Gear K, Marcus F I, Huang S K, Fenster P E, Appleton C, Moeller V, Renaud G, Serokman R
Am J Cardiol. 1986 Apr 15;57(11):947-9. doi: 10.1016/0002-9149(86)90736-8.
Twenty patients with an average of more than 30 ventricular premature complexes (VPCs) per hour were treated with ethmozine. Eighteen had either not responded or had adverse reactions to at least 1 other antiarrhythmic drug. Patients were treated with 200 to 300 mg 3 times daily (8.25 to 11.7 mg/kg) and were followed for up to 6 months. Three patients were withdrawn from ethmozine therapy because of unwanted effects before evaluation of efficacy. One of these patients had sustained ventricular tachycardia (VT) after a loading dose of ethmozine. Eleven of the remaining 17 patients (65%) experienced more than a 75% reduction in ventricular ectopic activity. Six patients had a smaller or no decrease in VPC frequency. Eleven of 16 patients (68%) with paired VPCs had a more than 90% reduction in paired VPC frequency. Eleven of 13 patients (84%) with VT events of 3 beats or more had more than a 90% reduction in VT events. Of the 11 patients in whom a more than 75% reduction in VPC frequency occurred, 1 patient died suddenly after 133 days of effective drug therapy. Three patients discontinued ethmozine therapy for reasons not related to the drug. Of the 6 patients in whom there was less than a 75% reduction in VPC frequency, 2 patients discontinued treatment, 1 patient because of hyperanxiety and 1 because of drug-related left anterior hemiblock. Ethmozine lengthened PR and QRS intervals but not the JT interval. Thus, ethmozine is effective and clinically useful for suppression of frequency VPCs in 50% (10 of 20 patients) of a selected population.
20例每小时平均有超过30次室性早搏(VPC)的患者接受了乙吗噻嗪治疗。其中18例对至少1种其他抗心律失常药物无反应或有不良反应。患者每日3次服用200至300毫克(8.25至11.7毫克/千克),随访长达6个月。3例患者在评估疗效前因不良反应而停止乙吗噻嗪治疗。其中1例患者在负荷剂量乙吗噻嗪后发生持续性室性心动过速(VT)。其余17例患者中有11例(65%)室性异位活动减少超过75%。6例患者的室性早搏频率降低较小或未降低。16例成对室性早搏患者中有11例(68%)成对室性早搏频率降低超过90%。13例有3次或更多次室性心动过速发作的患者中有11例(84%)室性心动过速发作减少超过90%。在室性早搏频率降低超过75%的11例患者中,1例在有效药物治疗133天后突然死亡。3例患者因与药物无关的原因停止乙吗噻嗪治疗。在室性早搏频率降低不足75%的6例患者中,2例停止治疗,1例因高度焦虑,1例因药物相关的左前分支阻滞。乙吗噻嗪延长了PR和QRS间期,但未延长JT间期。因此,乙吗噻嗪对选定人群中50%(20例中的10例)的室性早搏频率抑制有效且具有临床实用性。