[Yariko]

Сообщение от Gilarov

Мнение о том. что верапамил укорачивает ЭРП пучка Кента кочует из статьи в статью. Однако, электрофизиологических подтверждений тому нет.

тем не менее в инструкции это прописано [Ссылки доступны только зарегистрированным пользователям ]

ISOPTIN may shorten the antegrade effective refractory period of accessory bypass tracts. Acceleration of ventricular rate and/or ventricular fibrillation has been reported in patients with atrial flutter or atrial fibrillation and a coexisting accessory AV pathway following administration of verapamil

хотя в одном из исследований [Ссылки доступны только зарегистрированным пользователям ]

verapamil had no significant effect on the anterograde refractory period of the accessory pathway as measured by the extrastimulus technique, it significantly increased maximal 1:1 atrioventricular (AV) conduction through the accessory pathway to incremental high rate atrial pacing in 10 of the 12 patients (control value 227 +/- 10 beats/min, value after verapamil 258 +/- 14 beats/min, p less than 0.001)

В любом случае, вывод

in patients with symptomatic Wolff-Parkinson-White syndrome, verapamil may increase the ventricular response through the accessory pathway if atrial fibrillation occurs.

хотя

This finding, which is of potential clinical significance, could not have been predicted from conventional anterograde refractory period estimations.