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作者报道利多卡因治疗双向性心动过速(bidirec-tional tachycardia,BT),并指出该药对毛地黄导致的伴传导阻滞的房速(artial tachycardia)也有明确效果。10例 BT 患者(男6,女4),年龄43～77岁。其心电图(EKG)特点:①心室内传导时间延长;②非室上性的 QRS 波;③标准导联 QRS 电轴每搏交替改变;④V_1导联呈右束支传导阻滞图形。10例中,动脉粥样硬化性心脏病4例,肥大性心肌病1例,段性肺疾患伴急性呼吸衰竭3例,二尖瓣脱垂(MVP)2例。利多卡因首剂用量为75mg,1例因室颤,未再继续,3分钟后再予75mg 并开始以3mg/min 速度静滴,持续7小时。其中3例做了希氏束 EKG。结果用药前 BT 患者心室率为140～188/min。
The authors report that bidirec-tional tachycardia (BT) is being treated with lidocaine and that the drug also has a clear effect on the artial tachycardia caused by foxglove. Ten cases of BT patients (male 6, female 4), aged 43 to 77 years. The ECG (EKG) features: ① ventricular conduction time extension; ② non-supraventricular QRS wave; ③ standard lead QRS axis alternating stroke; ④ V_1 lead showed right bundle branch block pattern. In 10 cases, atherosclerotic heart disease in 4 cases, hypertrophic cardiomyopathy in 1 case, segmental pulmonary disease in 3 cases with acute respiratory failure, mitral valve prolapse (MVP) in 2 cases. Lidocaine for the first dose of 75mg, 1 case of ventricular fibrillation, did not continue, 3 minutes and then to 75mg and began intravenous infusion of 3mg / min, sustained for 7 hours. Three of them did His bundle EKG. Results Before treatment, BT patients ventricular rate was 140 ~ 188 / min.