Hamer A W, Finerman W B, Peter T, Mandel W J
Am Heart J. 1981 Dec;102(6 Pt 1):992-1000. doi: 10.1016/0002-8703(81)90482-8.
Nine patients with life-threatening ventricular arrhythmias were administered oral amiodarone over a period of months. Sustained ventricular tachycardia (VT) was induced during programmed stimulation in seven of the nine patients prior to their receiving amiodarone therapy. Despite an excellent clinical response to the drug over a period of 10 to 24 months (median 15 months), sustained VT was still able to be initiated in seven patients after 7 to 20 weeks of therapy, with multiform VT induced in several patients both before and after amiodarone. Some effects of the drug were noted, however, in that the induced VT was often slower with an increased QRS width, and right ventricular refractory periods were prolonged. Repeated ambulatory ECG monitoring in six patients showed a reduction in the frequency and complexity of spontaneous ventricular arrhythmias, but there was no consistent effect on the prematurity of the ventricular complexes. The reason for the disparity in some patients between the effects of amiodarone on the electrical initiation of VT and its clinical recurrence is unclear, but the findings suggest that the clinical efficacy of amiodarone in patients with ventricular arrhythmias may not be reliably predicted by electrophysiologic studies (EPS).
9名患有危及生命的室性心律失常的患者在数月内接受了口服胺碘酮治疗。在9名患者中，有7名在接受胺碘酮治疗前的程序刺激期间诱发了持续性室性心动过速（VT）。尽管在10至24个月（中位数15个月）的时间里患者对该药物有良好的临床反应，但在治疗7至20周后，仍有7名患者能够诱发持续性VT，在胺碘酮治疗前后，有几名患者诱发了多形性VT。不过，还是注意到了该药物的一些作用，即诱发的VT通常较慢，QRS波宽度增加，右心室不应期延长。对6名患者进行的反复动态心电图监测显示，自发性室性心律失常的频率和复杂性有所降低，但对室性复合波的提前发生没有一致的影响。胺碘酮对VT电诱发的影响与临床复发在一些患者中存在差异的原因尚不清楚，但这些发现表明，电生理研究（EPS）可能无法可靠地预测胺碘酮在室性心律失常患者中的临床疗效。
