Garratt C, Antoniou A, Ward D, Camm A J
Department of Cardiological Sciences, St George's Hospital Medical School, London.
Lancet. 1989 Feb 18;1(8634):367-9. doi: 10.1016/s0140-6736(89)91734-0.
Of 18 patients who attended accident and emergency departments with pre-excited atrial fibrillation, 10 were inappropriately treated with intravenous verapamil. The reason for the inappropriate treatment was misdiagnosis of the arrhythmia, although diagnostic electrocardiograms were available for all patients: in only 3 of the 18 patients was the correct diagnosis made before intervention. Misdiagnosis occurred because of failure to consider pre-excitation as a possible diagnosis, rather than bias towards a single alternative arrhythmia. The use of intravenous verapamil was associated with deterioration in the clinical condition of 6 patients and continued arrhythmia in all 10.
在18例因预激综合征合并心房颤动而就诊于急诊科的患者中，有10例接受了不适当的静脉维拉帕米治疗。治疗不当的原因是心律失常误诊，尽管所有患者均有诊断性心电图：18例患者中只有3例在干预前做出了正确诊断。误诊是因为未能将预激综合征视为可能的诊断，而不是偏向于单一的替代心律失常。静脉使用维拉帕米导致6例患者临床状况恶化，所有10例患者心律失常持续存在。
