Fujimura O, Klein G J, Sharma A D, Yee R, Szabo T
Department of Medicine, University Hospital, London, Ontario, Canada.
J Am Coll Cardiol. 1989 Apr;13(5):1133-7. doi: 10.1016/0735-1097(89)90275-1.
Disopyramide was administered intravenously to 54 patients during atrial fibrillation and predominantly pre-excited QRS configuration at the time of electrophysiologic study. All patients had Wolff-Parkinson-White syndrome and no patient had coexistent heart disease. The drug was given during sustained atrial fibrillation (n = 45) or during sinus rhythm before induction of atrial fibrillation for patients whose atrial fibrillation was self-terminating in the control state (n = 9). Atrial fibrillation converted to sinus rhythm within 15 min after disopyramide in 37 (82%) of the 45 patients. The shortest RR intervals between two pre-excited cycles increased from 208 +/- 42 to 293 +/- 117 ms (p less than 0.0001). The average RR interval of all cycles prolonged from 332 +/- 60 to 396 +/- 117 ms(n = 45, p less than 0.0001). The 9 patients in whom pre-excitation was abolished after the drug had a significantly longer initial shortest RR interval than that of the 36 patients in whom pre-excitation persisted (246 +/- 47 versus 199 +/- 36 ms, p = 0.0022). No patients developed significant hemodynamic or other adverse effects after disopyramide. These data support the intravenous use of disopyramide in patients with normal ventricular function who have atrial fibrillation and a predominant ventricular response over an accessory atrioventricular pathway.
在电生理研究时，对54例心房颤动且QRS波群主要呈预激形态的患者静脉注射了丙吡胺。所有患者均患有 Wolff-Parkinson-White 综合征，且无合并心脏病。在持续性心房颤动患者中（n = 45）给予该药物，对于那些在对照状态下心房颤动可自行终止的患者（n = 9），则在窦性心律时于诱发心房颤动前给予该药物。45例患者中有37例（82%）在静脉注射丙吡胺后15分钟内心房颤动转为窦性心律。两个预激周期之间最短的RR间期从208±42毫秒增加到293±117毫秒（p<0.0001）。所有周期的平均RR间期从332±60毫秒延长至396±117毫秒（n = 45，p<0.0001）。用药后预激被消除的9例患者，其初始最短RR间期明显长于预激持续存在的36例患者（246±47毫秒对199±36毫秒，p = 0.0022）。静脉注射丙吡胺后，无患者出现明显的血流动力学或其他不良反应。这些数据支持在心室功能正常、患有心房颤动且通过房室旁道有明显心室反应的患者中静脉使用丙吡胺。
