ADENOSINE FOR THE MANAGEMENT OF PATIENTS WITH TACHYCARDIAS - A NEW PROTOCOL
ADENOSINE FOR THE MANAGEMENT OF PATIENTS WITH TACHYCARDIAS - A NEW PROTOCOL
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DOI：
10.1093/oxfordjournals.eurheartj.a060553
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发表时间：
1994-05-01
影响因子：
39.3
通讯作者：
LAGGNER, AN
中科院分区：
文献类型：
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作者：
DOMANOVITS, H;LASKE, H;LAGGNER, AN
我们开发了一种诊断和治疗持续性心动过速（心率> 150次）患者的新方案。min−1）。患者首先接受迷走神经操作;如果仍然不成功，则静脉注射腺苷，剂量增加至6、12和18 mg，直至记录到窦性心律（SR）或一过性房室（AV）阻滞，暴露潜在心律。46例患者共发生93次心动过速，均按本方案治疗。6例（6%）经颈动脉按摩终止，其余87例中有64例（74%）对腺苷有反应，恢复为SR。窄波心动过速转为SR的发生率高于宽波心动过速（81% vs 59%，P<00 5）。窄波心动过速的平均腺苷剂量低于宽波心动过速（13±8 vs 21 ± 10 mg; P<0.01）。两组腺苷治疗后心搏停止持续时间无显著差异，而心律失常持续时间有显著差异（8.5 ± 5.8vs18.6 ± 22.9s; P<0.05）。腺苷的副作用如潮红、呼吸困难和胸痛似乎与剂量无关，发生率约为20%。根据我们的方案，在迷走神经运动和腺苷治疗后持续心动过速的患者中，超过75%的患者实现了SR。
We developed a new protocol for diagnosis and treatment of patients with sustained tachycardias (heart rate > 150 beats. min−1). The patients first underwent vagal manoeuvres; if those remained unsuccessful, i.v. adenosine in increasing doses of 6, 12, and 18 mg was administered until sinus rhythm (SR) or transient atrioventricular (AV) block, unmasking the underlying rhythm, was recorded. In the latter and in the non-responding cases other antiarrhythmics were applied.Ninety-three episodes of tachycardia in 46 patients were treated according to this protocol. Six episodes (6%) were terminated by carotid massage, 64 of the remaining 87 episodes (74%) responded to adenosine with return to SR. Conversion to SR occurred more often in episodes with narrow- than in wide-complex tachycardia (81 vs 59%, P<005). To achieve SR, the mean adenosine dose was lower in narrow- than in wide-complex tachycardia (13±8 vs 21 ± 10 mg; P<0.01). The duration of asystole after adenosine did not differ between these two groups, whereas the duration of arrhythmia after adenosine differed significantly (8.5 ± 5.8 vs 18.6 ± 22.9 s; P<0.05). Side effects of adenosine such as flush, dyspnoea, and chest pain did not seem to be dose dependent and occurred in about 20%.According to our protocol, in more than 75% SR was achieved in patients with sustained tachycardias after vagal manoeuvres and adenosine.