Ventricular Arrhythmias With Left Bundle Branch Block Pattern and Inferior Axis : Assessment of Their Mechanisms on the Basis of Response to ATP, Nicorandil and Verapamil
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概要
- 論文の詳細を見る
The present study investigated the mechanism of ventricular arrhythmias showing left bundle branch block (LBBB) pattern with an inferior axis. The effects of 3 drugs, adenosine triphosphate (ATP), nicorandil and verapamil, were evaluated in 17 patients. ATP suppressed the arrhythmias in 14 patients and nicorandil suppressed them in 8 of those 14. Verapamil suppressed 5 of the 6 ATP-nicorandil-sensitive arrhythmias. Four patients with ATP- or nicorandil-sensitive arrhythmias were not sensitive to verapamil. On the other hand, 3 of the ATP- insensitive arrhythmias were sensitive to neither nicorandil nor verapamil. The QT intervals and QTc were shortened by nicorandil in 5 of the 6 patients who were sensitive to all 3 drugs. One mechanism of suppression by nicorandil could be related to less Ca^<++> entering the myocardium, which would decrease the duration of the action potential as indicated by the shortened QT intervals. The results suggest that the mechanism of some ventricular arrhythmias is related to triggered activity. Arrhythmias that are sensitive to ATP or nicorandil, but not to verapamil, may be caused by abnormal automaticity. On the other hand, arrhythmias that are insensitive to all 3 drugs might be related to reentry. The features of ventricular arrhythmias with LBBB pattern and inferior axis differ and therefore the causative mechanisms are not the same.
- 社団法人日本循環器学会の論文
- 2000-10-20
著者
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Kobayashi Youichi
The Third Department of Internal Medicine, Showa University school of Medicine
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Katagiri Takashi
The Third Department of Internal Medicine, Showa University school of Medicine
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Kawamura Mitsuharu
the third department of internral medicine, showa university scholl of medicine
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asano taku
the third department of internral medicine, showa university scholl of medicine
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Adachi Taro
Third Department Of Internal Medicine Showa University School Of Medicine
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Kobayashi Youichi
The Third Department Of Internal Medicine School Of Medicine Showa University
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YAZAWA TAKASHI
The Third Department of Internal Medicine, Showa University
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Yazawa Takashi
The Third Department Of Internal Medicine Showa University School Of Medicine
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Adachi Taro
The Third Department of Internal Medicine, Showa University
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Obara Chiaki
Third Department Of Internal Medicine Showa University Of Medicine
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Yazawa Takashi
Third Department Of Internal Medicine Showa University
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Obara Chiaki
The Third Department of Internal Medicine, Showa University School of Medicine
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Ryu Shunsho
The Third Department of Internal Medicine, Showa University School of Medicine
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Katagiri Takashi
The Third Department Of Internal Medicine Showa University
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Kawamura Mitsuharu
The Third Department of Internal Medicine, Showa University School of Medicine
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Asano Taku
The Third Department of Internal Medicine, Showa University School of Medicine
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