Shiga Tsuyoshi, Matsuda Naoki, Fuda Yuji, Haruta Shoji, Hagiwara Nobuhisa, Kasanuki Hiroshi
Department of Cardiology, Heart Institute of Japan, Tokyo Women's Medical University, Kawada-cho 8-1, Shinjuku-ku, Tokyo 162-8666.
J Cardiol. 2002 Mar;39(3):159-64.
Nifekalant is a class III antiarrhythmic drug, which prolongs the refractory period of the atrial and ventricular myocardium, without negative inotropic action. Intravenous nifekalant was administered in four patients with atrial tachyarrhythmia and severe heart failure to terminate or prevent atrial tachyarrhythmia.
Two of three episodes of atrial tachyarrhythmia were terminated by intravenous nifekalant (0.22 to 0.30 mg/kg) administration. Continuous intravenous infusion of nifekalant (0.15 to 0.40 mg/kg/hr) during six episodes to maintain the sinus rhythm, prevented recurrence of atrial tachyarrhythmia in five episodes in which prolongation of the QTc interval was observed to more than 450 msec. None of the patients showed worsening of the hemodynamics during treatment. One patient developed polymorphic ventricular tachycardia, which deteriorated into ventricular fibrillation.
Nifekalant may be effective for treating atrial tachyarrhythmia in patients with severe heart failure. Further clinical studies are needed to confirm these findings.
尼非卡兰是一种Ⅲ类抗心律失常药物，可延长心房和心室心肌的不应期，且无负性肌力作用。对4例房性快速心律失常合并严重心力衰竭患者静脉给予尼非卡兰，以终止或预防房性快速心律失常。
3次房性快速心律失常发作中有2次通过静脉给予尼非卡兰（0.22至0.30mg/kg）而终止。在6次发作期间持续静脉输注尼非卡兰（0.15至0.40mg/kg/小时）以维持窦性心律，在5次发作中预防了房性快速心律失常的复发，其中观察到QTc间期延长至450毫秒以上。治疗期间无一例患者出现血流动力学恶化。1例患者发生多形性室性心动过速，进而恶化为心室颤动。
尼非卡兰可能对治疗严重心力衰竭患者的房性快速心律失常有效。需要进一步的临床研究来证实这些发现。
