Bellone P, Spirito P, Vecchio C
Divisione di Cardiologia, Ente Ospedaliero Ospedali Galliera, Genoa, Italy.
Int J Cardiol. 1994 Mar 1;43(3):335-7. doi: 10.1016/0167-5273(94)90216-x.
Ventricular fibrillation is a complication in patients hospitalized for acute myocardial infarction. We report the case of an unusually high number of episodes of ventricular fibrillation (66 episodes) that occurred within a period of 4 h in a patient with recent anterior myocardial infarction. In patients with acute or recent myocardial infarction and recurrent episodes of ventricular fibrillation, intravenous lidocaine is the antiarrhythmic medication of choice. In our patient, recurrences of ventricular fibrillation were not prevented either by lidocaine, or amiodarone. The rate of recurrence of ventricular fibrillation, however, decreased dramatically, twice, in the minutes following two separate boluses of propafenone, and the arrhythmia did not recur when continuous infusion of propafenone was started. We cannot exclude that were the combined antiarrhythmic effects of lidocaine, amiodarone and propafenone that led to the final control of the arrhythmia.
心室颤动是急性心肌梗死住院患者的一种并发症。我们报告了1例近期发生前壁心肌梗死的患者在4小时内出现异常大量心室颤动发作（66次发作）的病例。对于急性或近期心肌梗死且反复发生心室颤动的患者，静脉注射利多卡因是首选的抗心律失常药物。在我们的患者中，利多卡因或胺碘酮均未能预防心室颤动复发。然而，在分别给予两次普罗帕酮推注后的数分钟内，心室颤动的复发率两次显著下降，且开始持续输注普罗帕酮后心律失常未再复发。我们不能排除是利多卡因、胺碘酮和普罗帕酮的联合抗心律失常作用最终控制了心律失常。
