Mexiletine and Disopyramide Suppress Ventricular Premature Contractions(VPC) Irrespective of the Relationship between the VPC and the Underlying Heart Rate.
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概要
- 論文の詳細を見る
The effects of mexiletine (300mg/day, 24 patients) and disopyramide (300mg/day, 20 patients) on ventricular premature contractions (VPCs) were studied using a 24-hour ambulatory electrocardiogram. The VPC frequency was evaluated as a function of the underlying heart rate (HR). The VPC-HR correlation was classified into 2 major types, depending on whether the frequency of the VPC increased with the increased HR (positive type) or not (nonpositive type). The effects of the drugs were assessed based on the VPC-HR correlation and on the percent reduction of the VPC frequency.Mexiletine and disopyramide significantly decreased the frequency of the VPCs of both the positive and nonpositive types. Each drug was assumed to be effective when the percent reduction of the VPC frequency exceeded 70%. Mexiletine (300mg/day) was 58.5% effective in positive type patients and 33.3% effective in nonpositive type patients, with a total efficacy of 45.8%. Disopyramide was effective in 50% of total cases with 44.4% in positive type patients and 54.5% in nonpositive type patients. However, the efficacy of these drugs on the 2 different types of VPCs was the same statistically. The findings strikingly contrasted those obtained with diltiazem and atenolol, which predominantly suppressed VPCs of the positive type which share similar characteristics with a triggered activity in vitro.We conclude that the mode of action of class I antiarrhythmics on the VPCs differs from that of class II or IV antiarrhythmics, as viewed from the VPC-HR relationship, and that the difference probably comes from the different arrhythmogenesis for positive and nonpositive types of VPCs, in addition to the different electrophysiological actions of mexiletine and disopyramide.
- International Heart Journal刊行会の論文
著者
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Shimoyama Nobuo
Department of Cardiovascular Medicine, Kumamoto University School of Medicine
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Saikawa Tetsunori
Department Of Cardiovascular Science Faculty Of Medicine Oita University
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Nakagawa Mikiko
Department Of Cardiovascular Science Oita University
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TAKAKI RYOSABURO
Department of Medicine, Oita Medical University
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ITO MORIO
Department of Laboratory Medicine, Oita Medical University
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ARITA MAKOTO
Department of Physiology, Oita Medical University
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Takahashi Naohiko
Department Of Cardiology Tenshindo-hetsugi Hospital
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Ishida Shuji
Department Of Botany Faculty Of Science Kyoto University
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FUJINO Takao
Department of Laboratory Medicine
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Tsumabuki Shigeru
Department of Laboratory Medicine , Medical College of Oita
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Maeda Toshihiro
Department Of Anatomy Of Shiga University Of Medical Science
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Takaki Ryosaburo
Department Of Internal Medicine Oita Medical University
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Yonemochi Hidetoshi
Department Of Bioclimatology And Medicine Medical Institute Of Bioregulation Kyushu University
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Hara Masahide
Department Of Internal Medicine 1 Faculty Of Medicine Oita University
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Arita Makoto
Department Of Cardiology Yufuin Kohseinenkin Hospital
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Ito Morio
Department Of Laboratory Medicine Medical Callege Of Oita
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HARA Masahide
Department of Medicine, Oita Medical University
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Takahashi Naohiko
Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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TAKAHASHI Naohiko
Department of Laboratory Medicine, Oita Medical University
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Saikawa Tetsunori
Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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SHIMOYAMA Nobuo
Department of Medicine, Oita Medical University
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Nakagawa Mikiko
Department of Cardiology and Clinical Examination, Faculty of Medicine, Oita University
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NAKAGAWA Mikiko
Department of Medicine, Oita Medical University
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Ito Morio
Department of Health Care Center, Munakata Ishikai-Hospital
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SAIKAWA Tetsunori
Department of Medicine, Oita Medical University
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