胺碘酮在体外直流同步电复律心脏瓣膜置换术后持续性房颤中的作用

Role Amiodarone in Patients with Persistent Atrial Fibrillation after Cardiac valve Replacement for Direct Current Cardioversion

目的研究胺碘酮在体外直流同步电复律心脏瓣膜置换术后持续性房颤中的作用。方法165例瓣膜置换术后的持续性房颤患者随机分为试验组(85例)和对照组(80例)。电复律前对照组给予常规药物和安慰剂。试验组除常规药物外,加用胺碘酮。两组比较体外同步直流电复律的成功率及复律12个月后窦性心律维持率。试验终点为电复律后第12个月。结果体外同步电复律后两组比较,试验组转复成功率(100%)高于对照组(70%),有统计学意义(P<0.05)。电复律12个月后窦性心律维持率比较,试验组(74.11%)大于对照组(51.2%),有显著差异。结论胺碘酮能提高瓣膜置换术后持续性房颤体外同步直流电复律的成功率及转复后窦性心律维持率。

Objective The purpose of the present study was to evaluate the role of amiodarone in patients with persistent atrial fibrillation aftercardiac valve replacement for direct current cardioversion. Methods one hurdred and sixty - five patients with persistent atrial fibrillation after cardiac valve replacement were randomly selected and divided into trial group （n = 85 ） and control group （n = 80） . The control group is given routine medicine and placebo before and after direct current cardioversion , while the trial group use routine medicine just the same as the control group and amiodarone is added before and after the surgery. The rate of successful cardioversion were compared between the two groups. 12 months after direct current cardioversion is defined as the end point. Results The electrical cardioversion was more successful in the trial group than that in the control group（ 100% versus 70%, P 〈0. 05）. 12months after electrical cardioversion, rate of maintaining sinus rhythm was significantly higher in the trial group than that in the control group （74. 11% versus 51.2% , P 〈 0.05 ）. Conclusions Amiodarone may increase electrical cardioversion efficacy and reduce atrial fibrillation in patients with persistent atrial fibrillation after cardiac valve replacement for direct current cardioversion.