Saikawa T, Ito M, Nakagawa M, Shimoyama N, Hara M, Yonemochi H, Maeda T, Inoue T, Takaki R, Arita M
Department of Internal Medicine, Oita Medical University, Japan.
Jpn Circ J. 1993 Jan;57(1):55-62. doi: 10.1253/jcj.57.55.
The effects of the washout of antiarrhythmic drugs on the frequency of ventricular premature contraction (VPC) were investigated in 64 patients (VPCs > 2000/day). Included were patients on mexiletine (300-600 mg/day; 23 patients), disopyramide (300-600 mg/day; 19 patients) and atenolol (50 mg/day; 22 patients). Holter monitoring was repeated before, during and after the treatment with the above 3 drugs and the efficacies of the drugs were evaluated based on the spontaneous variability before the treatment. VPC reduction exceeding the calculated spontaneous variability during drugs therapy (drug-responders) and after the washout of the drugs (wash-responders) was noted in 17 (63%) and 3 (13%) of the mexiletine group; 11 (58%) and 5 (26%) of the disopyramide group; and 13 (59%) and 8 (36%) of the atenolol group, respectively. For the entire group of 64 patients, wash-responders were noted significantly (p < 0.05) more among drug-responders (14 of 41 patients; 34%) than drug-nonresponders (2 of 23 patients; 9%). Therefore, the antiarrhythmic effects of drugs observed during drugs therapy seem to continue even after the discontinuation of antiarrhythmic drugs in 34% of patients those whose VPC reduction exceeded the spontaneous variability (drug-responders).
在64例室性早搏（VPC）频率＞2000次/天的患者中，研究了抗心律失常药物洗脱对室性早搏频率的影响。纳入的患者包括服用美西律（300 - 600毫克/天；23例患者）、丙吡胺（300 - 600毫克/天；19例患者）和阿替洛尔（50毫克/天；22例患者）的患者。在使用上述3种药物治疗前、治疗期间和治疗后重复进行动态心电图监测，并根据治疗前的自发变异性评估药物疗效。美西律组中，17例（63%）在药物治疗期间（药物反应者）和3例（13%）在药物洗脱后（洗脱反应者）的室性早搏减少超过计算出的自发变异性；丙吡胺组分别为11例（58%）和5例（26%）；阿替洛尔组分别为13例（59%）和8例（36%）。对于64例患者的整个组，洗脱反应者在药物反应者（41例患者中的14例；34%）中显著（p＜0.05）多于药物无反应者（23例患者中的2例；9%）。因此，在34%的室性早搏减少超过自发变异性的患者（药物反应者）中，即使在停用抗心律失常药物后，药物治疗期间观察到的抗心律失常作用似乎仍会持续。
