【摘要】 本文观察了应用静脉快速推注三磷酸腺苷(ATP)纠治10例阵发性室上速患者发作PSVT 时的电生理作用。9例为房室结折返(AV nodal reentry),1例为房室折返(AVre-entry)性心动过速。经用 ATP 20 mg 快速静脉推注后,9例房室结折返性心动过速均于55 sec 内转复为窦律。其作用主要是阻滞在前向慢通道。于中止室上速前可见 A′H 间期延长,而 VA′间期无变化。ATP 副作用及复律瞬间心律失常时间短暂,多不需治疗。但本组一名59岁心肌病忠者于复律后瞬间出现短暂室颤(6 sec),未经处理转为房颤,于16 sec 后恢复正常窦律,提示 ATP 为快速转复室上速之有效药物,一般来说很安全,但对老年或病窦患者应用 ATP 纠治室上速时应特别慎重。本文观察了预用肌苷(inosine)可增加 ATP 疗效更多还原

【Abstract】 Electrophysiologic effects of intravenous adenosine triphosphate disodium(ATP -2Na)on 10 patients with paroxysmal supraventricular tachycardias(PSVTs)werestudied.One patient had atrioventricular reentrant tachycardia(AVRT)with acce-ssory pathway(AP),9 patients had AV nodal reentry.After electrophysiologiccontrol studies,ATP was administered during sustained tachycardia.ATP terminatedall the tachycardias within 55 sec of administration(20mg iv rapid bolus)in 9patients with AV nodal reentry.Termination of the tachycardia was related to a blockin the antegrade slow pathway in patients with AV nodal reentry.Prolongation ofA′H interval was noted before the termination of the tachycardia.No changes inVA′interval were noted before the termination of the tachycardia.Short lasting(less than 1 min)side effects—chest discomfort and flushing were noted afteradministration of ATP.Transient episodes of sinus bradycardia,sinus arrest(less than 3sec),ectopic beats of atrial origin or ventricular origin were commonly noted after administration of ATP and did not require any treatment.But serious adverse effect was observed in a 59-year-old patient with cardiomyopathy in thisseries.After the attack was over during the shift to normal rate transient ventricular fibrillation occurred lasting for 6 sec,thereafter atrial fibrillation lasted for14 sec,then sinus rhythm was restored without treatment.The results suggested thatintravenous ATP injection was an effective drug for rapid termination of AVRT.But it should be used with great caution in the older patients and in patients withsick sinus syndrome.Inosine pretreatment potentiated the effect of ATP-2Na.更多还原