Pistolese M, Boccadamo R, Altamura G, Arrigo F, Oreto G, Mazzotti P V
G Ital Cardiol. 1981;11(3):388-93.
The authors report on two cases of ventricular fibrillation induced by bolus of atropine injected for diagnostic purpose. The electrophysiologic effect of adrenergic stimulation following the parasympathetic blockade, is probably the responsible mechanism rather than myocardial ischemia in the first patient, affected by complete a-v block with narrow QRS. The second patient, affected by coronary heart disease and suspected sick sinus syndrome, had more probably a ventricular fibrillation because of a worsening of the underlying myocardial ischemia due to the increase of the cardiac rate. the reported observations, together with those of other Authors, suggest that atropine, at least when used for diagnostic purpose, should be employed cautiously and preferably having available all the equipment for emergency treatment of cardiorespiratory arrest.
作者报告了两例因诊断目的注射大剂量阿托品诱发心室颤动的病例。在第一例患有完全性房室传导阻滞且QRS波狭窄的患者中，副交感神经阻滞后肾上腺素能刺激的电生理效应可能是其发病机制，而非心肌缺血。第二例患有冠心病且疑似病态窦房结综合征的患者，更可能是由于心率增加导致潜在心肌缺血加重而发生心室颤动。本文报告的观察结果，与其他作者的观察结果一起表明，阿托品至少在用于诊断目的时，应谨慎使用，并且最好配备所有用于心肺骤停紧急治疗的设备。
