Liem L B, Clay D A, Franz M R, Swerdlow C D
Am Heart J. 1987 Jun;113(6):1390-6. doi: 10.1016/0002-8703(87)90653-3.
We assessed the electrophysiologic effects and antiarrhythmic efficacy of intravenous pirmenol in 15 patients who had spontaneous and induced sustained ventricular tachyarrhythmias. At a plasma concentration of 2.29 +/- 0.75 micrograms/ml, pirmenol decreased sinus cycle length by 11 +/- 13%, increased QRS, QTc, and HV intervals by 14 +/- 12%, 13 +/- 12%, and 22 +/- 28%, respectively, and increased atrial and ventricular effective refractory periods (ERP) by 20 +/- 14% and 7 +/- 8%, respectively. There was a greater increase in QRS duration during ventricular tachycardia and ventricular pacing than during sinus rhythm (p less than 0.005). By electropharmacologic testing, pirmenol was judged effective in six patients (40%) and was proarrhythmic in one (6%). In the nine patients in whom pirmenol was judged ineffective, the cycle length of induced VT increased by 36 +/- 15% and the associated mean arterial pressure increased by 21 +/- 14 mm Hg. The only side effects were mild hypotension and mild nausea in one patient each. Intravenous pirmenol has type IA electrophysiologic effects. It can be administered safely to patients with sustained ventricular tachyarrhythmias and is as effective as approved antiarrhythmic drugs when assessed by electropharmacologic testing.
我们评估了静脉注射吡美诺对15例有自发性和诱发性持续性室性心律失常患者的电生理效应及抗心律失常疗效。在血浆浓度为2.29±0.75微克/毫升时，吡美诺使窦性周期长度缩短11±13%，使QRS、QTc和HV间期分别延长14±12%、13±12%和22±28%，使心房和心室有效不应期（ERP）分别延长20±14%和7±8%。室性心动过速和心室起搏时QRS时限的增加幅度大于窦性心律时（p<0.005）。通过电药理学测试，吡美诺在6例患者（40%）中被判定有效，在1例患者（6%）中具有促心律失常作用。在9例被判定无效的患者中，诱发性室性心动过速的周期长度增加了36±15%，相关平均动脉压升高了21±14毫米汞柱。仅1例患者出现轻度低血压，另1例患者出现轻度恶心。静脉注射吡美诺具有IA类电生理效应。它可安全用于持续性室性心律失常患者，经电药理学测试评估，其疗效与已批准的抗心律失常药物相当。
