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房室折返性快速心律失常的控制。胺碘酮与维拉帕米的初步电生理研究及比较(作者译)

[The control of the atrio-ventricular reciprocating tachyarrhythmias. A preliminary electrophysiological study and comparison between amiodarone and verapamil (author's transl)].

作者信息

Gronda M, Rognoni G, Rossi P

出版信息

G Ital Cardiol. 1978;8(8):868-78.

PMID:700299
Abstract

The effects of amiodarone (2.5 mg/Kg i.v.) and of verapamil (0.1 mg/Kg i.v.) on refractory periods and on conduction of structures interested in the reciprocating circuit, as well as on the possible echo zones, were comparatively evaluated through electrophysiological test in 8 patients, four of which with W.P.W. from Kent bundle, and four with double A-V pass with reciprocating supraventricular tachicardia (RST) documented crises. None of the two drugs seems to have the theorical requirements of balanced effect to be chosen for the antiarrhythmic prophylaxis in patients with ventricular pre-excitement. In patients with double A-V pass, while both drugs have a sufficiently balanced and regular action on refractory periods and on conduction the irregularity of their effects on echo zones appears to restrict their validity in chronical therapy. According to the Authors, the only useful criteria for the choice of an antiarrhythmic drug for the prophilaxis of R.S.T. to be derived through extrapolation from these electrophysiological tests are: 1) the functional suppression of a circuit structure; 2) the evaluation of effects on echo zones; 3) the possibility or not the evoking R.S.T.

摘要

通过电生理测试,对8例患者比较评估了胺碘酮(静脉注射2.5毫克/千克)和维拉帕米(静脉注射0.1毫克/千克)对不应期以及对参与折返环的结构的传导的影响,以及对可能的折返区域的影响。其中4例患者为Kent束预激综合征,另外4例有双房室传导通路且记录到折返性室上性心动过速(RST)发作。这两种药物似乎都不具备用于心室预激患者抗心律失常预防的理论上所需的平衡效应。在双房室传导通路患者中,虽然两种药物对不应期和传导都有足够平衡且规律的作用,但它们对折返区域影响的不规律性似乎限制了其在慢性治疗中的有效性。根据作者观点,从这些电生理测试推断得出的用于R.S.T.预防的抗心律失常药物选择的唯一有用标准是:1)对环路结构的功能性抑制;2)对折返区域影响的评估;3)诱发R.S.T.的可能性。

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