Electrophysiologic substrate of torsade de pointes: dispersion of repolarization or early afterdepolarizations?
作者： Borys Surawicz , None
DOI: 10.1016/0735-1097(89)90069-7
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摘要: Abstract Recent experimental and clinical studies suggest that torsade de pointes may be precipitated by early afterdepolarizations in the Purkinje or ventricular muscle fibers. This hypothesis offers an alternative to earlier one attributes underlying dispersion of repolarization. review lists conditions associated with examines background two proposed electrophysiologic substrates torsade, namely, repolarization afterdepolarizations. The strengths weaknesses hypotheses are compared relation following characteristics pointes: facilitation slow heart rate, suppression pacing, R on T phenomenon, difficulty induction programmed stimulation, aggravation hypokalemia, manifestation idiosyncratic reaction class IA anti-arrhythmic drugs, spontaneous termination, magnesium salts isoproterenol such drugs as sotalol, bepridil prenylamine. It appears most observations can explained either mechanism, but some cases difficulties encountered for afterdepolarization hypothesis.
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