逆行性副伝導路を介する reciprocating tachycardia に関する電気生理学的研究 : 特に verapamil と disopyramide の有用性と作用機序について
スポンサーリンク
概要
- 論文の詳細を見る
The effectiveness and mechanism of action were electrophysiologically studied after 10mg of intravenous verapamil (V) and 100mg of intravenous disopyramide (D) on reciprocating tachycardia (RT) utilizing retrograde accessory pathway (AP) in 27 patients including 23 cases of Wolff-Parkinson-White syndrome (WPW), 2 cases of concealed WPW and 1 case of concealed atrio-His bypass. Conduction properties were evaluated before and after each drug using i) incremental atrial pacing ; ii) atrial extrastimulus testing; iii) incremental ventricular pacing; iv) ventricular extrastimulus testing with obtained following results. 1) V revealed a remarkable effect in delaying conduction and prolonging refractoriness in the atrioventricular node (AVN), while D did a variable effect in the AVN. 2) D produced complete ante grade block in the AP in 7 of 12 cases with WPW syndrome. Although antegrade effective refractory period of AP (AP_<AERP>) was not significantly prolonged in the other 5 cases, AP conduction was suppressed after D by the incremental atrial pacing. As retrograde effective refractory period of AP (AP_<RERP>) was shorter than AP_<AERP> in WPW with RT, D suppressed retrograde AP conductin less than antegrade AP conducton as well as in concealed AP, although in one case with WPW syndrome the echo zone was abolished due to suppression of retrograde AP conduction by this agent. On the other hand V had no significant effect on AP_<AERP> or AP_<RERP>. 3) V abolished the echo zone in 7 of 8 cases, but D widened the echo zone in 3 of 11 cases and induced sustained RT in 3 cases with WPW syndrome because of shortened AVN_<AERP> and prolonged AP_<AERP>. 4) V could terminate the induced RT in all 7 cases, but D could neither terminate the induced RT nor decrease the cardiac rate remarkably in all 4 cases including one case of WPW, two cases of concealed WPW and one case of conceald atrio-His bypass. In conclusion, V was effective in terminating sustained RT in majority of patient with WPW syndrome because of an increase in AV nodal refractoriness, but D was not always effctive in these cases. However, D may have beneficial effect on AP_<AERP> in some patients with WPW syndrome.
- 神戸大学の論文
著者
関連論文
- 逆行性副伝導路を介する reciprocating tachycardia に関する電気生理学的研究 : 特に verapamil と disopyramide の有用性と作用機序について
- 発声により誘発された上室性頻脈症の1例