Kasanuki H, Ohnishi S, Tanaka E, Hirosawa K
Department of Internal Medicine, Heart Institute of Japan, Tokyo Women's Medical College.
Jpn Circ J. 1988 Mar;52(3):280-8. doi: 10.1253/jcj.52.280.
Ninety-eight cases of ventricular tachycardia (VT) were studied using clinical electrophysiological (EP)-pharmacological assessment to compare the efficacy of class IA (disopyramide-DP, procainamide-PA) and class IB (mexiletine-Mex, Lidocaine-Lid, aprindine-AP) agents available in Japan, and to evaluate the clinical significance of class subdivisions for the treatment of VT. In assessing the efficacy of drugs, we evaluated their ability to prevent and terminate induced sustained VT as well as their ability to suppress spontaneous premature ventricular beats (VPB). I. EP properties: DP significantly extended QTc, ERPRV, and the coupling interval by which VT or repetitive ventricular response (RVR) was induced. On the other hand, Mex and AP had no effect. Although no significant extension of QRS width was found, the significant extension of the interval from extrastimulus to the first induced VT or RVR complex by the three drugs indicates that all have suppressive effects on conduction velocity within the reentry circuit. II.
Correspondence of preventive effects was 67% for DP and PA (class IA), 54% for Mex and Lid (class IB), 55% for DP and Mex, 27% for AP and Mex, and 25% for AP and DP. Correspondence of terminating effect was 85% for DP and PA, 80% for DP and AP, 77% for DP and Mex, 75% for Mex and Lid, and 63% for Mex and AP. For suppression of spontaneous VPB's, correspondence rate was 100% for DP and PA, 39% for DP and Mex, 64% for Mex and Lid, 61% for Mex and AP, and 69% for DP and AP.(ABSTRACT TRUNCATED AT 250 WORDS)
对98例室性心动过速（VT）患者进行了临床电生理（EP）-药理学评估研究，以比较日本现有的ⅠA类（双异丙吡胺-DP、普鲁卡因胺-PA）和ⅠB类（美西律-Mex、利多卡因-Lid、阿普林定-AP）药物的疗效，并评估类别细分对VT治疗的临床意义。在评估药物疗效时，我们评估了它们预防和终止诱发的持续性VT的能力以及抑制自发性室性早搏（VPB）的能力。I. EP特性：DP显著延长了QTc、ERPRV以及诱发VT或反复心室反应（RVR）的耦合间期。另一方面，Mex和AP没有影响。虽然未发现QRS波宽度有显著延长，但这三种药物使额外刺激到首次诱发的VT或RVR复合波的间期显著延长，表明它们对折返环路内的传导速度均有抑制作用。II. 临床意义：DP和PA（ⅠA类）的预防效果对应率为67%，Mex和Lid（ⅠB类）为54%，DP和Mex为55%，AP和Mex为27%，AP和DP为25%。终止效果对应率：DP和PA为85%，DP和AP为80%，DP和Mex为77%，Mex和Lid为75%，Mex和AP为63%。对于抑制自发性VPB，DP和PA的对应率为100%，DP和Mex为39%，Mex和Lid为64%，Mex和AP为61%，DP和AP为69%。（摘要截断于250字）
