Stewart D A, Taylor J, Ghosh S, Macphee G J, Abdullah I, McLenachan J M, Stott D J
Department of Geriatric Medicine, Southern General Hospital, Glasgow, Scotland.
Eur J Clin Pharmacol. 1992;42(6):577-80. doi: 10.1007/BF00265918.
Recent reports have suggested an association between terodiline hydrochloride and cardiac arrhythmias. We report 4 patients presenting over a six month period who developed polymorphic ventricular tachycardia (polymorphic VT) while receiving treatment with this agent. In each case there was prolongation of QT interval on electrocardiogram (ECG). Two patients had hypokalaemia associated with diuretic therapy. In the 3 cases in which follow-up ECG was available, QT interval returned to normal after discontinuation of terodiline. In order to define the effects of terodiline on corrected QT interval (QTc) and heart rate in the elderly, a prospective study was performed in 8 elderly in-patients treated with terodiline for urinary incontinence. After 7 days treatment with terodiline 12.5 mg twice daily, there was a significant increase in QT by a mean of 29 ms, QTc by 15 ms and a decrease in resting heart rate by a mean of 6.7 beats.min-1. Terodiline increases QTc and reduces resting heart rate in elderly patients. Both these effects may be associated with polymorphic VT, a potentially life threatening arrhythmia. This drug should be avoided in patients with other known risk factors for polymorphic VT, particularly hypokalaemia and cardiac disease.
近期报告提示盐酸特罗地林与心律失常之间存在关联。我们报告了在6个月期间出现的4例患者，他们在接受该药物治疗时发生了多形性室性心动过速（多形性室速）。每例患者心电图（ECG）均显示QT间期延长。2例患者因利尿治疗出现低钾血症。在有后续心电图的3例患者中，停用特罗地林后QT间期恢复正常。为明确特罗地林对老年人校正QT间期（QTc）和心率的影响，对8例因尿失禁接受特罗地林治疗的老年住院患者进行了一项前瞻性研究。每日2次服用12.5 mg特罗地林治疗7天后，QT平均显著增加29 ms，QTc增加15 ms，静息心率平均降低6.7次/分钟。特罗地林可增加老年患者的QTc并降低静息心率。这两种效应都可能与多形性室速有关，多形性室速是一种有潜在生命危险的心律失常。对于有其他已知多形性室速危险因素的患者，尤其是低钾血症和心脏病患者，应避免使用该药物。
