Department of Clinical Neuroscience, Division of Neurology, Karolinska Hospital, Stockholm, Sweden.
Epilepsia. 1997 Nov;38(11 Suppl):S48-51. doi: 10.1111/j.1528-1157.1997.tb06128.x.
This article reviews the clinical evidence for cardiac arrhythmias and alterations in heart rate variability (HRV) induced by antiepileptic drugs (AEDs). The medical literature was searched for cases with documented arrhythmias induced by AEDs at therapeutic doses, for systematic studies of the prevalence of arrhythmias related to AED therapy, and for studies on HRV in relation to AED treatment. Phenytoin has been associated predominantly with bradyarrhythmias, some of which were fatal. This has occurred almost exclusively with i.v. administration of the drug. Several reports demonstrate car-bamazepine's depressant effects on the cardiac conduction system. This has occurred mainly in the elderly or in otherwise predisposed patients. There were no reports of arrhythmias induced by other AEDs. Although information on HRV is scarce, treatment with carbamazepine appears to be associated with a decreased HRV. AED-induced cardiac arrhythmias are rare and occur mainly in patient populations different from those with a high incidence of sudden unexpected death. Further studies of HRV and AEDs are needed.
这篇文章回顾了抗癫痫药物（AEDs）引起的心律失常和心率变异性（HRV）改变的临床证据。检索了医学文献中记录的在治疗剂量下由 AED 引起的心律失常病例，以及关于与 AED 治疗相关的心律失常患病率的系统研究，以及与 AED 治疗相关的 HRV 研究。苯妥英主要与心动过缓性心律失常有关，其中一些是致命的。这种情况几乎只发生在静脉注射药物时。有几份报告表明卡马西平对心脏传导系统有抑制作用。这种情况主要发生在老年人或其他易患病人群中。没有其他 AED 引起心律失常的报告。尽管关于 HRV 的信息很少，但卡马西平治疗似乎与 HRV 降低有关。AED 引起的心律失常很少见，主要发生在与突发性意外死亡发生率高的患者人群不同的患者人群中。需要进一步研究 HRV 和 AED。
