静脉滴注胺碘酮治疗急性冠脉综合征伴快速心房纤颤

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

目的 观察静脉滴注胺碘酮对急性冠脉综合征（ACS）伴快速房颤患者的临床疗效。方法 32例ACS伴新近发生快速房颤患者，静脉应用胺碘酮，先静脉注射负荷量（75—100mg）后，然后以0．5—1mg／min静脉滴注维持，观察房颤转复、心室率控制及不良反应。结果 32例患者用药后15min、2h、24h心室率分别是（135．8±12．5）次／min、（106．7±9．2）次／min、（84．4±14．0）次／vain，较用药前（143．7±13．8）次／min明显下降（P〈0．01）。其中25例患者（78.1％）在24h内恢复窦性心率，2例出现窦性心动过缓，3例出现长R-R间期，经停药或减量后恢复。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 intravenous usion of amiodarone on fast atrial fibrillation in patients with acute coronary artery syndrome（ACS）.Methods After a load dose （75- 100 mg） was given, intravenous infusion of amiodarone （0.5 - 1 mg/min） was administered continuously in 32 ACS patients whose fast atrial fibrillation took place recently. The reversion of atrial fibrillation, the controlled heart rhythm and the side effect of amiodarone were observed.Results The heart beat rates at 15 min,2 hour,24 beta- after the administration of amiodarone in the 32 patients were （135.8± 12.5） beats/min, （106.7 ± 9.2） beats/min, （84.4± 14.0） beats/rain re- spectively, significantly lowered than the rate （ 143.7 ± 13.8） beats/min before treatment （ P 〈 0.01）. Atrial fibrillation was reverted to sinus rhythm within 24 hour in 25 of 32 case （78.1% ）. Sinus bradycardia was occurred in 2 patients, and prolongation of R-R intermitment was observed in 3 patients, but cardiac rhythm in all the patients returned to normal after reducing the dose or ceasing the medicine. Conclusion Intravenous Intravenous of amiodarone is effective and safe in the treatment of fast atrial fibrillation in patients with ACS.