Brodsky M A, Allen B J, Abate D, Henry W L
Am Heart J. 1985 Oct;110(4):794-9. doi: 10.1016/0002-8703(85)90459-4.
The combined occurrence of impaired left ventricular function and ventricular tachyarrhythmias portend a high annual mortality. Although antiarrhythmic drugs can reduce ventricular arrhythmias, the prognosis may be unchanged. We administered propafenone to 12 patients with ventricular tachyarrhythmias and left ventricular ejection fractions less than 40%. Propafenone significantly reduced isolated ventricular premature depolarizations, couplets, and ventricular tachycardia on ambulatory monitoring. Propafenone eliminated all exercise provocable ventricular tachycardia. Propafenone additionally abolished ventricular tachycardia inducible by programmed stimulation in five of six patients. In eight patients studied before and during therapy, there was no significant change in left ventricular ejection fraction determined by nuclear ventriculography. Propafenone was discontinued in three patients due to side effects. All patients remain alive and without recurrence of clinically significant arrhythmia over a mean follow-up period of 14 months. Propafenone is an effective drug for the management of ventricular tachyarrhythmias, and may be used in patients with impaired left ventricular function.
左心室功能受损合并室性快速心律失常提示每年死亡率很高。尽管抗心律失常药物可减少室性心律失常，但预后可能并无改变。我们对12例室性快速心律失常且左心室射血分数低于40%的患者给予了普罗帕酮。动态监测显示，普罗帕酮可显著减少孤立性室性早搏、成对室性早搏及室性心动过速。普罗帕酮消除了所有运动诱发的室性心动过速。此外，在6例患者中有5例，普罗帕酮消除了程序刺激诱发的室性心动过速。在8例治疗前后均接受研究的患者中，核素心室造影测定的左心室射血分数无显著变化。3例患者因副作用停用了普罗帕酮。在平均14个月的随访期内，所有患者均存活，且无临床显著心律失常复发。普罗帕酮是治疗室性快速心律失常的有效药物，可用于左心室功能受损的患者。
