Eshchar Y, Belhassen B, Laniado S
Am J Cardiol. 1986 Apr 1;57(10):782-6. doi: 10.1016/0002-9149(86)90613-2.
Ajmaline test (50 mg intravenously over 1 minute) and ergometric exercise test were performed in 24 patients with the Wolff-Parkinson-White syndrome. The effects of both tests on the conduction in the accessory pathway (AP) were correlated with the anterograde effective refractory period (ERP) of the AP. Ajmaline caused transient anterograde block in the AP in 15 patients, 14 with an ERP of more than 250 ms and 1 with an ERP of 250 ms. Ajmaline failed to abolish preexcitation in 9 patients, all with ERP of the AP of 250 ms or less. Exercise testing caused anterograde block in the AP in 5 patients, in 2 during exercise (ERP of 340 and 360 ms) and in the remaining 3 patients during the recovery phase (ERP of 600, 520 and 460 ms). Of the 10 patients with an ERP of 250 ms or less, ajmaline did not abolish preexcitation in 9 and exercise did not abolish it in any of them. Of the 7 patients with an ERP of 330 ms or more, ajmaline abolished preexcitation in 7 and exercise abolished it in 5 patients. Of the 7 patients with ERP of the AP more than 250 ms but less than 330 ms, ajmaline but not exercise abolished preexcitation in all. Thus, ajmaline and exercise testing can detect patients with short and long ERPs of the AP, respectively, and the effects of ajmaline and exercise tests combined may be useful in the noninvasive assessment of various ranges of ERP of the AP.
对24例预激综合征患者进行了阿义马林试验（1分钟内静脉注射50毫克）和运动试验。这两种试验对旁路传导的影响与旁路的前向有效不应期（ERP）相关。阿义马林使15例患者的旁路出现短暂前向阻滞，其中14例ERP超过250毫秒，1例ERP为250毫秒。9例患者的预激未被阿义马林消除，这些患者的旁路ERP均为250毫秒或更短。运动试验使5例患者的旁路出现前向阻滞，2例在运动时出现（ERP分别为340和360毫秒），其余3例在恢复阶段出现（ERP分别为600、520和460毫秒）。在ERP为250毫秒或更短的10例患者中，9例患者的预激未被阿义马林消除，且所有患者的预激均未被运动消除。在ERP为330毫秒或更长的7例患者中，7例患者的预激被阿义马林消除，5例患者的预激被运动消除。在旁路ERP超过250毫秒但小于330毫秒的7例患者中，阿义马林能消除所有患者的预激，而运动不能。因此，阿义马林试验和运动试验分别可以检测出旁路ERP短和长的患者，联合应用阿义马林试验和运动试验可能有助于对旁路ERP的不同范围进行无创评估。
