预激综合征伴房颤的急诊复律

Acute conversion of atrial fibrillation in patients with preexcitation syndrome

目的探讨预激综合征伴房颤的急诊复律方法与效果。方法总结分析１９例预激综合征伴房颤的急诊治疗措施与疗效。结果用普罗帕酮１０例、普鲁卡因胺６例、利多卡因８例，分别有７例、４例和３例转为窦性心律；２例用维拉帕米、１例用阿拉明治疗均无效；１例静注毛花甙丙后症状加重；１例自行转为窦性心律；３例药物复律无效及１例来诊时伴休克、肺水肿者用１００～１５０Ｊ直流电复律，均一次成功转为窦性心律。结论普罗帕酮、普鲁卡因胺和利多卡因是常规使用的复律药物，而以前者为首选；药物复律无效或伴血流动力学障碍者宜用直流电复律。

Objective To investigate acute conversion of atrial fibrillation in patients with preexcitation syndrome.Methods We observed effects of antiarrhythmic agents and synchronized cardioversion treatment of atrial fibrillation in 19 patients with preexcitation syndrome.Results 7 of 10 patients given propafenone,4of 6 patients given procainamide,3 of 8 patients given lidocaine converted to sinus rhythm.Two patients given verapamil and one patient given aramine were not effective for termination.One patient given cedilanid caused rate acceleration,one patient converted to sinus rhythm automatically.Three patients used antiarrhythmic drugs were not effective for termination,and one patient with hemodynamic deterioration(shock,pulmonary edema,etc )wered used synchronized cardioversion(100～150 joules)converted to sinus rhythm.Conclusions Propafenone,procainamide,lidocaine have been used imtravenously for atrial fibrllation if patients with preexcitation syndrome acute termination with good success,and propafenone remains the drug of choice;the patient used antiarrhythmic agents was not effective for termination,and that with hemodynamic deterioration make use of electrical conversion. [