Manz M, Lüderitz B
Medizinische Universitätsklinik, Innere Medizin--Kardiologie, Bonn.
Dtsch Med Wochenschr. 1988 Aug 26;113(34):1317-21. doi: 10.1055/s-2008-1067813.
The efficacy of ajmaline (50-75 mg i.v.) or lidocaine (100-200 mg i.v.) in terminating persistent, haemodynamically stable ventricular tachycardia (VT) was compared in a prospective, randomized trial of 31 patients. There were no significant differences as to age, underlying heart disease, ejection fraction and rate of ventricular tachycardia between the two treatment groups. Ajmaline terminated VT in 10 of the 15 patients receiving it, lidocaine in only 2 of 16 (P less than 0.01). The frequency of VT was not significantly changed by lidocaine, while mean cycle length during VT changed under ajmaline from 369 +/- 82 ms to 452 +/- 11 ms (P less than 0.01). In contrast to lidocaine, QRS duration under ajmaline lengthened from 166 +/- 18 ms to 200 ms +/- 28 ms (P less than 0.01), but return cycles after tachycardia termination were similar (ajmaline, 863 +/- 296 ms; lidocaine, 917 +/- 367 ms). Both drugs were equally well tolerated, but in this series ajmaline was more effective in the acute treatment of persistent VT.
在一项针对31例患者的前瞻性随机试验中，比较了阿义马林（静脉注射50 - 75毫克）或利多卡因（静脉注射100 - 200毫克）终止持续性、血流动力学稳定的室性心动过速（VT）的疗效。两个治疗组在年龄、基础心脏病、射血分数和室性心动过速发生率方面无显著差异。在接受阿义马林治疗的15例患者中，有10例VT被终止；而在接受利多卡因治疗的16例患者中，仅有2例VT被终止（P<0.01）。利多卡因未显著改变VT的频率，而阿义马林治疗期间VT的平均周期长度从369±82毫秒变为452±11毫秒（P<0.01）。与利多卡因不同，阿义马林治疗时QRS时限从166±18毫秒延长至200±28毫秒（P<0.01），但心动过速终止后的折返周期相似（阿义马林，863±296毫秒；利多卡因，917±367毫秒）。两种药物的耐受性相当，但在本系列研究中，阿义马林在急性治疗持续性VT方面更有效。
