Total suppression of ventricular arrhythmias by encainide. Pharmacokinetic and electrocardiographic characteristics.
Total suppression of ventricular arrhythmias by encainide. Pharmacokinetic and electrocardiographic characteristics.
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恩卡尼完全抑制室性心律失常。
DOI：
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发表时间：
1980
影响因子：
158.5
通讯作者：
R. Woosley
中科院分区：
文献类型：
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作者：
D. Roden;S. Reele;S. Higgins;R. Mayol;R. Gammans;J. Oates;R. Woosley
我们研究了 11 名患有稳定高频室性心律失常的患者口服一系列恩卡尼胺的抗心律失常作用。记录了 10 名患者在各种剂量和血浆浓度下对心律失常的完全抑制，随后在安慰剂对照交叉研究中验证了这种抑制作用。药物消除很快（半衰期为 1.9 至 3.8 小时），但疗效和副作用之间的差距足够大，每 6 至 12 小时治疗一次对所有 10 名患者都是可行的，并在 6 至 12 个月内继续门诊治疗。 PR（平均 44%）和 QRS（平均 47%）持续时间显着延长与心律失常的消除同时发生，但在放射性核素心室造影、运动测试或长时间监测中没有观察到这些影响是有害的。一名患者在治疗期间心律失常和心电图没有变化，其药物消除速度比其他患者慢得多，并且是唯一在血浆中未检测到 O-去甲基形式的患者，这表明该代谢物可能具有活性。在这项研究中，恩卡尼是一种高效、耐受性良好的抗心律失常药。
We studied the antiarrhythmic effect of a range of oral doses of encainide in 11 patients with stable high-frequency ventricular arrhythmias. Total suppression of arrhythmia was documented in 10 patients at a wide range of doses and plasma concentrations, and the suppression was subsequently verified in a placebo-controlled crossover study. Drug elimination was rapid (the half-life was 1.9 to 3.8 hours), but the margin between efficacy and side effects was sufficiently wide for therapy every six to 12 hours to be feasible in all 10 patients, with continuing outpatient treatment at six to 12 months. Marked prolongation of PR (mean, 44 per cent) and QRS (mean, 47 per cent) durations coincided with abolition of arrhythmia, but no evidence that these effects were detrimental was observed in radionuclide ventriculograms, exercise testing, or prolonged monitoring. A single patient whose arrhythmia and electrocardiogram were unchanged during therapy eliminated the drug much more slowly than the others and was the only patient in whom no O-demethyl form could be detected in plasma, suggesting that this metabolite may be active. In this study, encainide was a highly effective, well-tolerated antiarrhythmic agent.