Kühlkamp V, Ickrath O, Haasis R, Seipel L
Abteilung Innere Medizin III, Eberhard-Karls-Universität Tübingen.
Z Kardiol. 1988 Aug;77(8):527-33.
The electrophysiologic effects of the beta-1 selective beta adrenergic blocking drug Betaxolol were investigated after intravenous (0.15 mg/kg body weight) and oral (20 mg/day) administration in 11 patients with atrioventricular-nodal reentrant tachycardia. Betaxolol significantly (p less than 0.01) prolonged cycle length, sinus node recovery time, AH-interval, as well as the antegrade functional refractory period of the slow and fast AV-nodal pathway. The effective refractory period of the fast AV-nodal pathway was also markedly increased (p less than 0.05). In only six patients could the effective refractory period of the slow AV-nodal pathway be determined; in the other patients, it was shorter than the effective refractory period of the atrium. The effective refractory period of the atrium and the ventricle was not significantly altered by Betaxolol. Intravenous administration of Betaxolol suppressed induction of tachycardia in eight patients, whereas after oral Betaxolol, tachycardia was not inducible in ten patients. Betaxolol prevented induction of tachycardia in two patients by prolonging antegrade conduction over the slow AV-nodal pathway. The retrograde fast AV-nodal pathway was blocked in eight patients. Presumably the increased effectiveness of oral Betaxolol can be attributed to higher Betaxolol plasma concentrations, reached after oral treatment (58 +/- 38 ng/ml), as compared to intravenous administration (40 +/- 40 ng/ml). There were no false positive results after intravenous testing of Betaxolol.
在11例房室结折返性心动过速患者中,静脉注射(0.15mg/kg体重)和口服(20mg/天)β1选择性β肾上腺素能阻滞剂倍他洛尔后,研究了其电生理效应。倍他洛尔显著(p<0.01)延长了心动周期长度、窦房结恢复时间、AH间期以及慢、快房室结通路的前向功能不应期。快房室结通路的有效不应期也明显延长(p<0.05)。仅在6例患者中可测定慢房室结通路的有效不应期;在其他患者中,其短于心房的有效不应期。倍他洛尔对心房和心室的有效不应期无明显改变。静脉注射倍他洛尔可抑制8例患者的心动过速诱发,而口服倍他洛尔后,10例患者的心动过速不能被诱发。倍他洛尔通过延长慢房室结通路的前向传导,防止了2例患者的心动过速诱发。8例患者的逆向快房室结通路被阻断。推测口服倍他洛尔有效性增加可归因于口服治疗后达到的较高倍他洛尔血浆浓度(58±38ng/ml),相比静脉注射(40±40ng/ml)。倍他洛尔静脉试验后无假阳性结果。