Perri C, Bosco G, Ventriglia F, Giglioni E, Mandolido P, Colloridi V
Cattedra di Cardiologia Pediatrica, Università degli Studi di Roma La Sapienza.
G Ital Cardiol. 1993 Mar;23(3):273-8.
The diagnostic and therapeutic utility of adenosine triphosphate (ATP) in pediatric age was investigated in fifteen children aged 4 days-16 years (mean age 6.4 years) observed for paroxysmal (Group A-9 pts) or incessant (Group B-6 pts) tachycardia. Twelve patients underwent transesophageal electrophysiological study. ATP was given as an intravenous bolus (0.075-0.5 mg/Kg). In Group A patients, ATP resulted in termination of spontaneous or induced tachycardia, and in all cases interruption in anterograde limb of the re-entry circuit occurred. In Group B patients, ATP induced transient atrioventricular block with persistence of atrial tachycardia, suggesting the atrial origin of the arrhythmia. No adverse haemodynamic effects were observed in any patient. We conclude that in pediatric age ATP must be considered the drug of first choice for junctional reciprocating tachycardias because of its efficacy, short mid-life and insignificant side-effects. Furthermore, it represents an effective diagnostic test for differentiating between junctional reciprocating tachycardias and atrial ectopic tachycardias.
对15名年龄在4天至16岁（平均年龄6.4岁）的儿童进行了研究，观察三磷酸腺苷（ATP）在儿科的诊断和治疗效用，这些儿童患有阵发性（A组-9例）或持续性（B组-6例）心动过速。12例患者接受了经食管电生理研究。ATP以静脉推注的方式给药（0.075-0.5mg/Kg）。在A组患者中，ATP导致自发性或诱发性心动过速终止，并且在所有病例中折返环的前传支均发生中断。在B组患者中，ATP诱发了短暂的房室传导阻滞，房性心动过速持续存在，提示心律失常的起源为心房。未在任何患者中观察到不良血流动力学效应。我们得出结论，在儿科，由于ATP疗效显著、半衰期短且副作用不明显，必须将其视为交界性折返性心动过速的首选药物。此外，它是区分交界性折返性心动过速和房性异位性心动过速的有效诊断试验。
