Suppression of Ventricular Premature Contractions Possibly Related to Triggered Activity by Oral Diltiazem and Atenolol : SYMPOSIUM ON VENTRICULAR ARRHYTHMIA : BASIC AND CLINICAL STUDIES : 50th Annual Scientific Session of the Japanese Circulation Society
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概要
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The clinical importance of triggered activity as a cause of arrhythmias is uncertain. We assumed that ventricular premature contractions (VPCs) caused by triggered activity could be increased at higher heart rates and be suppressed by calcium channel blockers and beta-adrenoceptor blockers. Thus, we evaluated VPC frequency as a function of underlying heart rate and examined the efficacy of diltiazem and atenolol on VPCs, using 24 hour ECG recording. Plots of VPC frequency vs. heart rate were made at 1-beat/min intervals for all heart rates recorded for at least 5 min during 24 hours. Diltiazem (90-180 mg/day) and atenolol (50 mg/day) were given orally for 4 weeks, respectively in 36 and 16 patients with VPCs of more than 2000/day. Patterns of relationship between VPC frequency and heart rate observed before diltiazem therapy included: 1) an increase of VPCs at higher heart rates (positive correlation) in 16 patients, 2) an increase at low heart rates and a decrease at high heart rates (bidirectional correlation) in 13 patients, 3) an increase at low heart rates and flat curve at high heart rates ( positive-flat correlation) in 5 patients, 4) a linear decrease (negative correlation) in 1 patient, and 5) flat curve (flat correlation) in 1 patient. The patterns of correlation in patients treated with atenolol were positive in 6, bidirectional in 7, positive-flat in 2 and negative in 1. Both drugs significantly reduced the VPC frequency per 24 hours for patients with a positive correlation (P group), but induced no significant change for those with the other patterns of correlation (NP group). At the 70% VPC suppression level, diltiazem was effective in 9 of 16 patients of P group and only 1 of 20 patients of NP group (p<0.01); atenolol was effective in 5 of 6 patients of P group only 1 of 10 patients of NP group (p<0.05). Both drugs reduced the slope of a positive correlation. These results suggest that: 1) VPCs which increase at higher heart rates may be related to triggered activity, and 2) an evaluation of VPC frequency as a function of heart rate predicts the response of VPCs to diltiazem and atenolol, and probably to other calcium antagonists and beta blockers.
- 社団法人日本循環器学会の論文
- 1987-02-20
著者
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Saikawa Tetsunori
Department Of Cardiovascular Science Oita University
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FUJINO Takehiko
Institute of Health Science, Kyushu University
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Maeda Yasuhiro
The Department Of Laboratory Medicine Medical College Of Oita
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Fujino Takehiko
The First Department of Medicine, Kyushu University
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Kagiyama Yutaka
The Department Of Internal Medicine Kyushu Koseinenkin Hospital
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Fujino Takao
Laboratory Medicine School Of Medicine Oita Medical University
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Fukumoto Teruo
The School Of Nursing And Medical Technology University Of Occupational And Environmental Health
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Arita M
Department Of Cardiovascular Science Oita Medical University
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Arita M
The Department Of Physiology Medical College Of Oita
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Fujino Takehiko
The First Department Of Internal Medicine School Of Medicine Kyushu University
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Fujino Takehiko
1st Dept. Of Intern. Med. Facult. Of Med. Kyushu Univ.
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ITO MORIO
The Department of Laboratory Medicine Medical College of Oita
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TSUMABUKI SHIGERU
The Department of Laboratory Medicine Medical College of Oita
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ARITA MAKOTO
The Department of Physiology, Medical College of Oita
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SAIKAWA TETSUNORI
The Department of Internal Medicine,Medical College of Oita
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ITO SUKENOBU
The Department of Internal Medicine,Medical College of Oita
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YAMADA KENSUKE
The Department of Internal Medicine, Hamanomachi Hospi-tal
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KIKUCHI YUTAKA
The Department of Internal Medicine, Kyushu Koseinenkin Hospital
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Ito Snkenobu
1st Dept. Of Intern. Med. Facult. Of Med. Kyushu Univ.
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Saikawa Tetsunori
First Department Of Internal Medicine Medical College Of Oita
-
Ito Morio
Department Of Laboratory Medicine School Of Medicine Oita Medical University
-
Ito Seiki
1st Department Of Medicine Medical College Of Oita
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Arita M
Department Of Physiology Oita Medical University
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Arita Makoto
Department Of Cardiovascular Science Oita Medical University
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Arita Makoto
The Department Of Physiology Medical College Of Oita
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Ito Sukenobu
Department Of Internal Medicine Medical College Of Oita
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Ito Sukenobu
1st Department Of Medicine Medical College Of Oita
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Ito Sukenobu
First Department Of Internal Medicine Faculty Of Medicine Kyushu University
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Yamada Kensuke
The Department Of Internal Medicine Hamanomachi Hospi-tal
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Tsumabuki Shigeru
Department of Laboratory Medicine , Medical College of Oita
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ITO MORIO
Kyushu Univ.
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Fujino Takehiko
The First Department Of Internal Medicine Faculty Of Medicine Kyushu University
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Itoh Morio
The First Department Of Internal Medicine Faculty Of Medicine Kyushu University
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Ito Morio
1st Div. Dept. Of Intern. Med Faculty Of Med. Kyushu Univ.
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Ito Morio
Oita Medical Univ. Oita
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Tsumabuki Shigeru
Department Of Laboratory Medicine Medical College Of Oita
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