A Comparison of Electrophysiologic Properties between Responders and Non-responders to DL-sotalol among Patients with Ventricular Tachyarrhythmia. Importance of the Lack of a Reverse Use-dependent Effect on Ventricular Refractoriness to Responders. : Impo

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概要

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• This study was undertaken to determine whether dl-sotalol can prevent ventricular tachyarrhythmia inducibility that can be predicted from electrophysiologic parameters. The effects of dl-sotalol in 16 patients (ventricular tachycardia (VT) in 11 and fibrillation (VF) in 5) were determined in electrophysiologic studies before and after dl-sotalol (320mg/day).In 9 of 16 patients (56%) after dl-sotalol, ventricular tachyarrhythmia could not be induced by the entire stimulation protocol (responders).There were significant differences in QT interval (462±52 vs. 415±34 msec; p<0.05) and ventricular effective refractory period (VERP) at 600, 400 and 300 msec (302±28 vs. 262±20 msec; p<0.001, 280±23 vs. 240±21 msec; p<0.001, 256±24 vs. 222±12 msec; p<0.005, respectively) between responders and non-responders. The percentile increases in VERP (%VERP) at 600, 400, and 300 msec in responders were 25%, 26%, and 27%, whereas those in non-responders was 9%, 7%, and 7%, respectively.Isoproterenol administered to responders did not fully reverse the dl-sotalol-induced prolongation of VERP (ΔVERP) at 600, 400, and 300 msec, which remained significantly prolonged compared to the baseline (281±18 vs. 241±16 msec; p<0.01, 258±20 vs. 223±21 msec; p<0.01, 247±22 vs. 202±16 msec; p<0.01, respectively). %VERP did not exhibit significant differences at 600 (16%), 400 (15%), and 300 (20%) msec, indicating the lack of a reverse use-dependency.The results suggest that ΔVERP in responders did not show reverse use-dependency, and that the phenomenon may account for the efficacy of dl-sotalol.

著者

• Aizawa Yoshifusa

  First Department of Internal Medicine, Niigata University School of Medicine

• Yamaura Masayuki

  First Department Of Internal Medicine Niigata University School Of Medicine

• Tagawa Minoru

  First Department of Internal Medicine, Niigata University School of Medicine

• Naitoh Naoki

  First Department Of Internal Medicine Niigata University School Of Medicine

• Aizawa Yoshifusa

  First Department Of Internal Medicine Niigata Universaity School Of Medicine

• Yamaura Masayuki

  First Department of Internal Medicine, Niigata University School of Medicine

• Naitoh Naoki

  First Department of Internal Medicine, Niigata University School of Medicine

• AIZAWA Yoshifusa

  First Department of Internal Medecine, Niigata University School of Medicine, Niigata, Japan.

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