Lidell C, Rehnqvist N, Sjögren A, Yli-Uotila R J, Rønnevik P K
Am Heart J. 1985 May;109(5 Pt 1):970-5. doi: 10.1016/0002-8703(85)90237-6.
In an open, randomized, crossover study, the efficacy of sotalol and procainamide was compared in 33 patients with frequent, chronic premature ventricular contractions (PVCs). A 75% reduction in PVCs/24 hours (two 24-hour recordings) was arbitrarily considered to constitute an adequate therapeutic effect. Sotalol was started at a dose of 160 mg once daily for 1 week, followed by a 24-hour recording. In the absence of any therapeutic effect, the same procedure was repeated with 320 mg, 480 mg, and 640 mg daily. Procainamide, 1 gm three times/day, was given or, if plasma concentrations were insufficient, 1.5 gm three times/day for 1 week. PVC control was obtained in 22 (67%) patients on sotalol, including all 12 with ischemic heart disease. Procainamide was successful in 13 (39%) patients. Effects on the number of attacks of ventricular tachycardia were achieved by both drugs in those patients where PVCs were reduced by at least 75%. Sotalol caused side effects in five patients, who therefore could not accept planned increases in dosage. Side effects were noted by 12 patients with procainamide. Nine patients responded to both drugs, seven to neither. Thirteen responded to sotalol only and four to procainamide only. We conclude that sotalol is a useful alternative to procainamide in controlling chronic PVCs, especially in patients with ischemic heart disease.
在一项开放性、随机、交叉研究中，对33例频发慢性室性早搏（PVC）患者比较了索他洛尔和普鲁卡因胺的疗效。以PVC次数/24小时（两次24小时记录）减少75%被随意认为构成足够的治疗效果。索他洛尔起始剂量为每日160mg，服用1周，随后进行24小时记录。若未产生任何治疗效果，则依次以每日320mg、480mg和640mg重复相同程序。给予普鲁卡因胺1g，每日3次，若血浆浓度不足，则给予1.5g，每日3次，共1周。索他洛尔使22例（67%）患者的PVC得到控制，其中包括所有12例缺血性心脏病患者。普鲁卡因胺使13例（39%）患者的PVC得到控制。在PVC减少至少75%的患者中，两种药物对室性心动过速发作次数均有影响。索他洛尔使5例患者出现副作用，因此这些患者无法接受计划中的剂量增加。12例服用普鲁卡因胺的患者出现副作用。9例患者对两种药物均有反应，7例对两种药物均无反应。13例仅对索他洛尔有反应，4例仅对普鲁卡因胺有反应。我们得出结论，在控制慢性PVC方面，索他洛尔是普鲁卡因胺的一种有用替代药物，尤其是在缺血性心脏病患者中。
