Rezkalla M A, Pochop C
VA Hospital, Sioux Falls, SD.
S D J Med. 1994 May;47(5):161-4.
We report a case of an 82 year old woman with bilateral pneumonia who developed repeated episodes of polymorphic ventricular tachycardia with QT prolongation (Torsades de Pointes) after intravenous infusion of erythromycin. After discontinuation of erythromycin, the QT interval returned to normal and there was no recurrence of this arrhythmia. The association of intravenous erythromycin and this potentially fatal ventricular arrhythmia has been described in 15 similar cases reported in the literature. Both in vitro and in vivo studies have shown that erythromycin exerts electrophysiologic effects on the cardiac muscle similar to that of class IA antiarrhythmic drugs and that cross sensitivity may exist between this class of drugs and erythromycin. The definition, pathophysiology, etiology, clinical and electrocardiographic feature, and prevention and treatment of "Torsades de Pointes" are described in this article.
我们报告一例82岁双侧肺炎女性患者，静脉输注红霉素后出现多形性室性心动过速伴QT间期延长（尖端扭转型室速）的反复发作。停用红霉素后，QT间期恢复正常，且该心律失常未再复发。静脉用红霉素与这种潜在致命性室性心律失常之间的关联在文献报道的15例类似病例中已有描述。体外和体内研究均表明，红霉素对心肌产生的电生理效应类似于IA类抗心律失常药物，且这类药物与红霉素之间可能存在交叉敏感性。本文描述了“尖端扭转型室速”的定义、病理生理学、病因、临床及心电图特征，以及预防和治疗方法。
