Hösl P, Rust M, Johannigmann J, Schmidt G
Institut für Anästhesiologie, Frauenklinik der Technischen Universität München.
Geburtshilfe Frauenheilkd. 1996 Jun;56(6):313-6. doi: 10.1055/s-2007-1023236.
Adenosine versus Verapamil and other Antiarrhythmic Drugs: Paroxysmal supraventricular tachycardia is the most common sustained arrhythmia during pregnancy. Verapamil has been the most commonly used agent for the treatment of PSVT with a narrow QRS complex. Potential side effects of verapamil including systemic hypotension, acute heart failure, bradyarrhythmia and heart block may occur in pregnant women; after placental transfer bradycardia, heart block, depression of contractility and hypotension may be induced in the fetus. We report on the case of a 22-year old pregnant woman with hypotension and tachycardia, who was admitted for suspected haemorhagic shock. Indeed, she suffered from paroxysmal supraventricular tachycardia, which was successfully terminated by intravenous adenosine. Because of its known rapid onset, high effectivity, low incidence and brevity of side effects in the mother and comparative safety in the fetus, adenosine seems to be the drug of choice for treating PSVT during pregnancy.
阵发性室上性心动过速是孕期最常见的持续性心律失常。维拉帕米一直是治疗QRS波群狭窄的阵发性室上性心动过速最常用的药物。孕妇使用维拉帕米可能出现全身低血压、急性心力衰竭、缓慢性心律失常和心脏传导阻滞等潜在副作用;经胎盘转运后,可导致胎儿心动过缓、心脏传导阻滞、心肌收缩力抑制和低血压。我们报告一例22岁的孕妇,因疑似失血性休克入院,伴有低血压和心动过速。实际上,她患有阵发性室上性心动过速,静脉注射腺苷后成功终止发作。由于腺苷起效迅速、疗效高、副作用发生率低且持续时间短,对母亲而言副作用小,对胎儿相对安全,因此腺苷似乎是孕期治疗阵发性室上性心动过速的首选药物。