伊布利特对人体心房与心室电生理特性的影响

The Study of Atrium and Ventricle Electrophysiological Effect of Ibutilide on Human.

探讨伊布利特对人体右房、左房及右室有效不应期(RA-ERP、LA-ERP及RV-ERP)与房间、室间传导时间的影响。测定25例射频消融术后患者于静脉推注伊布利特(0.0167mg/kg)前后在基础起搏周长为600ms时的RA-ERP、LA-ERP及RV-ERP,同时测量起搏与窦性心律时的心房、心室传导时间。其中通过起搏冠状静脉窦远端间接起搏左房。结果:①伊布利特明显延长RA-ERP、LA-ERP及RV-ERP(P均<0.001)。②使用伊布利特后,对窦性心律时的P波宽度、PR间期、QRS时限、AH及HV均无明显影响(P>0.05),对房间及室间传导时间无明显影响(P>0.05),亦对急性期的起搏阈值无明显影响(P>0.05)。③使用伊布利特后2例出现右束支阻滞。结论:伊布利特可明显延长RA-ERP、LA-ERP及RV-ERP,但不影响房间、室间传导时间。

We studied the effect of ibutilide on the electrophysiological parameters of human atrium and ventricle to explore the mechanism of ibutilide in Converting atrial fibrillation to sinus rhythm. Effective refractory period of left atrium, right atrium and right ventricular （ RA-ERP, LA-ERP, and RV-ERP） during pacing at cycle length of 600 ms, intra-atrial conduction time （IACT） and intra-ventricular conduction time （IVCT） were measured before and after intravenous administration of ibutilide （0. 0167 mg/kg） in 25 patients who underwent radiofrequency catheter ablation successfully. Results：（1） Ibutilide prolonged RA-ERP, LA-ERP, and RV-ERP （all P 〈 0.001 ）. （2） The differences of P wave duration, PR interval, QRS duration, AH interval and HV interval at sinus rhythm before and after the administration of ibutilide weren＇t significant （all P 〉 0.05 ）. When the pacing cycle length was 600 ms, IACT and IVCT did not change significantly either by ibutilide（ all P 〉 0.05 ）. （3） 2 patients developed complete right bundle branch block. Conclusions： Ibutilide prolongs RA-ERP, LA-ERP, and RV-ERP, but it does not affect IACT, IVCT. [ Chinese Journal of Cardiac Pacing and Electrophysiology,2005,19 （5） ：335 - 337 ]