Effects of Oral Propafenone in Patients with Frequent Ventricular Extrasystoles

口服propafenone對頻發性心室期外收縮病人的效果

曾春典(Chuen-Den Tseng) ； 林俊立(Jiunn-Lee Lin) ； 江福田(Fu-Tien Chiang) ； 許寬立(Kwan-Li Hsu) ； 駱惠銘(Huey-Ming Lo) ； 曾淵如(Yung-Zu Tseng)

《慈濟醫學雜誌》 9卷4期 (1997/12) Pp. 259-264

https://doi.org/10.6440/TZUCMJ.199712.0259

摘要

對心室期外收縮的抑制效果。並於每週門診時測量血壓並詢問有無副作用。結果發現接受300mg/day者對心室期外收縮沒有明顯的抑制效果，而接受450mg/day者對心室期外收縮有明顯的抑制效果。在治療成功(壓制85%以上的心室期外收縮)的比率方面，接受300mg/day者為5位(41.7%)，而接受450mg/day者為7位(63.6%)。接受450mg/day者失敗的3位中，有兩位在增加劑量到600mg/day後可成功地壓制85%以上的心室期外收縮;副作用方面雖然有3位的霍特心電圖呈現一過度心搏過緩，但均無不適之主訴或血行力學不穩之現象。因此我們結論為口服Propafenone 300-600mg/day對心臟機能正常併頻發性心室期外收縮的病人為有效且安全的治療方式。(慈濟醫學 1997;9:259-264)

關鍵字

心室期外收縮 ； 霍特心電圖

並列摘要

Propafenone is an antiarrhythmic drug with class IC sodium channel blocking agent with mildly B-blocking and calcium channel blocking properties. Oral therapy effectively suppresses supraventricular and ventricular arrhythmias. However, experience with propafenone in Chinese patients is limited. To assess the efficacy and safety of oral propafenone in Chinese patients with frequent ventricular extrasys-toles(＞ 20/hour in average) and normal treadmill exercise test and echocardiographic results, 23patients (14 males and 9 females, mean age 56.5 years) were studied using 24-hour Holter ECG recording. Oral propafenone at a dose of 300 mg/day (12 patients) and 450 mg/day (11 patients) was then given. The 24-hour Holter ECG recording was repeated 4 weeks later to evaluate the suppressive effect of propafenone. Blood pressure and adverse effects were also recorded at each visit. When all patients taking 300 mg/day were analyzed as a group, no stastistically significant suppression of ventricular extrasystoles was noted, whereas patients taking 450 mg/day had significant suppression of total ventricular ectopies, isolated ventricular ectopies, and average ventricular ectopiees. Therapeutic success (＞85% suppression of ventricular ectop) was achieved in 41.7% (5/12) of in those taking 300 mg/day and in 63.6% (7/11) of those taking 450mg/day. Of the three patients taking 450 mg/day, who did not achieve ＞85% suppression, two patients showed significant suppression of ventricular ectopies without adverse effects when the dose was increased to 600 mg/day. During the treatment period, no patient reported arrhythmia-related ill effects or developed hemodynamic instability, although three patients had transient and asymptomatic bradycardia during the 24-hour Holter ECG recording. Therefore, we conclude that oral propafenone is effective at a dose range of 300 to 600 mg/day is effective and safe in the suppression of frequent ventricular extrasystoles in patients with functionally normal heart.(Tzu Chi Med J 1997;9:259-264)

並列關鍵字

propafenone ； ventricular ectopies ； Holter monitoring