Beck O A, Witt E, Hochrein H
Z Kardiol. 1975 Feb;64(2):179-87.
The influence of the new antiarrhythmic agent Propafenon on cardiac conduction and sinus node function was studied by using His-bundle recordings and atrial stimulation in 14 patients with normal and diseases conduction system. Intravenous administration of Propafenon in therapeutic dose (1-2 mg/kg) produced a significant prolongation of the atrioventricular conduction time. Increase of the A-H interval was observed in 13 of 14 subjects during sinus rhythm. Second degree A-V block (Wenckebach form) during atrial stimulation occurred at lower frequencies after administration of the drug. The impulse propagagion within the His-Purkinje system was depressed significantly (H-V interval in 8, H-S interval in 10 of 14 subjects). Propafenon did not cause any alteration in intraatrial conduction, but depression of the sinus node automaticity was noted. Total reversal of the drug induced prolonged atrioventricular conduction and a decrease of the sinus rate was seen after administration of orciprenaline. Beta-adrenergic receptor blocking and local anaesthetic direct membrane actions are discussed as possible cause of the prolongation of atrioventricular and intraventricular conduction.
采用希氏束电图记录和心房刺激技术,在14例传导系统正常和异常的患者中研究了新型抗心律失常药物普罗帕酮对心脏传导和窦房结功能的影响。静脉注射治疗剂量(1 - 2mg/kg)的普罗帕酮可显著延长房室传导时间。在14例受试者中的13例窦性心律时观察到A - H间期延长。给药后心房刺激时二度房室传导阻滞(文氏型)在较低频率时出现。希氏 - 浦肯野系统内的冲动传导明显受抑制(14例受试者中的8例H - V间期、10例H - S间期延长)。普罗帕酮未引起心房内传导的任何改变,但可观察到窦房结自律性降低。给予奥西那林后,药物所致的房室传导延长和窦性心率减慢完全逆转。讨论了β - 肾上腺素能受体阻滞和局部麻醉药直接的膜效应作为房室和室内传导延长的可能原因。