异搏定治疗特殊类型室性心动过速的临床疗效与安全性研究

目的　探讨异搏定治疗特殊类型室性心动过速 (室速 )的临床疗效与安全性。方法　对 2 3例特发性单形性室速和短联律间距室性早搏 (室早 )诱发的多形性室速患者 ,使用异搏定每次 5～ 10mg稀释后缓慢静脉注射 ,监测注药前后的心电与血压改变。室速终止后口服该药 40～ 80mg ,每日 3次维持治疗。 结果　 1例患者死亡 ,余2 2例均予静注该药而及时终止了室速发作 ,部分静注总量超过 2 0mg的患者出现短时血压下降和窦房结功能抑制。 16例口服维持治疗并随访 8个月至 6年的患者 ,室速未再发作或发作次数明显减少。结论　异搏定对于这类特殊类型室速的疗效肯定 ,安全性较好 ,副作用少。不良反应发生与剂量有关。但异搏定不能防止短联律间距室早诱发的多形性室速患者猝死发生。

Efficacy and safety of verapamil in treatment of special types of ventricular tachycardia

Objective　To evaluate the effic acy and safety of verapamil in treatment ofspecial types of ventricular tachyca rdia(VT).Methods　Twenty-three patients withidiopathic monomorphi c VT and polymorphic VT with extremely short coupling interval weretreated wit h intravenous verapamil in a dose of 5～10mg. Electrocardiogram and bloodpressu re were continuously monitored before and after intravenous verapamil administration.Oral verapa mil in a dose of 40～80mg three times daily was administered to thesepatients a fter terminating VT.Results　 One patient failed to prevent a fatal event anddied, whereas intravenous ve r apamil timely teminated VT in the other twenty-twopatients.Short-time lower bloo d pressure and sinus depression developed in some patientswhen the total intrav enous verapamil dose was over 20mg.During a follow-up of 8 month to6 years, or al verapamil prevented the recurrence of VT or significantly reduced thefreque ncy of recurrence in 16 patients. Conclusion　Verapamil is an effective and safeagent for the treat ment of the special types of VT. No obvious side effects has beenfound.Adverse resp onse development is related to the dosage.But verapamil can't preventsudden dea th induced by polymorphic VT with extremely short coupling interval.