普罗帕酮和胺碘酮对起搏功能影响的临床研究

Clinical Study on the Effects of Propafenone and Amiodarone on Pacing Threshold

目的:探讨普罗帕酮和胺碘酮对不同起搏系统功能的影响及用药的安全性。方法:植入永久起搏器的患者20例,术后3个月内先后静脉推注普罗帕酮和胺碘酮,其中13例预先置入临时起搏电极。比较给药前后起搏阈值等参数的变化。结果:永久起搏器系统KDR70110例,SDR3039例,SWI1031例,全部为激素涂层双极电极,用药前后起搏阈值均保持在最低水平,即0.25V(KDR701)和0.5V(SDR303)。感知范围和电极阻抗无明显变化。临时起搏电极为STJUDEMEDICAL双极起搏电极,与用药前相比普罗帕酮使临时起搏阈值从(1.0±0.4)V升至(1.3±0.4)V(P<0.05),胺碘酮使其从(1.1±0.5)V降低至(1.0±0.4)V(P>0.05)。结论:具激素涂层电极的永久起搏系统急性期使用普罗帕酮和胺碘酮是安全的。

Objective： To explore the efficacy and safety of propafenone and amiodarone on different pacing systems. Methods： Propafenone and amiodarone were given intravenously to 20 patients with permanent pacemaker 3 months postoperatively in which 13 patients were with temporary pacing system. Pre- and post-test pacing threshold were recorded. Results： Ten patients were with permanent pacemaker system KDR701, 9 patients were with SDR303, and 1 patient was with SWI103. All of them were double steroid-eluting electrodes. All permanent pacemaker thresholds were kept at the lowest level （0.25 V for KDR 701 and 0.5 V for SDR 303） before and after the treatment. There was no significant change in perception range and electrode impedance. The temporary pacemaker electrode was ST JUDE MEDICAL double electrode. The temporary pacing threshold increased from （1.0 ± 0.4） V to （1.3 ± 0.4） V by propafenone （P 〈 0.05）, and decreased from （1.1±0.5） V to （1.0 ± 0.4） V by amiodarone （P 〉 0.05）. Conclusion： It is safe to give propafenone and amiodarone for patients with permanent pacing system which has steroid-eluting electrodes.