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已有实验资料说明扭转型室性心动过速(TdP)与早期后除极(EPD)之间的关系。作者研究3例房室阻滞伴TdP的病人静脉注射维拉帕米的疗效,获得Tdp发生机制涉及膜慢通道的间接证据。 3例皆为完全性房室阻滞伴宽QRS逸搏心律,皆未接受抗心律失常药物。1例因用利尿剂治疗,血清钾降低(3.5mEq/L)。各例皆在心室起搏>5分钟后记录交接区起搏点恢复时间。如病情稳定,连续记录5分钟。然后按同样的频率恢复起搏,并静脉注射维拉帕米10mg,注射4分钟以上,每分钟测一次血压。维拉帕米注完后再记录交接区恢复时间。维拉帕米未引起血压或窦性频率的显著改变(血压下降<10mmHg)。2例用药后交接区逸搏频率加速,即交接区恢复时间和逸搏心律的周期长度缩短,TdP
There are experimental data to illustrate the relationship between torsades de pointes (TdP) and early post-depolarization (EPD). The authors studied the efficacy of intravenous injection of verapamil in 3 patients with atrioventricular block and TdP, and obtained indirect evidence that the mechanism of Tdp involves a slow pathway in the membrane. 3 cases were complete atrioventricular block with QRS escape heart rhythm, all did not receive anti-arrhythmic drugs. One patient was treated with diuretics and serum potassium was decreased (3.5 mEq / L). In each case, ventricular pacing> 5 minutes, the recovery time of the pacemaker point in the transfer area was recorded. Such as stable condition, continuous record 5 minutes. Then pacing the same frequency recovery, and intravenous injection of verapamil 10mg, injection of more than 4 minutes, measured once a minute blood pressure. Verapamil note after the record transfer zone recovery time. Verapamil did not cause significant changes in blood pressure or sinus frequency (blood pressure <10 mmHg). 2 cases of medication after delivery area esophageal frequency acceleration, the junction recovery time and escape rhythm of the cycle length is shortened, TdP