Disertori M, Molinis G, Lanzetta T, Antonini L, Furlanello F
G Ital Cardiol. 1976;6(2):300-11.
Effects of verapamil (5 mg i.v.) on excitation conduction in 20 patients who already had a basic alteration (7 with ventricular pre-excitation syndrome) were studied by His electrogram, during spontaneous sinusal rhythm and atrial electrostimulation in increasing frequencies. In 4 cases, a test crossed with atropine was carried out. The effects of the drug on the effective refractory period of the A-V node and the anomalous tract in 3 patients with W.P.W. syndrome of Kent's bundle were studied. The effects were: no significant modifications in the sinusal frequency; increase in the corrected preautomatic pause only in cases with sick sinus node syndrome and serious basic compromise of the sinus node function; slowing down of A-V conduction in the supra-hisian area and increase of the effective refractory period of the A-V node; no modification of the intra-atrial conduction, or the under-hisian and intraventricular A-V conduction; uneven slowing down of conduction along the anomalous tract of the pre-excitation syndrome of the James bundle; modification of the effective refractory period of the anomalous tract of the Kent bundle type, variable from case to case. On the basis of the electrophysiological properties, the possibilities and limits of use of the drug in sick sinud node syndrome in the common supraventricular paroxymal tachycardias, in atrial fibrillation, atrial flutter and arrhythmias of the ventricular pre-excitation syndrome are emphasized.
通过希氏束电图，在20例已有基础病变（7例有室性预激综合征）的患者中，于窦性心律及心房递增频率电刺激时，研究了维拉帕米（静脉注射5毫克）对兴奋传导的影响。4例患者进行了与阿托品的交叉试验。研究了该药对3例肯特束型预激综合征患者房室结及异常通道有效不应期的影响。结果如下：窦性频率无明显改变；仅在病态窦房结综合征及窦房结功能严重基础损害的病例中，校正后的自动期前停顿增加；希氏束以上区域房室传导减慢，房室结有效不应期延长；房内传导、希氏束以下及心室内房室传导无改变；沿詹姆斯束预激综合征异常通道的传导减慢不均一；肯特束型异常通道有效不应期改变，因病例而异。基于电生理特性，强调了该药在病态窦房结综合征、常见室上性阵发性心动过速、心房颤动、心房扑动及室性预激综合征心律失常中的应用可能性及局限性。
