ST segment elevation induced by Class IC antiarrhythmic agents: Underlying electrophysiologic mechanisms and insights into drug-induced proarrhythmia

被引:56
作者
Krishnan, S [1 ]
Josephson, ME [1 ]
机构
[1] Beth Israel Deaconess Med Ctr, Harvard Thorndike Electrophysiol Inst, Boston, MA 02215 USA
关键词
encainide; flecainide; ST segment elevation; proarrhythmia;
D O I
10.1111/j.1540-8167.1998.tb00088.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Three patients in whom Class IC sodium channel blockers induced ST segment elevation in leads V-1 through V-3 are described. The underlying electrophysiologic mechanism, implications for drug-induced proarrhythmia, and the relationship of the finding to the Brugada syndrome type of idiopathic ventricular fibrillation are discussed.
引用
收藏
页码:1167 / 1172
页数:6
相关论文
共 17 条
[1]   OCCURRENCE OF EXERCISE-INDUCED AND SPONTANEOUS WIDE COMPLEX TACHYCARDIA DURING THERAPY WITH FLECAINIDE FOR COMPLEX VENTRICULAR ARRHYTHMIAS - A PROBABLE PROARRHYTHMIC EFFECT [J].
ANASTASIOUNANA, MI ;
ANDERSON, JL ;
STEWART, JR ;
CREVEY, BJ ;
YANOWITZ, FG ;
LUTZ, JR ;
JOHNSON, TA .
AMERICAN HEART JOURNAL, 1987, 113 (05) :1071-1077
[2]   INTERACTIONS OF FLECAINIDE WITH GUINEA-PIG CARDIAC SODIUM-CHANNELS - IMPORTANCE OF ACTIVATION UNBLOCKING TO THE VOLTAGE DEPENDENCE OF RECOVERY [J].
ANNO, T ;
HONDEGHEM, LM .
CIRCULATION RESEARCH, 1990, 66 (03) :789-803
[3]  
[Anonymous], 1989, NEW ENGL J MED, V321, P406
[4]   HETEROGENEITY WITHIN THE VENTRICULAR WALL - ELECTROPHYSIOLOGY AND PHARMACOLOGY OF EPICARDIAL, ENDOCARDIAL, AND M-CELLS [J].
ANTZELEVITCH, C ;
SICOURI, S ;
LITOVSKY, SH ;
LUKAS, A ;
KRISHNAN, SC ;
DIDIEGO, JM ;
GINTANT, GA ;
LIU, DW .
CIRCULATION RESEARCH, 1991, 69 (06) :1427-1449
[5]  
Brugada J, 1998, CIRCULATION, V97, P457
[6]  
BRUGADA J, 1996, PACE, V19, P599
[7]   RIGHT BUNDLE-BRANCH BLOCK, PERSISTENT ST SEGMENT ELEVATION AND SUDDEN CARDIAC DEATH - A DISTINCT CLINICAL AND ELECTROCARDIOGRAPHIC SYNDROME - A MULTICENTER REPORT [J].
BRUGADA, P ;
BRUGADA, J .
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 1992, 20 (06) :1391-1396
[8]   Genetic basis and molecular mechanism for idiopathic: ventricular fibrillation [J].
Chen, QY ;
Kirsch, GE ;
Zhang, DM ;
Brugada, R ;
Brugada, J ;
Brugada, P ;
Potenza, D ;
Moya, A ;
Borggrefe, M ;
Breithardt, G ;
Ortiz-Lopez, R ;
Wang, Z ;
Antzelevitch, C ;
O'Brien, RE ;
Schulze-Bahr, E ;
Keating, MT ;
Towbin, JA ;
Wang, Q .
NATURE, 1998, 392 (6673) :293-296
[9]   I-to and action potential notch are smaller in left vs right canine ventricular epicardium [J].
DiDiego, JM ;
Sun, ZQ ;
Antzelevitch, C .
AMERICAN JOURNAL OF PHYSIOLOGY-HEART AND CIRCULATORY PHYSIOLOGY, 1996, 271 (02) :H548-H561
[10]  
DIDIEGO JM, 1991, CIRCULATION, V84, P179