尼非卡兰在持续性心房颤动导管消融术中的应用观察

Application of nifekalant in catheter ablation of persistent atrial fibrillation

目的观察尼非卡兰在持续性心房颤动导管消融术中转复的疗效及安全性。方法选取2019年3月~12月于哈尔滨医科大学附属第四医院心血管内科就诊的行持续性房颤导管消融术患者51例,对肺静脉隔离(pulmonary vein isolation,PVI)后未转复窦律者,静脉推注尼非卡兰0.3 mg/kg,观察其转复率、转复时间、QT和QTc间期和不良反应。结果51例患者中,6例行PVI后转窦律,45例行PVI未能转复。对45例未转复患者给予静脉推注尼非卡兰后,依据是否转复分为尼非卡兰转复组(34例)和尼非卡兰未转复组(11例),转复率75.6%,转复时间3~14 min,平均(6.4±4.1)min;用药20 min后QTc恢复至基线水平;尼非卡兰转复组与未转复组身体质量指数(body mass index,BMI)、左房大小、房颤持续时间、左房纤维化面积差异有统计学意义(均P<0.05)。结论尼非卡兰在持续性房颤导管消融术中、PVI后的房颤患者中具有良好的转复效果,转复时间短,安全性较好。

Objective To observe the efficacy and safety of nifekalant in catheter ablation of persistent atrial fibrillation.Methods A total of 51 patients with persistent atrial fibrillation who underwent catheter ablation treated in the Department of Cardiology at the Fourth Affiliated Hospital of Harbin Medical University from March 2019 to December were selected.Patients who had not been converted to sinus rhythm after pulmonary vein isolation(PVI)were treated with intravenous injection of 0.3 mg/kg nifekalant.The conversion rate,conversion time,QT and QTc intervals,and adverse reactions were observed.Results We enrolled 51 patients of whom 6 had cardioversion after PVI and 45 had not.Among the 45 patients who had not cardioversion successfully after PVI,we further assigned them to nifekalant cardioversion group(34 patients)and nifekalant non-cardioversion group(11 patients)according to whether they had cardioversion after intravenous infusion of nifekalant.The conversion rate of nifekalant was 75.6%,and the conversion time was 3~14 min,with an average of(6.4±4.1)min.QTc returned to baseline 20 min after dosing.There were significant differences in body mass index(BMI),left atrial size,duration of atrial fibrillation,and left atrial fibrosis area between the cardioversion group and the non-cardioversion group(P<0.05).Conclusion Nifekalant has a good conversion effect in persistent atrial fibrillation catheter ablation,and in patients with atrial fibrillation after PVI.The conversion time is short,and the safety is good.