通过静脉注射磷酸丙吡胺的超速抑制试验评估窦房结恢复时间。

Sinus node recovery time assessment by the overdrive suppression test employing an intravenous injection of disopyramide phosphate.

作者信息

Ishikawa T, Sumita S, Kimura K, Kikuchi M, Kosuge M, Endo T, Sugano T, Sigemasa T, Usui T, Umemura S

机构信息

Second Department of Internal Medicine, Yokohama City University Urafune Hospital, Yokohama, Japan.

出版信息

Europace. 2000 Jan;2(1):54-9. doi: 10.1053/eupc.1999.0073.

DOI:10.1053/eupc.1999.0073

PMID:11225596

Abstract

Although sinus node recovery time (SNRT) assessment by the overdrive suppression test (ODST) is important in detecting sick sinus syndrome (SSS), its sensitivity is still inadequate. We have evaluated the effect of intravenous injection (i.v.) of disopyramide phosphate (DP) in ODST. The subjects were 30 SSS patients (64.9 +/- 10.0 years old). If SNRT was <2,000 ms or the corrected SNRT (CSNRT) was < 1,000 ms, ODST was repeated after DP i.v. (2 mg. kg(-1), < or = 100 mg in total). Eleven normal subjects (59.3 +/- 9.0 years old) were also studied. Although SNRT was <2,000 ms or the CSNRT was < 1,000 ms in 13 of the 30 SSS patients (43%), SNRT was prolonged from 1,510 +/- 300ms to 3,400 +/- 1,160 ms (P<0.01), and CSNRT from 510 +/- 190 to 2,470 +/- 1,470 ms (P<0.01) after DP i.v. in these patients. Thus, SNRT was > or = 2,000 ms and the CSNRT was > or = 1,000 ms in 27 of 30 SSS patients (90%) after DP i.v. Using a combination of overdrive suppression and intravenous injection of disopyramide phosphate, the corrected sinus node recovery time was diagnostic (>525 ms) in 29 of the 30 patients (97%). In contrast, SNRT and CSNRT were shortened in the normal subjects during ODST after DP i.v. (P<0.01). The plasma concentration of DP estimated in nine patients was 4.1 +/- 1.0 microg.ml(-1). No serious side effect occurred. ODST employing DP i.v. is safe and seems to be highly effective in diagnosing SSS.

摘要

尽管通过超速抑制试验（ODST）评估窦房结恢复时间（SNRT）对于检测病态窦房结综合征（SSS）很重要，但其敏感性仍不足。我们评估了静脉注射磷酸丙吡胺（DP）在ODST中的作用。受试者为30例SSS患者（年龄64.9±10.0<标准差>岁）。如果SNRT<2000毫秒或校正的SNRT（CSNRT）<1000毫秒，则在静脉注射DP（2毫克·千克-1，总量≤100毫克）后重复ODST。还研究了11名正常受试者（年龄59.3±9.0岁）。在30例SSS患者中的13例（43%）中，尽管SNRT<2000毫秒或CSNRT<1000毫秒，但这些患者静脉注射DP后，SNRT从1510±300毫秒延长至3400±1160毫秒（P<0.01），CSNRT从510±190延长至2470±1470毫秒（P<0.01）。因此，30例SSS患者中有27例（90%）静脉注射DP后SNRT≥2000毫秒且CSNRT≥1000毫秒。使用超速抑制和静脉注射磷酸丙吡胺相结合的方法，30例患者中有29例（97%）校正的窦房结恢复时间具有诊断意义（>525毫秒）。相比之下，正常受试者静脉注射DP后在ODST期间SNRT和CSNRT缩短（P<0.01）。9例患者中估计的DP血浆浓度为4.1±1.0微克·毫升-1。未发生严重副作用。静脉注射DP的ODST安全，似乎在诊断SSS方面非常有效。