Vangeli R S, Naumov V G, Blank M L, Sergakova L M, Grigoriants R A
Ter Arkh. 1987;59(9):81-6.
Three-day ECG monitoring before and after digitalization of 55 patients with heart failure (HF) was performed. Digoxin did not make a considerable effect on the frequency of detection of high gradations of ventricular arrhythmias. Nevertheless it significantly reduced the mean number of ventricular extrasystoles (VES) per hour and the mean number of complex VES per hour in 8 (33.3%) patients out of 24 with frequent extrasystoles. A significant increase in the VES mean number per hour and in the complex VES mean number per hour was observed in 6 (25%) patients out of 24 with basal frequent extrasystoles. In patients with the antiarrhythmic effect of digoxin indices of the central hemodynamics (diastolic pressure in the pulmonary artery and ejection fraction) were significantly better and in patients with the arrhythmogenic effect of digoxin significantly worse in the absence of a significant difference between digoxin and K+ concentration in the plasma. Digoxin possessed a moderately pronounced antiarrhythmic effect mainly in the patients with HF early stages and in moderately pronounced disturbances of the central hemodynamics. In patients with severe manifestations of HF and with considerable deterioration of indices of the central hemodynamics digoxin in therapeutic concentrations can make an arrhythmogenic effect.
对55例心力衰竭（HF）患者在洋地黄化前后进行了为期三天的心电图监测。地高辛对高等级室性心律失常的检出频率没有显著影响。然而，它显著降低了24例频发早搏患者中8例（33.3%）每小时室性早搏（VES）的平均数量和每小时复杂性室性早搏的平均数量。在24例基础频发早搏患者中，有6例（25%）观察到每小时室性早搏平均数量和每小时复杂性室性早搏平均数量显著增加。在地高辛具有抗心律失常作用的患者中，中心血流动力学指标（肺动脉舒张压和射血分数）明显更好，而在地高辛具有致心律失常作用的患者中则明显更差，血浆中地高辛和钾离子浓度之间没有显著差异。地高辛主要在HF早期患者和中心血流动力学中度明显紊乱的患者中具有中度明显的抗心律失常作用。在HF严重表现且中心血流动力学指标显著恶化的患者中，治疗浓度的地高辛可产生致心律失常作用。
