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维拉帕米预防心肌梗死急性期心室颤动的疗效

[Efficacy of verapamil in the prevention of ventricular fibrillation in the acute phase of myocardial infarction].

作者信息

Rolli A, Favaro L, Finardi A, Aurier E, Bonatti V, Botti G

机构信息

Divisione di cardiologia, Ospedale regionale, Parma, Italia.

出版信息

Arch Mal Coeur Vaiss. 1988 Jul;81(7):907-11.

PMID:2461179
Abstract

The effectiveness of verapamil in preventing ventricular fibrillation caused by coronary occlusion or reperfusion has been well demonstrated in animal studies, but these experimental data have not yet been confirmed in man. In this study we evaluated the prevalence of ventricular arrhythmias (fibrillation, sustained tachycardia and frequent extrasystoles) in patients hospitalized for myocardial infarction and treated with or without verapamil. The records of patients admitted to our Coronary Intensive Care unit during a 5-year period were analyzed retrospectively. Strict selection criteria enabled us to divide our patients into two homogeneous groups. The control group (group A) consisted of 106 patients who received only continuous infusions of heparin. The treated group (group B) comprised 89 patients who received exclusively verapamil by intravenous injections followed by continuous infusions. The prevalence of ventricular arrhythmia of all types was significantly lower in group B (22 p. 100) than in group A patients (71 p. 100; p less than 0.001). Episodes of ventricular fibrillation, in particular, were considerably less frequent in group B patients (1 p. 100) than in group A patients (13 p. 100; p less than 0.001). It would appear from these results that verapamil is highly effective in preventing death due to cardiac arrhythmia in the acute phase of myocardial infarction.

摘要

在动物研究中,维拉帕米预防冠状动脉闭塞或再灌注所致心室颤动的有效性已得到充分证实,但这些实验数据尚未在人体中得到验证。在本研究中,我们评估了因心肌梗死住院且接受或未接受维拉帕米治疗的患者室性心律失常(颤动、持续性心动过速和频发期前收缩)的发生率。回顾性分析了5年间入住我们冠心病重症监护病房患者的记录。严格的入选标准使我们能够将患者分为两个同质组。对照组(A组)由106例仅接受肝素持续静脉输注的患者组成。治疗组(B组)包括89例仅通过静脉注射随后持续输注维拉帕米的患者。B组所有类型室性心律失常的发生率(22%)显著低于A组患者(71%;P<0.001)。尤其是,B组患者心室颤动发作频率(1%)远低于A组患者(1%;P<0.001)。从这些结果来看,维拉帕米在预防心肌梗死急性期因心律失常导致的死亡方面非常有效。

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