胺碘酮对人在体心室复极离散度的影响  

Effects of amiodarone on the dispersion of ventricular repolarization in vivo human bodies

作　　者：陈宇 赵新华 尹德录 CHEN Yu;ZHAO Xin-hua;YIN De-lu(Suqian People′s Hospiatl of Nanjing Drun-Tower Hospital Group,First People′s Hospital of Lianyungang,Li.anyungang 222004,Jiangsu,China)

机构地区：[1]南京鼓楼医院集团宿迁市人民医院,江苏宿迁223835 [2]连云港市第一人民医院/徐州医科大学附属连云港医院心内科,江苏连云港222004

出　　处：《中国心脏起搏与心电生理杂志》2021年第4期340-342,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的使用单相动作电位技术评价静脉推注胺碘酮对人在体心室复极离散度的影响.方法使用铂电极导管记录29例无器质性心脏病患者应用胺碘酮前后右室心尖部和右室流出道的单相动作电位图形,测量各标测点的激动时间(A T)、动作电位时程(A PD90)、复极时间(RT)、舒张期基线和平台期峰点之间的电位差幅度(AMP),计算各指标的离散度ATd、APDd、RTd.结果29例患者静脉推注胺碘酮20 min前后,右室心尖部的AT、APD90、RT分别为(16.8±6.1)ms vs(24.3±5.5)ms、(248.3±10.6)ms vs(265.0±13.8)ms、(265.0±13.6)ms vs(282.1±17.3)ms(P均<0.01),而右室流出道的AT、APD90、RT分别为(19.1±5.7)ms vs(26.2±6.6)ms、(260.0±18.6)ms vs(270.0±15.4)ms和(275.4±16.5)ms vs(294.7±16.4)ms(P均<0.01).而AMP、ATd、AP-Dd、RTd值较用药前差别无统计学意义(P>0.05).结论静脉推注胺碘酮可延长不同部位AT、APD90及RT,但对人在体心室复极离散度各指标无明显影响.Objective To investigate the effect of intravenous amiodarone on the dispersion of ventricular repolarization. Methods Monophasic action potentials(MAP) of the right ventricular apex and the right ventricular outflow tract were recorded in 29 patients without structural heart disease.Activation time(AT), MAP duration at 90% repolarization(APD90), repolarization time(RT) and amplitudes(AMP) during sinus rhythm as well as their dispersions ATd, APDd,RTd were recorded at every recorded site with a platinum-electrode ablation catheter. These indicators were measured again after intravenous amiodarone. Results Before and after intravenous amiodarone, AT, APD90 and RT of the right ventricular apex were(16.8±6.1)ms vs(24.3±5.5)ms;(248.3±10.6)ms vs(265.0±13.8)ms and(265.0±13.6)ms vs(282.1±17.3)ms(P all <0.01).At the same time, AT, APD90 and RT of the right ventricular outflow tract were(19.1±5.7)ms vs(26.2±6.6)ms;(260.0±18.6)ms vs(270.0±15.4)ms and(275.4±16.5)ms vs(294.7±16.4)ms(P all <0.01). However, no significant differences were found in AMP, ATd, APDd and RTd before and after intravenous amiodarone. Conclusion Intravenous amiodarone could prolong AT, APD90 and RT of different parts in the ventricular distinctly, whereas it does not exert distinct effect on ventricular dispersion.

关 键 词：电生理学 胺碘酮 复极离散度 动作电位 

分 类 号：R972.2[医药卫生—药品] R331.38[医药卫生—药学]