Yeh S J, Fu M, Lin F C, Lee Y S, Hung J S, Wu D
Chest. 1985 May;87(5):639-43. doi: 10.1378/chest.87.5.639.
In 16 patients with paroxysmal supraventricular tachycardia, electrophysiologic studies were done before and serially at hourly intervals for eight hours after the third oral dose of 90 mg diltiazem given every eight hours. Diltiazem increased both the longest atrial paced cycle length producing type 1 atrioventricular block and the effective refractory period of the atrioventricular conducting system at all measurements. Before diltiazem, all 16 patients had induction of sustained tachycardia. After diltiazem, sustained tachycardia could not be induced in ten patients at any measurements; in these patients, either echo or nonsustained tachycardia was induced. In the remaining six patients, sustained tachycardia was induced, particularly after six hours. Follow-up observations in 12 patients receiving the same dosage of oral diltiazem for 6 +/- 2 months (mean +/- SD), showed that of the eight patients in whom electrophysiologic testing induced either echo or nonsustained tachycardia, six were asymptomatic and two experienced transient palpitation. Of the other four patients with induction of sustained tachycardia, three had transient palpitation and one had occasional attacks of sustained tachycardia requiring modification of therapy. Thus, oral diltiazem increases atrioventricular nodal refractoriness, with an effect lasting up to eight hours. It is an effective agent for the prophylaxis of paroxysmal supraventricular tachycardia.
对16例阵发性室上性心动过速患者，在每8小时口服90 mg地尔硫䓬第三次给药前及给药后每小时连续进行8小时的电生理研究。在所有测量中，地尔硫䓬均增加了产生1型房室传导阻滞的最长心房起搏周期长度以及房室传导系统的有效不应期。在使用地尔硫䓬前，所有16例患者均可诱发持续性心动过速。使用地尔硫䓬后，10例患者在任何测量中均不能诱发持续性心动过速；在这些患者中，诱发的是回波或非持续性心动过速。其余6例患者可诱发持续性心动过速，尤其是在6小时后。对12例接受相同剂量口服地尔硫䓬治疗6±2个月（平均±标准差）的患者进行随访观察，结果显示，在8例电生理检查诱发回波或非持续性心动过速的患者中，6例无症状，2例出现短暂心悸。在另外4例诱发持续性心动过速的患者中，3例出现短暂心悸，1例偶尔发作持续性心动过速，需要调整治疗。因此，口服地尔硫䓬可增加房室结不应期，其作用可持续长达8小时。它是预防阵发性室上性心动过速的有效药物。
