Weiss T, Lattin G M, Engelman K
Am Heart J. 1975 Jun;89(6):700-7. doi: 10.1016/0002-8703(75)90184-2.
Twelve patients with PVC's were studied to assess the possible role of the vagus nerves in suppressing PVC's. All were without significant heart disease and under forty years of age. A series of five autonomically active drugs, including vagotonic and vagolytic agents, was administered intravenously, each drug being given after the effects of the previous one had abated. Two of the patients did not have PVC's at the time of study. Of the remaining ten patients, five showed vagally mediated suppression of PVC's. Phenylephrine (40 to 60 mug per minute) reduced HR, from an average of 63.2 bpm to 48.5 bpm by a vagally mediated reflex, and decreased PVC incidence in all five patients. The per cent of ventricular heart beats which were PVC's (per cent PVC) decreased from an average of 18.2 per cent to 3.2 per cent in these patients (p smaller than 0.005 in each case). Edrophonium (10 mg.) produced less bradycardia and less reliable PVC suppression. In two of these five patients, atropine (1.5 mg.) increased PVC incidence markedly, although the per cent PVC did not change significantly because of the concomitant tachycardia. These data suggest that strongly increased vagal tone can suppress PVC's in a significant percentage of such patients. This finding in man extends previous animal work which has shown a protective role of the vagus against ventricular arrhythmias under certain conditions.
对12例室性早搏（PVC）患者进行了研究，以评估迷走神经在抑制室性早搏方面的可能作用。所有患者均无明显心脏病且年龄在40岁以下。静脉注射了一系列五种具有自主神经活性的药物，包括迷走神经兴奋药和迷走神经阻滞药，每种药物在前一种药物的作用消退后给药。有两名患者在研究时没有室性早搏。在其余10名患者中，有5名表现出迷走神经介导的室性早搏抑制。去氧肾上腺素（每分钟40至60微克）通过迷走神经介导的反射使心率从平均63.2次/分钟降至48.5次/分钟，并使所有5名患者的室性早搏发生率降低。这些患者中室性早搏占心室搏动的百分比（室性早搏百分比）从平均18.2%降至3.2%（每种情况p均小于0.005）。依酚氯铵（10毫克）引起的心动过缓较轻，对室性早搏的抑制作用也较不可靠。在这5名患者中的2名中，阿托品（1.5毫克）使室性早搏发生率明显增加，尽管由于同时出现的心动过速，室性早搏百分比没有显著变化。这些数据表明，迷走神经张力的显著增加可在相当比例的此类患者中抑制室性早搏。在人体中的这一发现扩展了先前的动物研究工作，该研究表明在某些情况下迷走神经对室性心律失常具有保护作用。
