胺碘酮治疗急性冠脉综合征伴快速房颤

Intravenous amiodarone for fast atrial fibrillation in patients with acute coronary artery syndrome

目的观察静脉滴注胺碘酮在急性冠状动脉综合征(ACS)伴快速房颤患者的临床疗效。方法23例ACS患者伴新近发生快速房颤,静脉应用胺碘酮,先静脉注射负荷量后,继以静脉滴注维持观察房颤转复及心室率控制及不良反应。结果23例患者用药后15分钟、1小时、2小时、24小时心室率分别为(141.3±18.7)次/min、(128.1±17.2)次/min、(105.3±15.9)次/min、(82.5±20.1)次/min,较用药前(149.2±19.3)次/min明显下降(P<0.01)。其中17例患者(73.9%)在24小时内转为窦性心律,2例用药后出现长R-R间期,3例出现窦性心动过缓,经停药或减药后恢复。结论静脉应用胺碘酮治疗ACS伴快速房颤是有效及安全的。

Objective To observe the effect of amiodarone to fast atrial fibrillation in patients with aeute coronary artery syndrome（ACS）. Methods Twenty-three ACS patients with newly onset fast atrial fibillation were observed. After a load dose, intravenous amiodarone was administered continuously. Efficacy of amiodarone in the reversion of atrial fibrillation and the control of ventrieular rate as well as the side effects were observed. Results The ventricular rate 15 min,1 hour,2 hour,24 hour after the administration of amiodarone in the 23 patients was （141.3± 18.7） beats/min, （128.1 ± 17.2） beats/min, （105.3 ± 15.9） beats/min, （82.5 ± 20.1） beats/min, respectively, significantly lowered than the rate （149.2±19.3） beats/min before the drug was given（ P 〈0.01）. Atrial fibrillation was reverted to sinus rhythm with 24 hour in 17 of 23 case（73.9%）. Long R-R intermitment observed in 2 patients, sinus bradycardia was occurred in 3 patients, cardiac rhythm in all the patients＇ returned to normal after redueing the dose or ceasing the medicine. Conclusion Intravenous amiodarone is effective and safe in the treatment of fast atrial fibrillation in patients with ACS.