Corr P B, Pearle D L, Gillis R A
Am Heart J. 1976 Dec;92(6):741-9. doi: 10.1016/s0002-8703(76)80011-7.
We have previously demonstrated that atropine pretreatment increases the incidence of fatal ventricular arrhythmias induced by left anterior descending coronary artery (LAD) occlusion. The purpose of the present study was to determine whether the deleterious effect of atropine also applies to arrhythmias induced by right coronary artery (RCA) occlsusion. Occlusion of the RCA resulted in ventricular arrhythmias in all 20 animals studied, followed by ventricular fibrillation in three animals (15 per cent). Right coronary occlusion also resulted in bradycardia (-30.3 +/- 5.1 beats per minute) and hypotension (-23.1 +/- 4.9 mm. Hg). Pretreatment of 15 animals with atropine caused no significant increase in the incidence of ventricular fibrillation (i.e., 20 per cent). In addition, atropine pretreatment had no effect on the fall in heart rate and hypotension associated with RCA ligation. Sectioning the vagus nerves produced results similar to atropine pretreatment with the exception that a significant portion of the bradycardia was prevented. These results indicate that the increase in deaths after atropine observed in animals undergoing experimental LAD occlusion in not demonstrated with RCA occlusion. The results also indicate that the potential for deleterious effects of atropine in acute infarction might depend on the anatomic location of the involved myocardium.
我们之前已经证明，阿托品预处理会增加由左前降支冠状动脉（LAD）闭塞诱发的致命性室性心律失常的发生率。本研究的目的是确定阿托品的有害作用是否也适用于由右冠状动脉（RCA）闭塞诱发的心律失常。在所有20只接受研究的动物中，RCA闭塞均导致了室性心律失常，随后有3只动物（15%）发生了心室颤动。右冠状动脉闭塞还导致了心动过缓（每分钟-30.3±5.1次心跳）和低血压（-23.1±4.9毫米汞柱）。对15只动物进行阿托品预处理并未使心室颤动的发生率显著增加（即20%）。此外，阿托品预处理对与RCA结扎相关的心率下降和低血压没有影响。切断迷走神经产生的结果与阿托品预处理相似，只是有很大一部分心动过缓得到了预防。这些结果表明，在接受实验性LAD闭塞的动物中观察到的阿托品给药后死亡增加的情况，在RCA闭塞时并未出现。结果还表明，阿托品在急性梗死中产生有害作用的可能性可能取决于受累心肌的解剖位置。
