Sellers T D, Kirchhoffer J B, Modesto T A
Prog Clin Biol Res. 1987;230:283-99.
The efficacy and side-effects of adenosine for treatment of supraventricular arrhythmias were compared to verapamil therapy in patients presenting to the emergency room. Clinical variables and the time interval from the initiation of treatment to the termination of the supraventricular tachycardia, as well as the time from the initial effective dose of medication to the termination of supraventricular tachycardia were compared for adenosine and verapamil. Adenosine was given to a total of 44 patients, 16 patients in the electrophysiology laboratory, and 28 patients in the emergency room for evaluation and termination of their tachycardia. In the electrophysiology laboratory, 7 patients had AV node reentry, 5 had Wolff-Parkinson-White syndrome, 2 of whom had atrial flutter and fibrillation but no bypass tract reentry, 1 had concealed bypass tract reentry, 1 had Lown-Ganong-Levine syndrome, 1 had intraatrial reentry, and 1 had an automatic atrial tachycardia. Twenty-five patients received adenosine in the emergency room and 3 patients in the hospital for 31 episodes of supraventricular arrhythmias. In the emergency room, 11 patients had supraventricular tachycardia due to AV node reentry, 3 had Wolff-Parkinson-White syndrome, 6 had atrial flutter or intra-atrial re-entry, 2 had ventricular tachycardia, and 3 had sinus tachycardia. In the hospital, 2 patients had atrial flutter and one had sinus tachycardia. The group of 14 patients with supraventricular tachycardia due to Wolff-Parkinson-White syndrome or AV node reentry presenting in the emergency room were compared in a retrospective manner to the patients treated with standard verapamil therapy with respect to time from initiation of therapy to termination of supraventricular tachycardia and time from effective dose of medication to the termination of supraventricular tachycardia, as well as side-effects. There was no significant difference between the two groups with respect to clinical variables. Adenosine converted 18 of 18 episodes of supraventricular tachycardia in 14 patients 24.6 +/- 9.6 seconds from the administration of the effective dose (0.104 +/- 0.024 mg/kg) and a mean of 4.4 +/- 2.0 minutes from the initiation of therapy. Verapamil converted 29 of 32 episodes of supraventricular tachycardia in 20 patients, 10.9 +/- 7 minutes from the administration of the effective dose, and a mean of 16.8 +/- 20 minutes from the initiation of therapy using a mean of 8.4 +/- 3.4 mg of IV verapamil.(ABSTRACT TRUNCATED AT 400 WORDS)
在急诊室就诊的患者中，比较了腺苷与维拉帕米治疗室上性心律失常的疗效和副作用。比较了腺苷和维拉帕米的临床变量以及从开始治疗到室上性心动过速终止的时间间隔，以及从药物初始有效剂量到室上性心动过速终止的时间。总共44例患者接受了腺苷治疗，其中16例在电生理实验室，28例在急诊室，用于评估和终止心动过速。在电生理实验室，7例患者为房室结折返，5例为预激综合征，其中2例有房扑和房颤但无旁道折返，1例为隐匿性旁道折返，1例为洛氏综合征，1例为房内折返，1例为自律性房性心动过速。25例患者在急诊室接受腺苷治疗，3例在医院接受治疗，共发生31次室上性心律失常。在急诊室，11例患者因房室结折返出现室上性心动过速，3例为预激综合征，6例为房扑或房内折返，2例为室性心动过速，3例为窦性心动过速。在医院，2例患者有房扑，1例有窦性心动过速。对急诊室中14例因预激综合征或房室结折返出现室上性心动过速的患者，与接受标准维拉帕米治疗的患者在从开始治疗到室上性心动过速终止的时间、从药物有效剂量到室上性心动过速终止的时间以及副作用方面进行了回顾性比较。两组在临床变量方面无显著差异。腺苷使14例患者的18次室上性心动过速发作中的18次在给予有效剂量（0.104±0.024mg/kg）后24.6±9.6秒内转复，从开始治疗起平均4.4±2.0分钟。维拉帕米使20例患者的32次室上性心动过速发作中的29次在给予有效剂量后10.9±7分钟内转复，使用平均8.4±3.4mg静脉注射维拉帕米从开始治疗起平均16.8±20分钟。（摘要截取自400字）
