Mitchell L B, Jutzy K R, Lewis S J, Schroeder J S, Mason J W
Am Heart J. 1982 Jan;103(1):57-66. doi: 10.1016/0002-8703(82)90530-0.
Fifteen patients without sinoatrial (SA) or atrioventricular (AV) node dysfunction underwent electrophysiologic study (EPS) before and after intravenous diltiazem: 0.20 mg/kg bolus followed by 0.0007 mg/kg/min infusion (seven patients) or 0.25 mg/kg bolus followed by 0.0012 mg/kg/min infusion (eight patients). In six patients intravenous digoxin (0.018 mg/kg) was given and 45 minutes later EPS was repeated while the diltiazem infusion continued. Diltiazem prolonged sinus cycle length (+7%, p less than 0.01), lengthened AH conduction time (+22% in constant rate atrial paced rhythm, p less than 0.001), prolonged AV node functional and effective refractory periods (+6%, p less than 0.01 and +16%, p less than 0.05, respectively), lengthened AV node Wenckebach cycle length (+13%, p less than 0.001), shortened atrial functional refractory period (-3%, p less than 0.05), and reduced mean arterial pressure (-8%, p less than 0.005 in constant rate atrial paced rhythm). Subsequently, intravenous digoxin further prolonged sinus cycle length (+12%, p less than 0.05), AH conduction time (+17%, p less than 0.05), AV node Wenckebach cycle length (+9%, p less than 0.05), and AV node functional refractory period (+7%, p less than 0.05), shortened atrial effective refractory period (-7%, p less than 0.05) and ventricular effective refractory period (-6%, p less than 0.05), and increased systolic arterial pressure (+6%, p less than 0.05). Diltiazem and digoxin have additive depressant effects on SA and AV node function without significant adverse effects.
15例无窦房（SA）或房室（AV）结功能障碍的患者在静脉注射地尔硫䓬前后接受了电生理研究（EPS）：先静脉推注0.20mg/kg，随后以0.0007mg/kg/min的速度输注（7例患者），或先静脉推注0.25mg/kg，随后以0.0012mg/kg/min的速度输注（8例患者）。6例患者静脉注射了地高辛（0.018mg/kg），45分钟后在继续输注地尔硫䓬的同时重复进行EPS。地尔硫䓬延长了窦性周期长度（+7%，p<0.01），延长了AH传导时间（在固定频率心房起搏节律下延长22%，p<0.001），延长了房室结功能和有效不应期（分别为+6%，p<0.01和+16%，p<0.05），延长了房室结文氏周期长度（+13%，p<0.001），缩短了心房功能不应期（-3%，p<0.05），并降低了平均动脉压（在固定频率心房起搏节律下降低8%，p<0.005）。随后，静脉注射地高辛进一步延长了窦性周期长度（+12%，p<0.05）、AH传导时间（+17%，p<0.05）、房室结文氏周期长度（+9%，p<0.05）和房室结功能不应期（+7%，p<0.05），缩短了心房有效不应期（-7%，p<0.05）和心室有效不应期（-6%，p<0.05），并升高了收缩压（+6%，p<0.05）。地尔硫䓬和地高辛对窦房结和房室结功能有相加的抑制作用，且无明显不良反应。
