ADENOSINE - ELECTROPHYSIOLOGIC EFFECTS AND THERAPEUTIC USE FOR TERMINATING PAROXYSMAL SUPRA-VENTRICULAR TACHYCARDIA
ADENOSINE - ELECTROPHYSIOLOGIC EFFECTS AND THERAPEUTIC USE FOR TERMINATING PAROXYSMAL SUPRA-VENTRICULAR TACHYCARDIA
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DOI：
10.1161/01.cir.68.6.1254
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发表时间：
1983-01-01
期刊：
影响因子：
37.8
通讯作者：
BELARDINELLI, L
中科院分区：
文献类型：
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作者：
DIMARCO, JP;SELLERS, TD;BELARDINELLI, L
腺苷静脉注射。 17 名接受心内电生理学研究的患者。平均剂量为 179 .+/-。 88.mu.g/kg(.+-.SD)，腺苷抑制窦房结自律性和抑制房室(AV)结传导。这些作用的持续时间< 20 秒，并且不受阿托品（0.02-0.03 mg/kg）毒蕈碱阻断的影响。该剂量的腺苷对沃尔夫-帕金森-怀特综合征患者的旁路顺行传导没有影响。没有观察到独立的血流动力学效应。 6 名患者静脉注射腺苷。在刺激引起的阵发性室上性心动过速期间。在 5 名心动过速折返环包括 AV 结的患者中，腺苷的平均剂量为 83 +/-。 35 .mu.g/kg (.+-. SD) 在外周静脉注射后 20 秒内终止其心动过速。注射。终止心动过速所需的腺苷剂量不会产生明显的窦房结抑制，所有患者均迅速恢复窦性心律。腺苷不会终止由于房内折返或心房扑动引起的室上性心动过速，但在这些心律失常期间确实产生短暂的房室传导阻滞。显然，人类窦和房室结对腺苷的生理剂量敏感，并且腺苷可以安全有效地用于终止涉及折返通路中房室结的室上性心动过速的急性发作。
Adenosine was administered i.v. to 17 patients undergoing intracardiac electrophysiologic studies. At a mean dose of 179 .+-. 88 .mu.g/kg (.+-. SD), adenosine suppressed sinus node automaticity and depressed atrioventricular (AV) nodel conduction. These effects were < 20 s in duration and were not influenced by muscarinic blockade with atropine (0.02-0.03 mg/kg). Adenosine at this dose had no effect on antegrade conduction over accessory pathways in patients with Wolff-Parkinson-White syndrome. No independent hemodynamic effects were observed. In 6 patients, adenosine was administered i.v. during stimulation-induced paroxysmal supraventricular tachycardia. In the 5 patients in whom the reentry loop of their tachycardia included the AV node, adenosine at a mean dose of 83 .+-. 35 .mu.g/kg (.+-. SD) terminated their tachycardia within 20 s after peripheral i.v. injection. The dose of adenosine required to terminate these tachycardias did not produce manifest sinus node suppression, and sinus rhythm promptly resumed in all patients. Adenosine did not terminate either supraventricular tachycardia due to intra-atrial reentry or atrial flutter, but did produce transient AV block during these arrhythmias. Evidently, the human sinus and AV nodes are sensitive to physiologic doses of adenosine and adenosine may be used safely and effectively to terminate acute episodes of supraventricular tachycardia that involve the AV node in the reentry pathway.