Leather R A, Klein G J, Murdoch C, Yee R, Leitch J W
Department of Medicine, University of Western Ontario, London.
Can J Cardiol. 1994 May;10(4):433-8.
The antiarrhythmic agent propafenone has been reported to prolong atrioventricular node conduction and may be suitable for rate control in atrial fibrillation (AF). To evaluate this, 10 patients (seven men and three women aged 29 to 67 years, mean +/- SD 48 +/- 14) were given intravenous propafenone during AF in both the supine and upright positions. Intracardiac catheters measured local electrograms from the high right atrium and right ventricular apex during AF. Atrial rate, ventricular rate and blood pressure were recorded in the control state and after head-up tilt with these measurements repeated after propafenone 1.5 mg/kg was infused over 5 mins. Four of 10 patients reverted to sinus rhythm. Propafenone increased the mean ventricular cycle length (496 +/- 147 versus 556 +/- 152 ms, P = 0.1), although this did not reach significance. In contrast, propafenone markedly increased the mean atrial cycle length (136 +/- 35 versus 226 +/- 39, P < 0.001). The mean ventricular cycle length reverted to baseline after tilt (447 +/- 103 ms) while the mean atrial cycle length decreased but not to baseline levels (170 +/- 21 ms). The authors conclude that intravenous propafenone is generally inadequate for rate control in AF, especially in the upright position.
据报道，抗心律失常药物普罗帕酮可延长房室结传导时间，可能适用于心房颤动（AF）时的心率控制。为评估这一点，对10例患者（7例男性和3例女性，年龄29至67岁，平均±标准差48±14）在仰卧位和直立位的房颤期间给予静脉注射普罗帕酮。在房颤期间，心内导管测量高位右心房和右心室心尖的局部心电图。在对照状态下记录心房率、心室率和血压，在头高位倾斜后重复测量，在5分钟内输注1.5mg/kg普罗帕酮后再次重复测量。10例患者中有4例恢复窦性心律。普罗帕酮增加了平均心室周期长度（496±147对556±152毫秒，P = 0.1），尽管未达到显著差异。相比之下，普罗帕酮显著增加了平均心房周期长度（136±35对226±39，P < 0.001）。倾斜后平均心室周期长度恢复到基线水平（447±103毫秒），而平均心房周期长度缩短但未恢复到基线水平（170±21毫秒）。作者得出结论，静脉注射普罗帕酮通常不足以控制房颤时的心率，尤其是在直立位时。
