He F, Zhao X, Cheng X
First Affiliated Hospital, Shanxi Medical College, Taiyuan.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 1994 Jun;16(3):239-41.
The clinical acute electrophysiological effects of propafenone were evaluated using transesophageal atrial pacing (TEAP) in 65 patients with various arrhythmias. The mean age of the patients was 41 years. Incremental pacing and programmed ectopic stimulation were performed on each patient before and during drug administration. Propafenone was given as a bolus injection of 1.5mg.kg-1 body weight followed by drip infusion at a rate of 1 mg.min-1. S-R, P wave, P-R and QRS intervals were prolonged from 194.43 +/- 21.59, 97.49 +/- 10.92, 148.00 +/- 16.20 and 82.21 +/- 7.18ms 223.00 +/- 29.25, 100.22 +/- 10.60, 166.60 +/- 20.10 and 86.54 +/- 7.19ms, respectively (P < 0.005), A-V conduction system effective refractory period (AVCSERP) was prolonged from 316.35 +/- 82.97ms to 360.31 +/- 82.67ms (P < 0.0001) in the treated group. There was no change of atrial ERP and QTc interval (P > 0.05). Fast and slow pathway ERP was prolonged by 13% and 28% of the control value, respectively (P < 0.015), and accessory pathway ERP was prolonged from 278.89 +/- 27.13ms to 305.56 +/- 33.58ms (P < 0.001), in the treated group. Sinus cycle length, corrected sinus nodal recovery time and total sinus-atrial conductive time were significantly prolonged (P < 0.0001). The results can partially explain the antiarrhythmic effects and the side effects of propafenone. TEAP is dependable in evaluating the clinical electrophysiological effects of drugs.
采用经食管心房起搏(TEAP)对65例各种心律失常患者进行了普罗帕酮临床急性电生理效应评估。患者的平均年龄为41岁。在给药前及给药期间对每位患者进行递增起搏和程控异位刺激。普罗帕酮按1.5mg·kg-1体重静脉推注,随后以1mg·min-1的速率静脉滴注。S-R、P波、P-R和QRS间期分别从194.43±21.59、97.49±10.92、148.00±16.20和82.21±7.18ms延长至223.00±29.25、100.22±10.60、166.60±20.10和86.54±7.19ms(P<0.005),治疗组房室传导系统有效不应期(AVCSERP)从316.35±82.97ms延长至360.31±82.67ms(P<0.0001)。心房有效不应期和QTc间期无变化(P>0.05)。治疗组快径路和慢径路有效不应期分别较对照值延长13%和28%(P<0.015),旁道有效不应期从278.89±27.13ms延长至305.56±33.58ms(P<0.001)。窦性周期长度、校正窦房结恢复时间和总窦房传导时间显著延长(P<0.0001)。这些结果可部分解释普罗帕酮的抗心律失常作用及副作用。TEAP在评估药物临床电生理效应方面是可靠的。