fibrillation due to the risk of increased ventricular contractions (Metelitsa V.N. 1997, Vidal Handbook 1995). Thus, this method is not applicable in the treatment of patients with sinus node weakness syndrome (SSS) against coronary heart disease and does not apply to the treatment of cardiac arrhythmias in the framework of SSS and the cardiac conduction system, developing in non-coronarogenic myocardial diseases.

 The purpose of the present invention is the elimination of cardiac arrhythmias and the prevention of their recurrence in patients with sinus node weakness syndrome by affecting the precardial region with magnetic laser radiation.

The stated goal is achieved by the fact that the precardial region is simultaneously exposed to infrared laser radiation and a constant magnetic field initially on the third intercostal space parasternally on the right, and then successively moving the emitter on the fourth intercostal space parasternally on the right, the apex of the heart, the right interscapular region at the level of the fifth thoracic vertebra for 4 daily with a power density of at least 4 mW / cm ² , magnetic field induction of 10-40 mT, for a course of 15 procedures.

 A feature of the proposed method of treatment is the possibility of a high effect of eliminating cardiac arrhythmias and preventing their recurrence in patients with CVS, regardless of the presence of IHD. So, among the observed patients, only 15% of CVS and dysrhythmia (including paroxysmal forms of blinking, atrial flutter, grade II AV block and severe bradycardia) developed against the background of IHD. In all the others, including in the examples cited above, CVS and heart rhythm and conduction disturbances developed against the background of myocardial dystrophy, neurocirculatory dystonia, or had an idiopathic character. It is these rhythm disturbances that are the most difficult for medical correction, and according to S.S. Grigorova (1987), M.S. Kushakovsky (1992), the main method of treatment of CVS and cardiac arrhythmias developing in the framework of this syndrome is surgical, namely implantation of a pacemaker, because This is a category of patients of young working age with a high probability of sudden death.

 The method is as follows. The patient is on the couch lying on his back. The sensor of the device for magnetic laser therapy AMLT-01 is placed on the chest in region 3 of the intercostal space, parasternally on the right and irradiated with laser light and a constant magnetic field for 4 minutes Then the sensor is transferred to the second zone of exposure - in the 4 intercostal space parasternally on the right - and irradiation is carried out for another 4 minutes The next zone of influence is the region of the apex of the heart and the last is the right interscapular region at the level of the fifth thoracic vertebra. When exposed to the last zone, the patient is on a couch lying on his stomach. Thus, all four zones are sequentially irradiated. The course of treatment is 15 procedures, one procedure per day.

 Clinical trials of a method for treating patients with SSSU were carried out in the therapeutic clinic of the institute during 1990-1994, which is confirmed by case histories of 39 patients.

 Example 1. Patient Peninsula, 25 years old, East. b-ni N 328, was admitted on 02.27.90 to the clinic of the institute with a diagnosis of vegetovascular dystonia. Syndrome of autonomic depression of the sinus node and cardiac conduction system: sinus bradycardia, atrial rhythm migration. Slowing of atrioventricular conduction, frequent polytopic supraventricular extrasystole. At admission, he complained of bouts of severe weakness, rare palpitations, interruptions in the work of the heart, discomfort in the region of the heart. When instrumental research is established. ECG. Sinus rhythm 40 beats / min. Frequent supraventricular extrasystole (single, paired, episodes of bigeminia). Atrial source migration. AV block 1 degree. Transesophageal electrocardiostimulation (CPEX). Initially: sinus rhythm T = 1400 mS, PQ = 240 mS, AV = 220 mS. During stimulation with frequencies of 70-90-100 cpm before each 2-minute series of stimuli, the duration of the cardio intervals (T) changed as follows: 1240-1600-1560 ms; the registered maximum value of the recovery time of the function of the sinus node (VVFSU) was 3840 ms; corrected time of restoration of the function of the sinus node (KVVFSU): 2240 ms. At the same time, sinoatrial conduction (VSAP) ranged up to 1140 mS. The Wenckebach point was 120 cpm. The patient received 15 procedures of magnetic laser therapy in the region of the heart, which he tolerated well. After treatment, the patient noted an improvement in overall health, greater tolerance to physical activity.

