Pfeiffer D, Rostock K J, Rathgen K, Schirdewan A, Kleiner H J
Bereich Herzinfarktforschung und Intensivmedizin, Zentralinstituts für Herz-Kreislauf-Forschung, Akademie der Wissenschaften der DDR Berlin-Buch.
Z Gesamte Inn Med. 1987 Jul 15;42(14):390-4.
Arrhythmogenic effects appear in 5-22% of all patients. On the basis of a literary investigation on 11,547 patients with 1,114 proarrhythmic effects and of 21 own observations mechanisms, risks and diagnostics of this dangerous side effect are demonstrated. In most cases patients with severe functional disturbances of the heart and known ventricular tachyarrhythmias are affected. Not infrequently a prolonged QT-internal is found. An accumulation of the known arrhythmias or an appearance of new disturbed rhythms, frequently Torsade de pointes, may occur. Holter-ECG and programmed stimulation are suited for recognition, which are together to be applied in malignant tachyarrhythmias. The prophylaxis deals with a careful indication, aimed selection of the antiarrhythmic drugs and a subtile control of therapy in the first days after the beginning of the therapy and after every increase of dosage.
致心律失常作用出现在所有患者中的比例为5%至22%。基于对11547例患者的文献研究（其中有1114例出现促心律失常作用）以及21例自身观察病例，证明了这种危险副作用的机制、风险和诊断方法。在大多数情况下，患有严重心脏功能障碍和已知室性快速性心律失常的患者会受到影响。经常会发现QT间期延长。可能会出现已知心律失常的累积或新的节律紊乱，常见的是尖端扭转型室速。动态心电图和程控刺激适用于识别，二者可联合应用于恶性快速性心律失常。预防措施包括谨慎用药指征、有针对性地选择抗心律失常药物，以及在治疗开始后的头几天和每次增加剂量后对治疗进行细致监测。
