Marchlinski F E, Miller J M
Chest. 1985 Dec;88(6):931-4. doi: 10.1378/chest.88.6.931.
A 75-year-old woman with acute respiratory failure due to pneumonia superimposed on bronchospastic chronic obstructive pulmonary disease and dilated cardiomyopathy developed multifocal and unifocal atrial tachycardia. Arrhythmia recurrence appeared to be dependent on reaching a critical but "nontoxic" serum theophylline concentration in the presence of high normal levels of digoxin. The arrhythmias responded to a decrease in serum theophylline concentration or to the administration of verapamil. The precipitation of the atrial arrhythmias by theophylline in the presence of digitalis, both of which may increase intracellular calcium and a dramatic response to verapamil, which inhibits calcium uptake and release, suggests that these arrhythmias may represent an example of "triggered activity" in man.
一名75岁女性，因支气管痉挛性慢性阻塞性肺疾病和扩张型心肌病并发肺炎导致急性呼吸衰竭，出现了多灶性和单灶性房性心动过速。在地高辛水平略高于正常时，心律失常的复发似乎取决于达到临界但“无毒”的血清茶碱浓度。心律失常对血清茶碱浓度降低或维拉帕米给药有反应。在存在洋地黄的情况下，茶碱引发房性心律失常，两者都可能增加细胞内钙，而对抑制钙摄取和释放的维拉帕米有显著反应，这表明这些心律失常可能是人类“触发活动”的一个例子。
