Abinader E, Borochowitz Z, Berger A
Helv Paediatr Acta. 1981 Nov;36(5):451-5.
The effectiveness and lack of undesirable side-effects has made Verapamil the drug of choice in the treatment of paroxysmal supraventricular tachycardia in infants without underlying heart disease. The case described demonstrates the occasional severe negative inotropic effect of the drug, independent of its influence on heart rate and conduction. Severe heart failure and shock ensued after a therapeutic dose of i.v. Verapamil in a newborn suffering from atrial flutter with no associated heart disease. Although the arrhythmia was promptly converted to sinus rhythm, the baby required two hours of cardiopulmonary resuscitation and inotropic support. Follow-up during the first year of life revealed a normal healthy baby. Attention to the hemodynamic status in addition to continuous ECG monitoring is mandatory during i.v. Verapamil administration also in patients without underlying heart disease.
维拉帕米的有效性及无不良副作用使其成为治疗无潜在心脏病婴儿阵发性室上性心动过速的首选药物。所描述的病例显示了该药物偶尔会出现严重的负性肌力作用，这与其对心率和传导的影响无关。一名患有房扑且无相关心脏病的新生儿在静脉注射治疗剂量的维拉帕米后，出现了严重心力衰竭和休克。尽管心律失常迅速转为窦性心律，但该婴儿仍需要两小时的心肺复苏和正性肌力支持。一岁内的随访显示婴儿健康正常。对于无潜在心脏病的患者，静脉注射维拉帕米时，除持续心电图监测外，关注血流动力学状态也是必不可少的。
