Strasberg B, Sclarovsky S, Erdberg A, Duffy C E, Lam W, Swiryn S, Agmon J, Rosen K M
Am J Cardiol. 1981 Jun;47(6):1309-14. doi: 10.1016/0002-9149(81)90264-2.
Seven cases of procainamide-induced polymorphous ventricular tachycardia are presented. In four patients, polymorphous ventricular tachycardia appeared after intravenous administration of 200 to 400 mg of procainamide for the treatment of sustained ventricular tachycardia. In the remaining three patients, procainamide was administered orally for treatment of chronic premature ventricular contractions or atrial flutter. These patients had Q-T prolongation and recurrent syncope due to polymorphous ventricular tachycardia. In four patients, the arrhythmia was rapidly diagnosed and treated with disappearance of further episodes of the arrhythmia. In two patients, the arrhythmia degenerated into irreversible ventricular fibrillation and both patients died. In the seventh patient, a permanent ventricular pacemaker was inserted and, despite continuation of procainamide therapy, polymorphous ventricular tachycardia did not reoccur. These seven cases demonstrate that procainamide can produce an acquired prolonged Q-T syndrome with polymorphous ventricular tachycardia.
本文报告了7例普鲁卡因胺诱发的多形性室性心动过速。4例患者在静脉注射200至400mg普鲁卡因胺治疗持续性室性心动过速后出现多形性室性心动过速。其余3例患者口服普鲁卡因胺治疗慢性室性早搏或心房扑动。这些患者因多形性室性心动过速出现Q-T间期延长和反复晕厥。4例患者的心律失常被迅速诊断并治疗，心律失常进一步发作消失。2例患者的心律失常恶化为不可逆的心室颤动，两人均死亡。在第7例患者中，植入了永久性心室起搏器，尽管继续使用普鲁卡因胺治疗，但多形性室性心动过速未再发生。这7例病例表明，普鲁卡因胺可导致获得性Q-T间期延长综合征并伴有多形性室性心动过速。
