Prystowsky E N
Clinical Electrophysiology Laboratory, Northside Cardiology and St. Vincent Hospital, Indianapolis, Indiana, USA.
Am J Cardiol. 1996 Oct 17;78(8A):35-41. doi: 10.1016/s0002-9149(96)00564-4.
The purpose of this review is to summarize available data concerning proarrhythmia during drug therapy for supraventricular tachycardia. Patients were included in this review if 4 elements of treatment were available from the citation: (1) presence or absence of heart disease; (2) type of supraventricular tachycardia; (3) type of antiarrhythmic drug; and (4) type of proarrhythmic event. Citations spanning the years 1922-1995 yielded 56 reports and 195 events meeting the inclusion criteria. Atrial fibrillation was the most common arrhythmia and occurred alone in 76% of patients. Heart disease was present in 96% of patients. Proarrhythmic events were associated with 8 antiarrhythmic drugs in a total of 195 administered regimens. An adverse arrhythmic event was reported most frequently with quinidine (72%). Torsades de pointes was the most common of the documented proarrhythmic events (61%). Although supraventricular tachycardias are rarely in themselves life-threatening, symptoms may be disabling for many patients, and their lifestyle may be measurably improved by the maintenance of sinus rhythm. An algorithm is presented that takes into account the factors that predispose to proarrhythmia; it attempts to minimize the risk of treating these patients with antiarrhythmic drugs.
本综述的目的是总结有关室上性心动过速药物治疗期间致心律失常作用的现有数据。如果引用文献中包含治疗的4个要素，则将患者纳入本综述：（1）有无心脏病；（2）室上性心动过速的类型；（3）抗心律失常药物的类型；（4）致心律失常事件的类型。1922年至1995年的文献检索得到56篇报告和195例符合纳入标准的事件。心房颤动是最常见的心律失常，76%的患者单独发生。96%的患者存在心脏病。在总共195种给药方案中，致心律失常事件与8种抗心律失常药物有关。奎尼丁报告的不良心律失常事件最频繁（72%）。尖端扭转型室速是记录在案的最常见的致心律失常事件（61%）。虽然室上性心动过速本身很少危及生命，但症状可能使许多患者致残，维持窦性心律可显著改善他们的生活方式。本文提出了一种算法，该算法考虑了易发生致心律失常作用的因素；它试图将使用抗心律失常药物治疗这些患者的风险降至最低。
