Grubb B P, Luck J C, Bacaner M
Division of Cardiology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey.
Chest. 1988 Aug;94(2):430-2. doi: 10.1378/chest.94.2.430.
We report the findings in a patient in whom intravenous bretylium was the only effective agent to suppress refractory ventricular tachycardia and ventricular fibrillation. After attempts to switch the patient to amiodarone and bethanidine (an oral analogue of bretylium) caused proarrhythmic effects, he was successfully converted to oral therapy with bretylium. Electrophysiologic testing was not predictive of the clinical response from oral bretylium. To our knowledge, this is the first report of a proarrhythmic effect from bethanadine and it suggests a divergence in the actions of various class 3 antiarrhythmic agents.
我们报告了一名患者的情况，在该患者中静脉注射溴苄铵是抑制难治性室性心动过速和心室颤动的唯一有效药物。在尝试将患者改用胺碘酮和苄乙胍（溴苄铵的口服类似物）后出现了促心律失常效应，之后他成功改用溴苄铵口服治疗。电生理检查无法预测口服溴苄铵的临床反应。据我们所知，这是苄乙胍促心律失常效应的首例报告，提示不同Ⅲ类抗心律失常药物的作用存在差异。
