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盐酸非诺地尔治疗心律失常

[Treatment of rhythm disorders by fenoxedil hydrochloride].

作者信息

Gérard R, Porte L, Luccioni R, Balansard P, Jullien G, Lévy S, Gatau-Pelanchon J, Duport G

出版信息

Arch Mal Coeur Vaiss. 1976 Nov;69(11):1179-89.

PMID:64236
Abstract

Fenoxedil chlorhydrate (FC), which is used as a treatment for cerebral circulatory failure and peripheral vascular disease, has been given to 100 patients with a cardiac arrhythmia: atrial fibrillation (78 cases), atrial flutter (4 cases), atrial tachysystole (2 cases), ventricular extrasystoles (12 cases), and supraventricular extrasystoles (4 cases). FC has been prescribed alone, or as a complement to current anticoagulant or digitalis treatment; combination with prenylamine, amiodarone, dysopyramide or a drug of the quinidine group must always be avoided, and the potassium level checked and corrected if necessary before treatment. In 78 cases of atrial fibrillation, the authors found that sinus rhythm was restored in 58 (74.4%); four cases of flutter were restored, and one case out of two of atrial tachycardia. In case of supraventricular and ventricular extrasystoles the results are less clear, and merit a further study with a larger number of cases. The electrocardiographic disorders encountered in this series have been evaluated: lenghthening of the QT interval, disorders of atrioventricular conduction, sinus inhibition. They were either produced by or aggravated by the FC. No cases of axis deviation were encountered. The authors make mention of the complications observed by other authors, but draw a distinction between the prescription of FC in cases of cerebral vascular insufficiency, without previous knowledge of the exact cardiac status of the patient (otherwise there is a risk of severe accidents), and the use of FC in cases of arrhythmia which have undergone full assessment before the drug is used. According to this study, FC appears to be a very effective anti-arrhythmic agent, but its use demands very rigorous clinical and electrocardiographic supervision.

摘要

盐酸非诺地尔(FC)用于治疗脑循环衰竭和周围血管疾病,已给予100例心律失常患者:心房颤动(78例)、心房扑动(4例)、房性心动过速(2例)、室性期前收缩(12例)和室上性期前收缩(4例)。FC单独给药,或作为当前抗凝或洋地黄治疗的补充;必须始终避免与普尼拉明、胺碘酮、丙吡胺或奎尼丁类药物联合使用,治疗前如有必要需检查并纠正血钾水平。在78例心房颤动患者中,作者发现58例(74.4%)恢复了窦性心律;4例心房扑动恢复,2例房性心动过速中有1例恢复。对于室上性和室性期前收缩,结果不太明确,值得进一步进行更大规模病例的研究。对本系列中遇到的心电图紊乱进行了评估:QT间期延长、房室传导紊乱、窦性抑制。它们要么由FC引起,要么因FC而加重。未遇到电轴偏移病例。作者提及了其他作者观察到的并发症,但区分了在脑血管功能不全病例中在不了解患者确切心脏状况(否则有发生严重事故的风险)的情况下使用FC,以及在心律失常病例中在使用该药物前已进行全面评估的情况下使用FC。根据这项研究,FC似乎是一种非常有效的抗心律失常药物,但其使用需要非常严格的临床和心电图监测。

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