Panidis I P, Morganroth J, Baessler C
Am J Cardiol. 1983 Dec 1;52(10):1197-201. doi: 10.1016/0002-9149(83)90573-8.
The safety and efficacy of oral verapamil to control exercise tachycardia in 27 patients with atrial fibrillation and 3 with atrial flutter receiving digitalis was evaluated in a double-blind, randomized, crossover study. The heart rate in patients who received verapamil compared with placebo group was lower at rest (mean 69 +/- 13 versus 87 +/- 20 beats/min, p less than 0.01), as was the degree of tachycardia at the end of 3 minutes of a standardized exercise test (104 +/- 14 versus 136 +/- 23 beats/min, p less than 0.01). Doses of verapamil required to achieve suppression of tachycardia were 240 mg/day in 18 patients, 320 mg/day in 6 patients, and 480 mg/day in 3 patients. Only 3 patients complained of adverse effects from verapamil during the double-blind phase of the study. Two patients were discontinued from the study because of adverse reactions. No clinically significant changes during verapamil therapy were observed on the electrocardiogram, chest roentgenogram, echocardiogram or in the laboratory evaluation. Digoxin blood levels were higher in patients who received concomitant verapamil compared with placebo (1.23 +/- 0.59 versus 0.85 +/- 0.46 ng/ml, p less than 0.01), but no patient had signs or symptoms of digitalis toxicity. Thus, oral verapamil given in addition to digitalis is a safe and effective agent in the treatment of patients with chronic atrial fibrillation or flutter to decrease exercise-induced tachycardia.
在一项双盲、随机、交叉研究中，评估了口服维拉帕米对27例房颤患者和3例接受洋地黄治疗的房扑患者控制运动性心动过速的安全性和有效性。与安慰剂组相比，接受维拉帕米的患者静息心率较低（平均69±13次/分钟对87±20次/分钟，p<0.01），在标准化运动试验3分钟末的心动过速程度也较低（104±14次/分钟对136±23次/分钟，p<0.01）。达到心动过速抑制所需的维拉帕米剂量为：18例患者为240毫克/天，6例患者为320毫克/天，3例患者为480毫克/天。在研究的双盲阶段，只有3例患者抱怨维拉帕米有不良反应。2例患者因不良反应退出研究。在维拉帕米治疗期间，心电图、胸部X线片、超声心动图或实验室评估均未观察到具有临床意义的变化。与安慰剂相比，同时接受维拉帕米的患者地高辛血药浓度更高（1.23±0.59对0.85±0.46纳克/毫升，p<0.01），但没有患者出现洋地黄中毒的体征或症状。因此，除洋地黄外给予口服维拉帕米是治疗慢性房颤或房扑患者以降低运动诱发心动过速的一种安全有效的药物。
