伊布利特转复心房扑动、心房颤动的对比研究

The convert research of ibutilide injection for cardioversion of atrial fibrillation and atrial flutter to sinus rhythm

目的:观察伊布利特注射液转复房颤、房扑的有效性及安全性。方法:选择心电图确诊为房颤、房扑且发作在90 d以内,符合入选条件的患者随机分为普罗帕酮组(静脉推注70～140 mg)和伊布利特组(静脉推注1～2 mg)。结果:29例患者入选,普罗帕酮组15例,男性9例,女性6例,4 h内房颤、房扑转复成功7例(46.7%),90 min内房颤、房扑转复成功分别为2例(16.7%)、1例(33.3%),90 min内的平均转复时间为(28.33±11.55)min,1例出现恶心、呕吐;伊布利特组14例,男性3例,女性11例,4 h内房颤、房扑转复成功9例(64.3%),90 min内房颤、房扑转复成功分别为6例(54.5%)、3例(100%),90 min内的平均转复时间为(27.89±18.14)min,1例发生频发室性早搏、短阵室速。结论:伊布利特是一个起效快,对房扑、房颤患者转复率高的新型抗心律失常药物,其疗效优于普罗帕酮,尤其对房扑患者。但其致心律失常作用应引起警惕,尤其对高危患者。

Objective： To evaluate the efficacy and safety of ibutilide for cardioversion of atrial fibrillation and atrial flutter to sinus rhythm. Methods： Atrial fibrillation or atrial flutter patients with history less than 90 days were diagnosed clearly by electrocardiogram. A total of 29 patients were randomly divided into propafenone group （70～140mg, intravenous bolus） and ibutilide group （1 ～2 mg intravenous bolus）. Results： Among 29 patients, 15 patients were selected for the propafenone group： 9 male and 6 female patients. Seven patients were converted successfully in 4 hours after administration （46.7%） and 2 patients of atrial fibrillation and 1 patient of atrial flutter were converted successfully in 90 minutes after administration （16.7%, 33.3%）. The average convert time in 90 minutes after administration was （28.33± 11.55） minutes and 1 patient had nausea and vomiting. Fourteen patients were in the ibutilide group： 3 male and 11 female patients. Nine patients were converted successfully in 4 hours after administration （64.3%） and 6 patients of atrial fibrillation and 3 patient of atrial flutter were converted successfully in 90 minutes after administration （54.5%, 100%）. The average convert time in 90 minutes after administration was （27.89±18.14） minutes and 1 patient had frequent premature ventricular contraction and paroxysmal ventricular tachycardia. Conclusion： Ibutilide is a rapid and effective new antiarryhthmic drug with high rate of conversion for atrial fibrillation and atrial flutter, especially for the latter. It should be carefully aware of the proarrhythmic effect of ibutilide.