胺碘酮治疗快速心房颤动伴急性充血性心力衰竭临床疗效的观察

Intravenous amiodarone for fast atrial fibrillation in patients with acute congestive heart failure

目的:观察胺碘酮在快速心房颤动(房颤)伴急性充血性心力衰竭患者的临床疗效。方法:26例快速房颤伴急性充血性心力衰竭患者静脉应用胺碘酮,先静脉注射负荷量后,继以静脉滴注维持,观察房颤转复、心室率控制及不良反应。结果:26例患者用药后15 min,1 h、2 h、24 h心室率分别为(140.1±18.3)、(127.7±16.8)、(104.9±15.4)、(82.1±20.5)次/min,较用药前(149.6±19.7)次/min明显下降(P<0.01)。其中15例患者(58.5%)在24 h内转为窦性心律,3例出现窦性心动过缓,经停药或减药后恢复,2例出现症状性低血压,无心衰加重表现。结论:静脉应用胺碘酮能迅速、安全、有效地控制快速房颤伴急性充血性心力衰竭患者的快速心室率,尤其适合并发急性冠状动脉综合征及原发性高血压的患者。

Objective：To observe the effect of amiodarone on fast atrial fibrillation in patients with acute congestive heat failure. Method： Twenty-six patients with fast atrial fibrillation and acute congestive heart failure were observed. After a load dose, intravenous amiodarone was administered continuously. Efficacy of amiodarone in the reversion of atrial fibrillation and the control of ventricular rate as well as the side effects were observed. Result： The avorages ventricular rate 15 min, 1 hour, 2 hour, 24 hour after the administration of amiodarone in the 26 patients were （140.1±18.3） beats/min, （127.7±16.8） beats/min, （104.9±15.4） beats/min, and （82.1±20.5） beats/min, respectively, significantly were lowered than the rate （149.6± 19.7）beats/min before the drug was given （P〈0. 01）. Atrial fibrillation was reverted to sinus rhythm within 24 hour in 15 of 26 cases （58.5%）, sinus bradycardia was occurred in 3 patients, cardiac rhythm in all the patients returned to normal after reducing the dose or ceasing the medicine, two patients developed symptomatic atic hypotension without worsening of congestive heart failure. Conclusion： Amiodarone is safe and rapid in the treatment of rapid ventricular rate in patients with atrial fibrillation and acute congestive heart failure, especially to the patients of ACS and hypertension.