Comparison of the effects of placebo and encainide on programmed electrical stimulation and ventricular arrhythmia frequency.
Comparison of the effects of placebo and encainide on programmed electrical stimulation and ventricular arrhythmia frequency.
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比较安慰剂和恩卡尼对程序性电刺激和室性心律失常频率的影响。
DOI：
10.1016/0002-9149(82)90181-3
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发表时间：
1982
期刊：
影响因子：
--
通讯作者：
Woosley,RL
中科院分区：
文献类型：
--
作者：
Duff,HJ;Roden,DM;Dawson,AK;Oates,JA;Smith,RF;Woosley,RL
恩卡尼是一种正在研究的抗心律失常药物，在治疗非危及生命的室性心律失常方面非常有效。由于其显着的功效和短的半衰期，可以控制剂量和给药间隔，以产生反复且可预测的心律失常消除发作和心律失常复发。这项研究检查了恩卡尼诱导的心律失常抑制和复发期间程序化电刺激的结果。 8 名慢性室性心律失常患者在 6 个月的恩卡尼门诊治疗期间通过动态监测评估室性心律失常受到抑制，并在无药物状态下接受了程序化电刺激测试。然后患者被随机分配接受安慰剂或恩卡尼。此后，在施用安慰剂或恩卡尼之前和之后1小时每天进行两次电生理学测试。在接受恩卡尼的患者中，重复性心室反应在心律失常抑制期间既不始终不存在，也不在心律失常复发期间始终存在。此外，在恩卡尼抑制自发性室性心律失常期间，四名患者表现出更容易诱发重复性心室反应。事实上，其中一名患者在恩卡尼存在的情况下进行了编程电刺激（单次额外刺激），引发了心室颤动。随机分配接受安慰剂治疗的 4 名患者中，有 3 名最初表现出重复性心室反应：然而，在一段时间内，所有患者中观察到重复性心室反应的舒张期区域逐渐减弱，并消失至少 1 天。在接受恩卡尼治疗的患者中观察到一段时间内无法区分的变化。当使用单个电极部位的编程电刺激来评估药物治疗时，必须考虑心脏电生理测量的时间依赖性变化。在这项研究中，恩卡尼给药或撤药时，重复性心室反应的存在或不存在与心律失常频率无关。在恩卡尼存在的情况下进行程序性电刺激可能会引起潜在致命的室性心律失常。
Encainide is an investigational antiarrhythmic agent that is very effective in the treatment of nonlife-threatening ventricular arrhythmias. Because of its marked efficacy and short half-life it has been possible to manipulate the dose and dosing interval to produce repeatedly and predictably episodes of arrhythmia abolition followed by arrhythmia recurrence. This study examined the results of programmed electrical stimulation during periods of arrhythmia suppression and recurrence induced by encainide. Eight patients with chronic ventricular arrhythmias who had suppression of ventricular arrhythmia as assessed by ambulatory monitoring during 6 months of outpatient treatment with encainide underwent programmed electrical stimulation testing in a drug-free state. Patients were then randomly assigned to receive placebo or encainide. Thereafter, electrophysiologic testing was performed twice daily immediately before and 1 hour after administration of either placebo or encainide. In patients receiving encainide, the repetitive ventricular response was neither consistently absent during periods of arrhythmia suppression nor consistently present during periods of arrhythmia recurrence. Furthermore, four patients showed increased ease of inducibility of the repetitive ventricular response during periods when encainide had suppressed the spontaneous ventricular arrhythmias. Indeed, in one of these patients programmed electrical stimulation (single extrastimulus) in the presence of encainide elicited ventricular fibrillation. Three of four patients randomly assigned to placebo therapy initially manifested a repetitive ventricular response: However, over a period of time the zone in diastole in which the repetitive ventricular response was observed progressively diminished and became absent for at least 1 day in all patients. Indistinguishable changes over a period of time were seen in the patients treated with encainide.Time-dependent variations in cardiac electrophysiologic measurements must be taken into account when programmed electrical stimulation at a single electrode site is used to evaluate drug therapy. In this study the presence or absence of the repetitive ventricular response bore no relation to arrhythmia frequency as encainide was administered or withdrawn. Programmed electrical stimulation in the presence of encainide may elicit potentially lethal ventricular arrhythmias.
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影响因子：
2.8
作者：
G. B. Bren;P. Varghese;R. Katz;A. Ross
通讯作者：
A. Ross
影响因子：
37.8
作者：
M. Akhtar
通讯作者：
M. Akhtar
人工心脏起搏器。
影响因子：
4.8
作者：
H. Thalen
通讯作者：
H. Thalen
DOI：
--
发表时间：
1982
期刊：
Clinical pharmacology and therapy
影响因子：
--
作者：
R. Kates;Donald C. Harrison;R. Winkle
通讯作者：
R. Winkle
恩卡尼完全抑制室性心律失常。
影响因子：
158.5
作者：
D. Roden;S. Reele;S. Higgins;R. Mayol;R. Gammans;J. Oates;R. Woosley
通讯作者：
R. Woosley