抗心律失常药所致心律失常恶化的心电生理药物试验266例次分析

通过266例次心电生理药物试验,对奎尼丁、普鲁卡因酰胺,慢心律,乙胺碘呋酮、双异丙吡胺、室安卡因、氟卡胺,Pirmenol等抗心律失常药所致心律失常恶化进行分析。结果提示:抗律心失常药所致心律失常恶化十分常见,涉及所用8种药物,发生率10％～29％(平均21.8％),与心脏病严重程度及心脏功能不相关 抗心律失常药室安卡因和奎尼丁或普鲁卡因酰胺台用,慢心律和奎尼丁合用时可减少心律失常恶化的发生。接受奎尼丁治疗的患者QRS时间明显延长130±20ms,预示可能发生药物所致心律失常。

Aggravation of Arrhythmias Induced by Antiarrhythmic Drugs during Electrophysiologie Testing

The purpose of oUr study is to evaluate aggravation of arrhythmia induced by antiarrhythmie drugs during electrophysiologic testing. The results of 266 tests treated with quinidine, procainamide, mexiletine, amiodarone, tocainide, pirmenol, flacainide and norpace were reported. Aggravation of arrhythmias induced by antiarrhythmie drugs were common, involving almost all antiarrhythmie drugs. The incidence of aggravation is 21.8%. There was no definite relationship between arrhythmic aggravation and underlying heart diseases, ejection fraction and presenting arrhythmias. In no instance blood levels were in toxic range at the time of arrhythmic aggravation. Combined with antiarrhythmie drugs Ia+Ib decreased the incidences of aggravation of arrhythmias. Dominant widened QRS might be a clue to recognize the danger of quinidine induced arrhythmic aggravation.