Gonzalez E R, Kannewurf B S, Ornato J P
Department of Pharmacy and Pharmaceutics, Virginia Commonwealth University, Medical College of Virginia Campus, Richmond 23298, USA.
Resuscitation. 1998 Oct-Nov;39(1-2):33-42. doi: 10.1016/s0300-9572(98)00111-7.
Numerous pharmacological agents with varying cellular electrophysiological effects are available to treat cardiac arrhythmias. Amiodarone is predominantly a Vaughan Williams Class III agent, but also possesses electrophysiological characteristics of the other three Vaughan Williams classes (Class I and IV and minor Class II effects). Amiodarone's primary mechanism is to prolong the cardiac action potential and repolarization time leading to an increased refractory period and reduced membrane excitability. The efficacy and tolerability of intravenous (IV) amiodarone for acute treatment of recurrent and refractory ventricular tachycardia and ventricular fibrillation has been demonstrated in clinical trials. The ARREST trial, a randomized trial comparing IV amiodarone to placebo, found a significant improvement in the proportion of patients surviving to the emergency department following out-of-hospital cardiac arrest in amiodarone-treated patients. Intravenous amiodarone is an effective anti-arrhythmic agent for the acute treatment of life-threatening ventricular arrhythmias and represents an important treatment option for emergency anti-arrhythmic therapy for patients suffering from cardiac arrest.
有多种具有不同细胞电生理效应的药物可用于治疗心律失常。胺碘酮主要是一种 Vaughan Williams Ⅲ类药物，但也具有其他三类 Vaughan Williams 药物的电生理特性（Ⅰ类和Ⅳ类以及轻微的Ⅱ类效应）。胺碘酮的主要机制是延长心脏动作电位和复极时间，导致不应期延长和膜兴奋性降低。静脉注射胺碘酮用于急性治疗复发性和难治性室性心动过速及室颤的疗效和耐受性已在临床试验中得到证实。ARREST 试验是一项比较静脉注射胺碘酮与安慰剂的随机试验，发现胺碘酮治疗的院外心脏骤停患者存活至急诊科的比例有显著改善。静脉注射胺碘酮是急性治疗危及生命的室性心律失常的有效抗心律失常药物，是心脏骤停患者紧急抗心律失常治疗的重要选择。
