Waleffe A, Bordalo A, Bruninx P, Wellens H J, Kulbertus H E
Br Heart J. 1979 Jan;41(1):89-98. doi: 10.1136/hrt.41.1.89.
The electrophysiological effects of L 9394 (benzoyl-indolizine), a substance chemically related to amiodarone, but devoid of iodine atoms, were investigated by programmed electrical stimulation of the heart in 12 patients with various forms of tachycardia. Four subjects had electrocardiographic evidence of the WPW syndrome and episodes of circus movement tachycardia. Paroxysmal supraventricular tachycardia, confined to the atrioventricular (AV) node, was found in 3 patients. In 2 cases, where a short PR interval was present, the main complaint was the occurrence of paroxysmal atrial fibrillation. In the remaining 3 instances, the arrhythmia consisted of slow ventricular tachycardia (1 case), supraventricular tachycardia of the focal type (1 case), and episodes of primary ventricular fibrillation, not related to acute myocardial ischaemia (1 case). L 9394 injected intravenously was seen to lengthen the transnodal conduction time as well as the effective and functional refractory periods of the node. Similar effects were found on the retrograde VA pathway. The drug had no action on the infra-Hisian conduction system, on the refractory periods of ventricular muscle, or on the refractory periods of accessory bypasses. The drug was injected during an episode of tachycardia in 6 cases with reproducible supraventricular re-entrant tachycardia. Three had a tachycardia circuit confined to the node. In those instances, the drug had beneficial effects (slowing and interruption of tachycardia, decrease or abolition of echo zone; loss of ability to induce tachycardia). In the other 3 cases, an accessory pathway was incorporated in the circuit. L 9394 interrupted the tachycardia in 2 instances (by anterograde AV block), but failed to protect all 3 patients against reinitiation of tachycardia by premature stimuli. It is concluded that L9394 does not share all the pharmacological properties of amiodarone and will not replace it in all its indications.
对12例患有各种类型心动过速的患者进行心脏程控电刺激，研究了L 9394（苯甲酰中氮茚）的电生理效应。L 9394是一种化学结构与胺碘酮相关但不含碘原子的物质。4例患者有心电图显示预激综合征及折返性心动过速发作。3例患者为局限于房室（AV）结的阵发性室上性心动过速。2例患者存在短PR间期，主要症状为阵发性心房颤动发作。其余3例中，心律失常包括缓慢型室性心动过速（1例）、局灶性室上性心动过速（1例）以及与急性心肌缺血无关的原发性心室颤动发作（1例）。静脉注射L 9394可延长跨结传导时间以及结的有效不应期和功能不应期。在逆向VA径路上也发现了类似效应。该药物对希氏束以下传导系统、心室肌不应期或旁路不应期无作用。6例有可重复性室上性折返性心动过速发作的患者在心动过速发作时注射了该药物。其中3例心动过速环路局限于结。在这些情况下，该药物有有益作用（使心动过速减慢和终止、回声区减小或消失；失去诱发心动过速的能力）。另外3例中，环路中有一条旁路。L 9394在2例中终止了心动过速（通过前向性房室阻滞），但未能保护所有3例患者防止早搏刺激再次引发心动过速。结论是，L9394并不具备胺碘酮的所有药理特性，也不会在所有适应证上取代胺碘酮。
