Betriu A, Chaitman B R, Bourassa M G, Brévers G, Scholl J M, Bruneau P, Gagné P, Chabot M
Circulation. 1983 Jan;67(1):88-94. doi: 10.1161/01.cir.67.1.88.
We tested the effectiveness and safety of i.v. diltiazem in the management of paroxysmal supraventricular tachyarrhythmias in 39 patients, 21 with organic heart disease and seven in heart failure. Fifteen patients presented with supraventricular tachycardia, 12 with atrial fibrillation and 12 with atrial flutter. End points were conversion to sinus rhythm or slowing of the ventricular rate to 100 beats/min or less. Diltiazem was given as an i.v. bolus of either 150 or 300 micrograms/kg over 2 minutes. A second injection was administered to patients who received the lower dose and failed to reach either end point within 30 minutes. The overall success rate was 82% (32 of 39 patients). Time to end point was 5 minutes or less in 20 patients. Conversion to sinus rhythm occurred in 13 of 15 patients (87%) with supraventricular tachycardia and in two of 12 patients with atrial fibrillation. Treatment side effects included a slow ventricular rate in one patient who had a sick sinus syndrome and hypotension in two patients that rapidly responded to fluid administration. We conclude that i.v. diltiazem is effective and well tolerated and advocate its use in the management of paroxysmal supraventricular tachyarrhythmias.
我们对39例阵发性室上性心律失常患者静脉注射地尔硫䓬的有效性和安全性进行了测试，其中21例患有器质性心脏病，7例患有心力衰竭。15例患者表现为室上性心动过速，12例为心房颤动，12例为心房扑动。终点指标为转为窦性心律或心室率减慢至100次/分钟或更低。地尔硫䓬以150或300微克/千克的静脉推注剂量在2分钟内给药。接受较低剂量且在30分钟内未达到任一终点指标的患者给予第二次注射。总体成功率为82%（39例患者中的32例）。20例患者达到终点指标的时间为5分钟或更短。15例室上性心动过速患者中有13例（87%）转为窦性心律，12例心房颤动患者中有2例转为窦性心律。治疗副作用包括1例病态窦房结综合征患者出现心室率减慢，2例患者出现低血压，经补液后迅速缓解。我们得出结论，静脉注射地尔硫䓬有效且耐受性良好，并提倡将其用于阵发性室上性心律失常的治疗。
