Redwood D
Br Med J. 1969 Jan 4;1(5635):26-9. doi: 10.1136/bmj.1.5635.26.
A study of 203 patients with chronic heart block treated with oral long-acting isoprenaline showed that 85 (42%) were maintained satisfactorily on the drug for a mean period of 18.2 months. The survival rates at one, two, and three years were 76%, 64%, and 57% respectively. In 115 patients treatment by pacing became necessary to control symptoms, and in these patients the survival rates at one, two and three years were 83%, 72%, and 60%.The two most valuable guides to patients' response to oral isoprenaline are the response to a trial dose of intravenous isoprenaline and the type of dysrhythmia associated with their Adams-Stokes attacks. Patients with heart failure with slow ventricular rates and those with angina of effort do not respond to treatment with sympathomimetic drugs.The majority of patients with chronic heart block are elderly, and in view of the complexity of pacing systems, and the need for skilled supervision of paced patients, oral long-acting isoprenaline remains of value in the longterm management of chronic heart block, provided patients are carefully selected for this form of therapy.
一项针对203例接受口服长效异丙肾上腺素治疗的慢性心脏传导阻滞患者的研究表明，85例（42%）患者使用该药后病情得到满意控制，平均时长为18.2个月。1年、2年和3年的生存率分别为76%、64%和57%。115例患者需要通过起搏治疗来控制症状，在这些患者中，1年、2年和3年的生存率分别为83%、72%和60%。判断患者对口服异丙肾上腺素反应的两个最有价值的指标是静脉注射异丙肾上腺素试验剂量后的反应以及与阿-斯发作相关的心律失常类型。伴有缓慢心室率的心力衰竭患者和劳力性心绞痛患者对拟交感神经药物治疗无反应。大多数慢性心脏传导阻滞患者为老年人，鉴于起搏系统的复杂性以及对起搏患者进行专业监护的必要性，只要对患者进行仔细筛选以确定适合这种治疗方式，口服长效异丙肾上腺素在慢性心脏传导阻滞的长期管理中仍具有价值。
