Kurita A, Mitani H, Kato R, Hikita H, Nishioka T, Takase B, Nagayoshi H, Uehata A, Satomura K
Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan.
Jpn Heart J. 1996 Sep;37(5):611-25. doi: 10.1536/ihj.37.611.
The effect of injecting ethanol directly into the myocardium to control aconitine-induced ventricular tachycardia (VT) was evaluated in anesthetized dogs. In 17 dogs, VT was induced by injecting aconitine (1.0 microgram, median dose) directly into the epicardium. After inducing persistent VT for up to 3 min, 0.6 ml (median volume) of 96% ethanol was injected into the same epicardial region. Regular sinus rhythm reappeared in 15 dogs with no change in systolic blood pressure; the other 2 dogs died of ventricular fibrillation (VF). In another 13 dogs, VT was induced by injecting aconitine directly into the endocardium using a Variocath needle catheter. After persistent VT for up to 3 min, a regular sinus rhythm was restored in 7 dogs by injecting 2.0 ml (median volume) of 96% ethanol; the remaining 6 dogs died of VF. Histology showed no transmural necrosis and the subendocardial necrotic areas were essentially the same in the dogs that recovered from VT as in those that died. There was no statistically significant relationship between doses of ethanol and VT duration. These preliminary results suggest that the injection of ethanol into the myocardium may efficiently terminate VT when other techniques fail.
在麻醉犬中评估了直接向心肌内注射乙醇以控制乌头碱诱导的室性心动过速（VT）的效果。在17只犬中，通过将乌头碱（1.0微克，中位剂量）直接注射到心外膜诱导VT。在诱导持续性VT长达3分钟后，将0.6毫升（中位体积）96%的乙醇注射到同一心外膜区域。15只犬恢复为规则的窦性心律，收缩压无变化；另外2只犬死于心室颤动（VF）。在另外13只犬中，使用Variocath针导管将乌头碱直接注射到心内膜诱导VT。在持续性VT长达3分钟后，通过注射2.0毫升（中位体积）96%的乙醇，7只犬恢复为规则的窦性心律；其余6只犬死于VF。组织学检查显示无透壁坏死，从VT恢复的犬与死亡犬的心内膜下坏死区域基本相同。乙醇剂量与VT持续时间之间无统计学显著关系。这些初步结果表明，当其他技术无效时，向心肌内注射乙醇可能有效终止VT。
