药物治疗肺静脉和腔静脉电隔离术后阵发性心房颤动

Treatment for patients with recurrent paroxysmal atrial fibrillation after pulmonary veins and superior vena cava isolation by radiofrequency catheter ablation

目的探讨阵发性心房颤动肺静脉和腔静脉电隔离术后早期复发患者药物治疗方法。方法阵发性心房颤动患者32例,行肺静脉和腔静脉电隔离术后,均给予美托洛尔治疗,早期复发患者加用普罗帕酮,若仍不能控制心房颤动发作,则给予索他洛尔替代上述两药。结果美托洛尔加普罗帕酮控制阵发性心房颤动的有效率54%。索他洛尔的有效率达83%。控制心房颤动总有效率92%,未发现严重不良反应。所用剂量小于常规剂量。结论美托洛尔加小剂量的普罗帕酮,或单用小剂量索他洛尔可有效地控制阵发性心房颤动肺静脉和腔静脉电隔离术后早期复发患者的发作。

Objectives To explore the drug treatment for patients with recurrent paroxysmal atrial fibrillation after pulmonary veins and superior vena cava isolation by radiofrequency catheter ablation. Methods Metoprolol as initial therapy was administered to 32 patients with paroxysmal atrial fibrillation after pulmonary veins and superior vena cava isolation by radiofrequency catheter ablation. Propafenone was added for that recurrent paroxysmal atrial fibrillation occurred in one week after catheter ablation. Sotalol was administered to the patients with fail treatment with above drugs. Results The effective rate in patients receiving combination propafenone and metoprolol was 54%,while sotalol alone,83%. The total effective rate was 92% with drug treatment. No severe side effect was found. The anti-arrhythmic drugs were used in lowdosages. Conchlusions Combination of metoprolol and low dose of propafenone, or sotalol alone are effective in the prevention of paroxysmal atrial fibrillation for patients with recurrent paroxysmal atrial fibrillation after pulmonary veins and superior vena cava isolation by radiofrequency catheter ablation.