Finerman W B, Hamer A, Peter T, Weiss D, Mandel W J
Am Heart J. 1982 Nov;104(5 Pt 1):987-96. doi: 10.1016/0002-8703(82)90430-6.
Detailed electrophysiologic studies were performed in nine patients with chronic refractory ventricular arrhythmias before and after 7 to 20 weeks (mean 11 weeks) of amiodarone therapy. The amiodarone dose at the time of the repeat study ranged from 400 to 800 mg/day. The drug reduced the sinus rate (p less than 0.001) and prolonged the sinoatrial conduction time (p less than 0.05) with some prolongation of the corrected sinus node recovery time. Intra-atrial conduction was slightly prolonged both in sinus rhythm and during atrial pacing. Anterograde conduction through the AV node was significantly prolonged both in sinus rhythm (p = 0.001) and during atrial pacing (p less than 0.005), and Wenckebach AV block was seen at significantly lower atrial pacing rates after the drug (p less than 0.005). The HV interval was prolonged both in sinus rhythm (p less than 0.05) and during atrial pacing (p = 0.001), and so was the QRS width during atrial pacing (p less than 0.005) and the QT interval in sinus rhythm (p less than 0.005) and during atrial pacing (p less than 0.005). Significant prolongation of the refractory periods in the atrium, AV node, and ventricular muscle were also seen following the drug. We concluded that the significant electrophysiologic effects of this drug throughout the heart during chronic oral use attest to its clinical effectiveness in patients with atrial and ventricular arrhythmias. With due care and despite its effects on the HV interval and QRS width, it can be used in patients with intraventricular conduction defects complicating severe organic heart disease.
对9例慢性难治性室性心律失常患者在胺碘酮治疗7至20周（平均11周）前后进行了详细的电生理研究。重复研究时胺碘酮剂量为每日400至800毫克。该药降低了窦性心率（p<0.001），延长了窦房传导时间（p<0.05），校正窦房结恢复时间也有一定延长。在窦性心律和心房起搏时，心房内传导均略有延长。在窦性心律（p = 0.001）和心房起搏时（p<0.005），经房室结的前向传导均显著延长，用药后在显著更低的心房起搏频率时出现文氏房室阻滞（p<0.005）。在窦性心律（p<0.05）和心房起搏时（p = 0.001），HV间期均延长，心房起搏时QRS宽度（p<0.005）以及窦性心律和心房起搏时QT间期（p<0.005）也延长。用药后心房、房室结和心室肌的不应期也显著延长。我们得出结论，该药在长期口服期间对心脏各部位有显著的电生理作用，证明其对房性和室性心律失常患者具有临床疗效。尽管其对HV间期和QRS宽度有影响，但在伴有严重器质性心脏病并发室内传导缺陷的患者中，谨慎使用该药仍可有效。
