Sarubbi B, Ducceschi V, Briglia N, Mayer M S, Santangelo L, Iacono A
Seconda Università degli Studi di Napoli, Facoltà di Medicina e Chirurgia, Istituto Medico Chirurgico di Cardiologia, Cattedra di Cardiologia, Italy.
Int J Cardiol. 1998 Sep 30;66(2):157-64. doi: 10.1016/s0167-5273(98)00201-0.
Antiarrhythmic drugs are known to affect the depolarization and repolarization time in a different fashion. The aim of the present study was to compare the effects of Sotalol, Flecainide and Propafenone on some common (QT, QTc, JT, JTc) or uncommon (QTc dispersion, T-peak to T-end interval) electrocardiographic parameters in order to evaluate the effects of these antiarrhythmic drugs on ventricular repolarization time both in terms of absolute values and of dispersion across the myocardium. The analysis of these antiarrhythmic drug effects was performed on the standard 12-lead electrocardiograms of 31 patients (17F and 14M, age 38.1+/-17 years, range 11-67 years) in the free-drug state and at the steady state after oral treatment with Sotalol (160 mg daily), Flecainide (200 mg daily) and Propafenone (450 mg daily). These drugs were prescribed, separately, to all the 31 patients, free of underlying structural heart disease, for the treatment of their atrio-ventricular nodal re-entry tachycardia. Data of the present study show that Sotalol, over the range prescribed, significantly prolongs ventricular repolarization index QT (P=0.001), JT (P=0.0001) and JTc (P=0.0001) values in an homogeneous fashion, as shown by the significant decrease in QTcD (P=0.019) and Tp-Te (P=0.01). On the contrary, Flecainide treatment was associated with an increase in QTcD (P=0.029), Tp-Te (0.0001), QT (P=0.001), QTc (P=0.0001) and QRS (P=0.0001), with no significant changes in JT and JTc. Propafenone, over the range prescribed, did not affect repolarization time, resulting only in a prolongation of depolarization time as expressed by the increase of QRS (P=0.0001).
已知抗心律失常药物会以不同方式影响去极化和复极化时间。本研究的目的是比较索他洛尔、氟卡尼和普罗帕酮对一些常见（QT、QTc、JT、JTc）或不常见（QTc离散度、T峰至T末间期）心电图参数的影响，以便从绝对值和心肌离散度方面评估这些抗心律失常药物对心室复极化时间的影响。对31例患者（17例女性和14例男性，年龄38.1±17岁，范围11 - 67岁）在未用药状态以及口服索他洛尔（每日160毫克）、氟卡尼（每日200毫克）和普罗帕酮（每日450毫克）达到稳态后的标准12导联心电图进行了这些抗心律失常药物效应分析。这31例无潜在结构性心脏病的患者均分别服用这些药物以治疗房室结折返性心动过速。本研究数据表明，在所规定的剂量范围内，索他洛尔以均匀方式显著延长心室复极化指数QT（P = 0.001）、JT（P = 0.0001）和JTc（P = 0.0001）值，QTcD（P = 0.019）和Tp - Te（P = 0.01）显著降低表明了这一点。相反，氟卡尼治疗与QTcD（P = 0.029）、Tp - Te（0.0001）、QT（P = 0.001）、QTc（P = 0.0001）和QRS（P = 0.0001）增加相关，JT和JTc无显著变化。在所规定的剂量范围内，普罗帕酮不影响复极化时间，仅导致去极化时间延长，表现为QRS增加（P = 0.0001）。
