Hano O, Konoe A, Hirata T, Kaibara M, Isomoto S, Shimizu A, Centurion O, Hayano M, Yano K
Third Department of Internal Medicine, Nagasaki University School of Medicine, Japan.
Jpn Circ J. 1995 Jun;59(6):337-46. doi: 10.1253/jcj.59.337.
The effects of aprindine on atrial vulnerability were studied in 11 patients; 9 with paroxysmal atrial fibrillation (PAF), and 2 with Wolff-Parkinson-White syndrome, aged 19 to 69 (55.9 +/- 16.5; mean +/- SD). Before and 10 min after the intravenous injection of aprindine (1.5 mg/kg), programmed extrastimulation was performed from the right atrial appendage. Atrial vulnerability was assessed by evaluating the repetitive atrial firing zone (RAFZ), conduction delay zone (CDZ), maximum conduction delay (Max. CD) and fragmented atrial activity zone (FAAZ). After the injection, the duration of the P wave and QTc interval was significantly prolonged without any change in blood pressure or heart rate. RAF was observed in 8 patients under control conditions. However, after the injection of aprindine, the RAFZ completely disappeared in 2 patients, was narrowed in 4, and became wider in 1. AF was induced in the remaining patient. The zone significantly reduced (p < 0.01) without any change in CDZ or Max. CD. While FAA was observed in 5 patients under control conditions, it completely disappeared in 2 patients, was narrowed in 1, and did not change in the remaining 7 after the injection of aprindine. In patients whose RAFZ narrowed after administration of aprindine, the wavelength, as determined from the atrial effective refractory period and conduction velocity, was augmented. These results indicate that aprindine suppresses atrial vulnerability with an augmentation of the wavelength. However aprindine exaggerated atrial vulnerability in some patients, such that atrial fibrillation was induced.
在11例患者中研究了阿普林定对心房易损性的影响；其中9例为阵发性心房颤动（PAF）患者，2例为预激综合征患者，年龄在19至69岁之间（55.9±16.5；均值±标准差）。在静脉注射阿普林定（1.5mg/kg）前及注射后10分钟，从右心耳进行程控期外刺激。通过评估重复心房激动区（RAFZ）、传导延迟区（CDZ）、最大传导延迟（Max.CD）和心房碎裂活动区（FAAZ）来评估心房易损性。注射后，P波时限和QTc间期显著延长，而血压和心率无变化。在对照条件下，8例患者观察到RAF。然而，注射阿普林定后，2例患者的RAFZ完全消失，4例变窄，1例变宽。其余患者诱发了房颤。该区域显著缩小（p<0.01），而CDZ或Max.CD无变化。在对照条件下，5例患者观察到FAA，注射阿普林定后，2例患者的FAA完全消失，1例变窄，其余7例无变化。在给予阿普林定后RAFZ变窄的患者中，根据心房有效不应期和传导速度确定的波长增加。这些结果表明，阿普林定通过增加波长来抑制心房易损性。然而，阿普林定在一些患者中会加剧心房易损性，从而诱发心房颤动。
