Bourret N, Kirkorian G, Chevalier P, Bellon C, Richalet C, Bouchayer D, Bonnefoy E, Touboul P
Hôpital cardiovasculaire et pneumologique Louis-Pradel, Lyon-Montchat.
Arch Mal Coeur Vaiss. 1996 Oct;89(10):1277-81.
A good result of electrophysiological investigations under amiodarone therapy distinguishes a low risk group of patients with malignant ventricular arrhythmias. The authors set out to determine the factors predictive of this response in order to identify patients better protected by amiodarone at an earlier stage. Fourty-five patients with an average age of 56 years, were referred for evaluation of severe ventricular arrhythmias, monomorphic ventricular tachycardia being inducible during electrophysiological investigation in all cases before treatment. Amiodarone was prescribed orally at degressive doses. A control electrophysiological study was performed 4 to 6 weeks later. Eighteen patients (40%) were considered to be responders (absence of inducible ventricular arrhythmia or inducible non-sustained tachycardia or tachycardia with a cycle length increased by over 100 ms with respect to the base-line study). The other 27 patients were considered to be non-responders. No clinical or paraclinical parameter was found to distinguish responders from non-responders. The authors conclude that the data obtained before control electrophysiological investigation under amiodarone does not allow prediction of the response to this drug. The search for early prognosis of the efficacy of amiodarone in preventing ventricular arrhythmias therefore requires electrophysiological investigation after impregnation.
胺碘酮治疗下电生理检查结果良好可区分出恶性室性心律失常的低风险患者组。作者着手确定预测这种反应的因素，以便在更早阶段识别出受胺碘酮更好保护的患者。45名平均年龄为56岁的患者因严重室性心律失常接受评估，在治疗前所有病例的电生理检查中均可诱发单形性室性心动过速。胺碘酮以递减剂量口服给药。4至6周后进行对照电生理研究。18名患者（40%）被认为是反应者（不存在可诱发的室性心律失常或可诱发的非持续性心动过速，或心动过速的周期长度相对于基线研究增加超过100毫秒）。其他27名患者被认为是非反应者。未发现临床或临床旁参数可区分反应者与非反应者。作者得出结论，在胺碘酮治疗下进行对照电生理检查之前获得的数据无法预测对该药物的反应。因此，寻找胺碘酮预防室性心律失常疗效的早期预后需要在用药后进行电生理检查。
