Polymorphous ventricular tachycardia: a side effect of intracoronary papaverine.
Polymorphous ventricular tachycardia: a side effect of intracoronary papaverine.
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多形性室性心动过速：冠状动脉内注射罂粟碱的副作用。
DOI：
10.1016/s0735-1097(10)80048-8
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发表时间：
1990
影响因子：
24
通讯作者：
Marcus,ML
中科院分区：
文献类型：
--
作者：
Talman,CL;Winniford,MD;Rossen,JD;Simonetti,I;Kienzle,MG;Marcus,ML
在47个月期间接受冠状动脉内罂粟碱治疗的患者中，1.3%（5/391）发生多形性室性心动过速。所有5名患者的心律失常持续时间<1分钟，4名患者自发转换，1名患者需要电击复律。4.4%的女性（4/90）和0.3%的男性（1/301）发生室性心动过速（p < 0.0025）。只有1例室性心动过速患者有冠状动脉疾病，为了确定是否有其他临床或手术因素使患者易患罂粟碱副作用，将这5例患者与25例性别和冠状动脉疾病程度相匹配的对照患者进行比较。分析了以下变量：年龄、基线血清钾和钙水平、左心室射血分数、基线心率、平均动脉压、校正QT间期、罂粟碱引起的校正QT间期变化和每公斤体重药物的最大剂量。在这些变量中，只有基线心率在两组患者中有显著差异，因此，多形性室性心动过速是罂粟碱的一种罕见但重要的副作用，通常是自限性的。心率相对较慢的女性似乎更容易出现这种副作用。
Polymorphous ventricular tachycardia occurred in 1.3% of patients (5 of 391) who received intracoronary papaverine over a 47 month period. The arrhythmia lasted <1 min in all five patients, converting spontaneously in four and requiring electrical cardioversion in one. Ventricular tachycardia occurred in 4.4% of women (4 of 90) and 0.3% of men (1 of 301) (p < 0.0025). Only one of the patients with ventricular tachycardia had coronary artery disease.To determine whether other clinical or procedural factors predispose patients to this side effect of papaverine, these 5 patients were compared with 25 control patients who were matched for gender and extent of coronary artery disease. The following variables were analyzed: age, baseline serum potassium and calcium levels, left ventricular ejection fraction, baseline heart rate, mean arterial pressure, corrected QT interval, the change in corrected QT interval produced by papaverine and the maximal dose of the drug per kilogram of body weight. Of these variables, only baseline heart rate differed significantly in the two groups of patients.Thus, polymorphous ventricular tachycardia is an infrequent, but important, side effect of papaverine that is usually self-limited. Women with a relatively slow heart rate appear to be predisposed to this side effect.