Tordjman T, Lampert S, Lown B
Department of Nutrition, Harvard School of Public Health, Boston, MA 02115.
Pharmacotherapy. 1988;8(2):89-93. doi: 10.1002/j.1875-9114.1988.tb03541.x.
Antiarrhythmic drugs frequently cause extracardiac side effects that limit their use. If intracoronary delivery of a lower dose of drug to an electrically unstable focus can control arrhythmias, systemic adverse effects of these agents might be avoided. We investigated whether intracoronary lidocaine can suppress ventricular arrhythmia induced by acetylstrophanthidin, a rapidly acting digitalislike agent. We isolated and then cannulated either the left anterior descending or the left circumflex coronary artery in 12 pentobarbital-anesthetized dogs. Sustained ventricular tachycardia that persisted for 11.4 +/- 8.6 minutes was reliably induced by the intracoronary infusion. In all of 24 trials, an intracoronary lidocaine bolus at 2% of the usual systemic dose (0.77 mg/30 sec) abolished digitalis-induced ventricular tachycardia for an average of 2.0 +/- 1.8 minutes. This effect was not observed after a saline bolus. We conclude that an intracoronary bolus of low-dose lidocaine can suppress acetylstrophanthidin-induced ventricular arrhythmia.
抗心律失常药物经常会引起心脏外的副作用，从而限制了它们的使用。如果将较低剂量的药物经冠状动脉输送到电不稳定病灶能够控制心律失常，那么这些药物的全身不良反应或许可以避免。我们研究了冠状动脉内注射利多卡因是否能抑制由乙酰洋地黄毒苷（一种速效洋地黄类药物）诱发的室性心律失常。我们在12只戊巴比妥麻醉的犬中，分离并插管左前降支或左旋冠状动脉。经冠状动脉输注可可靠地诱发持续11.4±8.6分钟的持续性室性心动过速。在所有24次试验中，以通常全身剂量的2%（0.77毫克/30秒）进行冠状动脉内推注利多卡因，平均2.0±1.8分钟消除了洋地黄诱发的室性心动过速。推注生理盐水后未观察到这种效果。我们得出结论，冠状动脉内推注低剂量利多卡因可抑制乙酰洋地黄毒苷诱发的室性心律失常。
