Chinushi Masaomi, Furushima Hiroshi, Hosaka Yukio, Komura Satoru, Sato Akinori, Iijima Kenichi, Aizawa Yoshifusa
School of Health Science, Niigata University, Japan.
Intern Med. 2011;50(16):1695-702. doi: 10.2169/internalmedicine.50.5114. Epub 2011 Aug 15.
We injected acetylcholine (Ach) into the coronary artery to ascertain whether coronary vasospasm contributed to the syncopal events or chest oppression suffered by 3 patients with long QT syndrome (LQTS). During the test, a quadripolar electrode catheter was placed in the right ventricle and the activation-recovery interval was reanalyzed from the stored data. Intracoronary Ach transiently prolonged the QT intervals in all 3 patients without inducing coronary vasospasm. The Ach-induced QT prolongation was associated with enhanced spatial and temporal dispersion of intra-ventricular repolarization. The electrophysiological abnormalities were consistent with the putative arrhythmogenic mechanisms identified in experimental studies of LQTS.
我们向冠状动脉内注射乙酰胆碱（Ach），以确定冠状动脉痉挛是否导致了3例长QT综合征（LQTS）患者出现的晕厥事件或胸部压迫感。在测试过程中，将四极电极导管置于右心室，并从存储的数据中重新分析激活-恢复间期。冠状动脉内注射Ach可使所有3例患者的QT间期短暂延长，且未诱发冠状动脉痉挛。Ach诱发的QT间期延长与心室内复极的空间和时间离散度增加有关。电生理异常与LQTS实验研究中确定的假定致心律失常机制一致。
