索他洛尔对室上性心动过速疗效及其作用机制的初步研究

A Preliminary Study on Efficacy and Mechanism of Intravenous Sotalol for Paroxysmal Supraventricular Tachycardia

目的 研究索他洛尔注射液对阵发性室上性心动过速 (室上速 )的疗效及其作用机制。方法 室上速患者食管左房刺激诱发室上速后静脉注射索他洛尔或生理盐水。结果 2 3例室上速患者静注索他洛尔总剂量 1.5 mg/ kg,15例 (65 .2 % )转复为窦性心率 ,平均转复时间 (10 .7± 11.6) m in;2 1例静注生理盐水 ,1例 (4 .8% )转复 ;2组疗效有显著差异 (P<0 .0 5 )。用药后房室折返性心动过速 (AVRT)和房室结内折返性心动过速 (AVNRT,收缩压 <10 .7k Pa)的终止部位主要 (3 / 4和4 / 6)在前传房室结和房室结逆传快通道。 2例患者在静注索他洛尔过程中出现无症状性低血压。结论 静脉注射索他洛尔终止室上速安全。

Objective To study the efficacy and mechanism of intravenous sotalol for paroxysmal supravent ricular tachycardia (SVT). Methods Patients with SVT induced by trans esophagus left atrial stimulation were managed with intravenous sotalol or normal saline. Results Twenty three patients were treated with intravenous administration of sotalol, and 15(65.2%) were converted to sinus rhythm, the average converting time being (10 7±11.6) min. Twenty one patients were treated with intravenous normal saline, and 1(4.8%) was converted to sinus rhythm. The efficacies between two groups were significantly different ( P <0.05). After sotalol was injected, the site of termination of tachycardia was predominantly at the antegrade atrioventricular nodal in atrioventricular re entrant tachycardia (AVRT) (3/4) and at the retrograde fast pathway of atrioventricular nodal in atrioventricular nodal re entrant tachycardia (AVNRT) (4/6). Asymptomatic hypotension (systolic blood pressure <10.7 kPa) was found in two patients during the course of administration of sotalol. Conclusions It was safe and effective for sotalol to terminate SVT.