INDUCTION OF MALIGNANT VENTRICULAR TACHYCARDIA ON AMIODARONE IN HCM PATIENTS

胺碘酮诱发 HCM 患者恶性室性心动过速

• 批准号: 3920192
• 负责人: L FANANAPAZIR
• 金额: --
• 依托单位: NATIONAL HEART, LUNG, AND BLOOD INSTITUTE
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/3920192
• 关键词: antiarrhythmic agent; heart disorder chemotherapy; human subject; hypertrophic myocardiopathy; tachycardia

Although amiodarone has been reported to improve survival in at- risk patients with hypertrophic cardiomyopathy (HCM), we have noted an unexpected mortality rate in highly symptomatic HCM patients treated with this potent antiarrhythmic medication. The study reports the results of programed electrical stimulation (PS) in 14 HCM patients - 10 patients presented with syncope and 4 with presyncope. All patients had nonsustained ventricular tachycardia (VT) on Holter monitoring. Before amiodarone therapy, sustained VT was induced in 11 patients. In 10 patients the VT was polymorphic. On amiodarone, sustained VT was induced with significantly less aggressive PS protocol in all 14 patients. In 12 patients this was monomorphic VT. Although the VT was slower on amiodarone, in all patients induction of VT was associated with marked hypertension requiring rapid termination. We conclude that in most HCM patients amiodarone facilitates induction of a hemodynamically unstable sustained monomorphic VT and thus its use is potentially dangerous and requires evaluation by PS.

尽管胺碘酮已被报道可改善at- 我们注意到，在患有肥厚型心肌病（HCM）的风险患者中， 高度症状性HCM患者的意外死亡率 用这种强效抗抑郁药治疗 研究 报告了14例程控电刺激（PS）的结果 HCM患者- 10例患者出现晕厥，4例患者出现 晕厥先兆 所有患者均出现非持续性室性心动过速 (VT)进行霍尔特监测。 胺碘酮治疗前，持续 11例患者诱发VT。 在10例患者中， 多态的 胺碘酮组，持续性室性心动过速， 在所有14名患者中，PS方案的积极性显著降低。 在 12例为单形性室性心动过速。 尽管VT速度较慢 胺碘酮组，所有患者的VT诱导均与 需要迅速终止的显著高血压。 我们的结论是 在大多数HCM患者中，胺碘酮有助于诱导 血流动力学不稳定持续性单形性VT及其应用 存在潜在危险，需要PS进行评估。