Tsagalou Eleftheria P, Anastasiou-Nana Maria I, Charitos Christos E, Siafakas Costantinos X, Drakos Stavros G, Ntalianis Argirios, Terrovitis John V, Mavrikakis Emmanuel M, Doufas Antonios, Nanas John N
Department of Clinical Therapeutics, University of Athens School of Medicine, Alexandra Hospital, Makedonias 24, 104 33 Athens, Greece.
Resuscitation. 2004 Apr;61(1):83-9. doi: 10.1016/j.resuscitation.2003.12.003.
Experimental studies have described an increase in ventricular fibrillation threshold (VFT) by intravenous amiodarone. The aim of this study was to examine the early time course of changes in VFT and defibrillation thresholds (DFT) after an intravenous bolus of amiodarone in an experimental pig model of transient myocardial ischemia.
VFT and relative effective ventricular refractory period (ERP) were measured in 15 anaesthetized open-chest pigs after 3 min of regional coronary ischaemia before (time 0) and 2, 15, 30, 60, and 90 min after the intravenous injection of normal saline (group A, n = 5) or amiodarone, 5 mg/kg over 15 s (group B, n = 10). DFT was measured by increasing the strength of DC shocks until defibrillation was accomplished. Amiodarone caused an increase in VFT, starting at 2 min after the infusion (11.4 +/- 8.4 mA versus 9.2 +/- 4.6 mA, P = 0.03), became significant at 15 min (13.7 +/- 6.5 mA, P = 0.009), continued to rise at 30 min (34.2 +/- 28.7 mA, P = 0.03) and reached a plateau at 60 min (50.3 +/- 37.8 mA, P = 0.008). An increase was also observed in the ERP (204 +/- 25 ms at 2 min versus 197 +/- 26 ms at baseline, P = 0.074, 211 +/- 38 ms at 15 min, P = 0.084, 212 +/- 40 ms at 30 min, P = 0.037, 220 +/- 34 ms at 60 min, P = 0.002, and 227 +/- 32 ms at 90 min, P = 0.008). No change was observed in DFT after amiodarone administration. No significant change in VFT, ERP, or DFT occurred in the control group.
In this porcine model, the intravenous administration of amiodarone increased VFT and ERP over 60 min after the injection, without effect on DFT.
实验研究表明静脉注射胺碘酮可提高室颤阈值（VFT）。本研究旨在探讨在短暂性心肌缺血的实验猪模型中静脉推注胺碘酮后VFT和除颤阈值（DFT）变化的早期时间进程。
在15只麻醉开胸猪中，于局部冠状动脉缺血3分钟后（时间0）以及静脉注射生理盐水（A组，n = 5）或15秒内注射5mg/kg胺碘酮（B组，n = 10）后的2、15、30、60和90分钟测量VFT和相对有效心室不应期（ERP）。通过增加直流电击强度直至除颤成功来测量DFT。胺碘酮使VFT升高，输注后2分钟开始升高（11.4±8.4mA对9.2±4.6mA，P = 0.03），15分钟时显著升高（13.7±6.5mA，P = 0.009），30分钟时继续升高（34.2±28.7mA，P = 0.03），60分钟时达到平台期（50.3±37.8mA，P = 0.008）。ERP也有升高（2分钟时为204±25ms，基线时为197±26ms，P = 0.074；15分钟时为211±38ms，P = 0.084；30分钟时为212±40ms，P = 0.037；60分钟时为220±34ms，P = 0.002；90分钟时为227±32ms，P = 0.008）。胺碘酮给药后DFT未观察到变化。对照组的VFT、ERP或DFT无显著变化。
在该猪模型中，静脉注射胺碘酮后60分钟内可提高VFT和ERP，对DFT无影响。
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