Creamer J E, Nathan A W, Camm A J
Am Heart J. 1987 Aug;114(2):397-406. doi: 10.1016/0002-8703(87)90509-6.
Although antiarrhythmic drugs are effective for controlling cardiac arrhythmias, they may also induce or exacerbate them. Case reports have appeared implicating all classes of antiarrhythmic drugs. It is difficult to assess the size of the problem in practice, as it varies with different subgroups of patients, but rates of up to 13% have been found where proarrhythmic effects were actively sought. Their occurrence is affected both by the electrophysiologic characteristics of the drugs and by the arrhythmia substrate. Mechanisms of proarrhythmic effects may be classified according to the electrophysiologic and hemodynamic effects of the drugs. Detection of drug-induced arrhythmias depends on appreciation of the problem by physicians and, although there are few clear predictors, some form of monitoring of antiarrhythmic drug treatment is recommended. Management of such arrhythmias when they occur involves withdrawal of the offending agent, correcting contributory factors, and reassessing the initial arrhythmia and the strategy for its management.
尽管抗心律失常药物对控制心律失常有效，但它们也可能诱发或加重心律失常。已有病例报告表明各类抗心律失常药物均有此作用。在实际中很难评估这一问题的严重程度，因为它因患者的不同亚组而异，但在积极寻找促心律失常作用的情况下，发现发生率高达13%。其发生受药物的电生理特性和心律失常基质的影响。促心律失常作用的机制可根据药物的电生理和血流动力学效应进行分类。药物诱发的心律失常的检测取决于医生对该问题的认识，尽管几乎没有明确的预测指标，但仍建议对抗心律失常药物治疗进行某种形式的监测。当此类心律失常发生时，处理方法包括停用致病药物、纠正促成因素，以及重新评估初始心律失常及其处理策略。
