异丙肾上腺素和美托洛尔对普罗帕酮抗室上性心动过速效应的影响

Effects of Isoproterenol and Metoprolol on the Suppression of Propafenone on with Supraventricular Tachycardia

选择３０例诱发的持续性室上性心动过速（ＳＶＴ），研究了异丙肾上腺素（Ｉｓｏ）和美托洛尔（Ｍｅｔ）对普罗帕酮（Ｐｒｏ）抗ＳＶＴ效应的影响。结果：Ｉｓｏ对Ｐｒｏ抑制ＳＶＴ电诱发效应的完全和部分逆转率分别为５７％和１８％；随访期间服用Ｐｒｏ，ＳＶＴ临床复发率为３１％（５／１６例），后者中８０％（４／５例）为Ｉｓｏ对Ｐｒｏ抑制ＳＶＴ电诱发效应有完全逆转作用者，加服Ｍｅｔ后，５例临床复发均得以控制，提示Ｉｓｏ能逆转Ｐｒｏ抗ＳＶＴ效应者单服Ｐｒｏ可能出现临床复发，加用β阻滞剂有预防作用。

This study was to determine whether isoproterenol(Iso) reverses the effects of propafenone(Pro)on the induction of supraventricular tachycardia and whether the reversal during electrophysiologic study(EPS)is predictive of clinical recurrences of SVT during long-term treatment With Pro. Thirty patients with inducible sustained SVT at base-line state were studied.Iso infusion at a rate necessary to achieve a 20%～40% increase in heart rate completely(16/28 eases,57%)or partially(5/28 cases,18%)reversed Pro‘s suppressant effects on the induction of SVT. There were clinical recurrences of SVT in five of 16 patients(31%)treated on a long-term basis(mean 4.5+3.6 months)with pro;Iso completely reversed Pro's supprssant effect on the induction of SVT in four of these five patients(80%).These five patients then were treated with Pro and metoprolol and no further clincal recurrence of SVT. These results suggested that reversal by lso of Pro's suppressant effects on the induction of SVT may identify patients who are likely to experience clinical recurrence of SVT and these patients may benefit from treatment with a β-blocker during longterm therapy with Pro.