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伊布利特对犬心率的抑制及快速终止心房扑动的研究

[The study of inhibiting heart rate and rapidly terminating atrial flutter of ibutilide on canine].

作者信息

Sun Jian-ling, Li Xiao-ying, Guo Ji-hong, Liu Peng, Zhang Ping, Yi Zhong

机构信息

Department of Geriatric Cardiology, Chinese PLA General Hospital, Beijing 100853, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2009 Oct;37(10):920-4.

Abstract

OBJECTIVE

To observe the electrophysiological effects of ibutilide on canine and to explore the potential mechanisms of ibutilide on terminating atrial flutter.

METHODS

Eighteen mongrel dogs were anesthetized and intubated. The heart was exposed through thoracotomy for electrodes implantation. The electrophysiologic variables (heart rate, the conduction of intraatrium and interatrium, the conduction ratio of isthmus, the effective refractory period) were measured in the absence or presence of ibutilide (10 minute infusion with 0.10 mg/kg ibutilide, 30 minutes later with a maintaining dose of 0.01 mg/min).

RESULTS

Ibutilide significant suppressed sinus atrial node function, the peak effect was observed at 20 - 30 min post drug infusion and heart rate returned to normal at 2 hours post infusion. Post ibutilide infusion, 1 canine developed sinus pause for 5 seconds and 2:1 atrioventricular conduction block was evidenced in another canine. The atrial, ventricular and pulmonary vein effective refractory periods were all significant prolonged (all P < 0.05) post ibutilide infusion. However, conduction of intraatrium, interatrium and isthmus remained unchanged post ibutilide infusion (all P > 0.05).

CONCLUSIONS

Ibutilide could suppress sinus atrial node and the atrioventricular node function. The mechanism of ibutilide on rapidly terminating atrial flutter might be related to the prolongation of the refractory periods which might then result in the reduction of the whole excitable gap of the reentrant circuit and induce proceed inability of reentrant wavefront.

摘要

目的

观察伊布利特对犬的电生理作用,探讨伊布利特终止心房扑动的潜在机制。

方法

18只杂种犬麻醉后插管。通过开胸暴露心脏以植入电极。在给予或不给予伊布利特(以0.10mg/kg伊布利特静脉输注10分钟,30分钟后以0.01mg/min的维持剂量)的情况下测量电生理变量(心率、心房内和心房间传导、峡部传导率、有效不应期)。

结果

伊布利特显著抑制窦房结功能,在药物输注后20 - 30分钟观察到峰值效应,输注后2小时心率恢复正常。输注伊布利特后,1只犬出现5秒的窦性停搏,另1只犬出现2:1房室传导阻滞。输注伊布利特后,心房、心室和肺静脉有效不应期均显著延长(均P < 0.05)。然而,输注伊布利特后心房内、心房间和峡部的传导保持不变(均P > 0.05)。

结论

伊布利特可抑制窦房结和房室结功能。伊布利特快速终止心房扑动的机制可能与不应期延长有关,这可能导致折返环整个可兴奋间隙减小并诱导折返波前进展无能。

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