Varriale P, Ramaprasad S
Cardiology Division, Cabrini Medical Center, New York Medical College, New York 10003.
Pacing Clin Electrophysiol. 1993 Oct;16(10):1953-5. doi: 10.1111/j.1540-8159.1993.tb00987.x.
Atrial fibrillation (AF) with a rapid ventricular response was induced by intravenous (i.v.) aminophylline during treatment for symptomatic pulmonary disease in three patients who had no evidence of underlying heart disease or previous cardiac arrhythmia. Serum theophylline concentration was therapeutic in two patients and toxic in the third. Previous reports of AF related to aminophylline have underscored its association with toxic serum theophylline concentration. Conversion to sinus rhythm occurred at a time interval (9-14 hours) appropriate to the serum decay of aminophylline, after its cessation. A shortened atrial refractory period and dispersed recovery of excitability consequent to aminophylline may engender multiple reentrant circuits and lead to AF. i.v. diltiazem was more effective than digoxin in the ventricular rate control of AF prior to conversion to sinus rhythm.
在对三名无潜在心脏病证据或既往心律失常的有症状肺部疾病患者进行治疗期间，静脉注射氨茶碱诱发了快速心室反应的心房颤动（AF）。两名患者的血清茶碱浓度处于治疗水平，第三名患者的血清茶碱浓度有毒性。先前有关氨茶碱相关性AF的报道强调了其与血清茶碱毒性浓度的关联。在停用氨茶碱后，在与氨茶碱血清衰减相适应的时间间隔（9 - 14小时）内恢复为窦性心律。氨茶碱导致的心房不应期缩短和兴奋性恢复离散可能会产生多个折返环路并导致AF。在恢复为窦性心律之前，静脉注射地尔硫䓬在控制AF心室率方面比地高辛更有效。
