Stemple D R, Hall R J, Mason J W, Harrison D C
Br Heart J. 1978 Jun;40(6):644-9. doi: 10.1136/hrt.40.6.644.
In order to determine the mechanism of action of edrophonium on the cardiac conduction system, we used His bundle recording and pacing techniques to examine the electrophysiological effect of edrophonium in 6 patients undergoing diagnostic evaluation for coronary artery disease and in 9 cardiac transplant recipients who were free of acute graft rejection. After control measures were made of sinus cycle length, conduction intervals, and conduction system refractory periods, edrophonium was administered by constant intravenous infusion, and all electrophysiological measurements were repeated. In the normally innervated patients, edrophonium significantly increased sinus cycle length from 778 +/- 21 ms to 883 +/- 36 ms (P less than 0.01), AH interval from 88 +/- 11 ms to 100 +/- 12 ms (P less than 0.01), and AV nodal functional refractory period from 351 +/- 44 ms to 391 +/- 36 ms (P less than 0.05). In the patients with transplanted hearts, edrophonium had no electrophysiological effect other than increasing the cycle length of the remnant recipient atrium from 722 +/- 21 ms to 798 +/- 31 ms (P less than 0.01). We conclude that the electrophysiological effects of edrophonium in man are mediated primarily through autonomic innervation of the heart.
为了确定依酚氯铵对心脏传导系统的作用机制，我们采用希氏束记录和起搏技术，对6例接受冠状动脉疾病诊断评估的患者以及9例无急性移植物排斥反应的心脏移植受者进行了研究，以检测依酚氯铵的电生理效应。在对窦性周期长度、传导间期和传导系统不应期进行对照测量后，通过持续静脉输注给予依酚氯铵，并重复所有电生理测量。在正常神经支配的患者中，依酚氯铵使窦性周期长度从778±21毫秒显著增加至883±36毫秒（P<0.01），AH间期从88±11毫秒增加至100±12毫秒（P<0.01），房室结功能不应期从351±44毫秒增加至391±36毫秒（P<0.05）。在心脏移植患者中，依酚氯铵除了使残余受者心房的周期长度从722±21毫秒增加至798±31毫秒（P<0.01）外，没有其他电生理效应。我们得出结论，依酚氯铵在人体中的电生理效应主要通过心脏的自主神经支配介导。