 According to additional survey methods.

 ECG. Sinus rhythm heart rate = 50 beats / min. There is no recorded extrasystole and atrial rhythm migration. CHPEX. Initially: periodic sinoatrial block with shortened cardiointerval before falling out. T = 1000 mS, PQ = 240 mS, AV = 220 mS. During stimulation with frequencies of 70-90-100, the duration of the cardio intervals before each 2-minute series of stimuli changed as follows: 1000-1080-920 mS, respectively, VVFSU up to 2040, KVVFSU up to 1040 and VSAP up to 250 mS, Wenckebach point 140 imp / min. Thus, immediately after the course of treatment, the patient noted a decrease in the degree of sinus bradycardia, the disappearance of migration of the rhythm source (MIR) and extrasystole, favorable dynamics of the CPEX indicators, characterizing the activation of the automatism function of the sinus node and the improvement of AV conduction. The patient was discharged with improvement. Until 1993, he did not turn to doctors for heart disease.

 Example 2. Patient S. v.A. N.I., 50 years old (source no. N 232, was received on March 9, 1992). Was in the clinic of the Institute with a diagnosis of myocardial dystrophy of neurovegetative origin. Sinus node depression syndrome and AV connection. Paroxysmal form of atrial flutter. Ventricular parasystole. Upon admission, she complained of general weakness, fatigue, dizziness, heart attacks up to 2-3 times a day with little physical activity, short-term (up to 10 minutes), which stopped on their own. ECG out of attack. Sinus rhythm with a frequency of 58 beats / min. PQ = 180 ms. Extraordinary contractions of the ventricles. ECG during an attack. Paroxysm of atrial flutter with ventricular conduction 3: 1, FF = 220 mS, average ventricular contraction rate of 100-120 beats / min. CPEX data. Initially: sinus rhythm 57 beats / min, T = 1040 mS, PQ = 200 mS, AV = 160 mS. Ventricular parasystole. During stimulation, the maximum values are T = 1060 mS, VVFSU = 1760 mS, KVVFSU = 700 mS, ventricular parasystoles are recorded; Wenckebach point - 100 imp / min. The patient received a course of magnetic laser therapy, including 15 procedures on the precardial region. It was well tolerated. After 10 sessions, she noted the cessation of rhythm disruptions, which did not resume until the end of the hospitalization period. CPEX data after treatment. Initially: sinus rhythm, T = 1220 mS, PQ = 200 mS, AV = 190 mS. Rare ventricular parasystoles. When stimulated at frequencies of 70-80-90-100 cpm, the maximum duration of the cardio interval is 1160 mS, VVFSU = 1560 mS, KVVFSU = 400 mS, VSAP = 170 mS, the Wenckebach point is 120 cpm. Recovery through ventricular parasystoles was not recorded. The data presented indicate that immediately after the course of treatment, the patient completely stopped having atrial flutter, the number of parasystoles decreased, and impulse conduction through the atrioventricular system improved. The patient was discharged with improvement. The results of follow-up studies show that in this patient, rhythm disturbances did not resume within 4 months, then reappeared against the background of nervous load with a frequency of 1 time per week and disturbed the patient for two months. After that, until May 1993 (10 months), the patient did not observe any cardiac arrhythmias.

 Thus, the use of magnetic laser therapy can improve the function of the sinus node and the cardiac conduction system, eliminate cardiac arrhythmias and prevent their recurrence in patients with sinus node weakness syndrome. The method can be combined with drug treatment of the main pathology of the heart (coronary heart disease, myocardial dystrophy (MCD), neurocirculatory dystonia (NCD)), so it can be a method of monophysiotherapy of the sinus node weakness syndrome and the pathology underlying it.

Claims (1)

A method of treating patients with sinus node weakness syndrome, including simultaneous exposure to the precardial region with infrared laser radiation and a constant magnetic field, characterized in that it initially acts on the third intercostal space parasternally to the right, and then sequentially moves the emitter to the fourth intercostal space parasternally on the right, the apex of the heart, right the interscapular region at the level of the fifth thoracic vertebra for 4 min daily with a power density of at least 4 mW / cm ² , magnetic field induction of 10 - 40 mT on a course of 15 procedures.