食管法心脏电生理检查对口服胺碘酮致窦性心动过缓不良反应的临床研究

目的:评价食管法心脏电生理检查在口服胺碘酮导致窦性心动过缓患者不良反应中应用效果及安全性。方法:70例患者分别进行食管法心脏电生理检查,按检查是否出现窦房结和(或)房室结功能障碍分成两组,调查两组患者出现心动过缓相关症状的发生情况并进行统计学分析。同时对患者进行随访,了解其预后情况。结果:70例患者当中食管法电生理检查阳性27例(38.6%),阴性43例(61.4%)。食管法电生理检查阳性组出现心动过缓相关症状18例,食管法电生理检查阴性组出现心动过缓相关症状4例,两者间有明显统计学差异,Spearman相关性分析两者间呈高度正相关。随访显示:阳性组患者停药6个月后复查有16例(59.3%)转为阴性,所有患者均无心动过缓相关症状;有11例(40.7%)患者复查仍为阳性,有4例仍有心动过缓相关症状。阴性组继续按原剂量服用胺碘酮,未新出现有心动过缓相关症状患者,原4例有心动过缓相关症状的患者当中有2例症状缓解,2例症状持续存在。结论:食管法电生理检查可应用于胺碘酮导致的窦性心动过缓患者评价患者是否存在潜在危险的评定指标,并可应用于患者的随访。其检查成功率、安全性较高。

Objective：To evaluate application effect and safety of sinus bradycardia ad-verse effect caused by oral application amio- darone using transesophageal cardiac electrophysiological examination. Methods：After esophageal cardiac electrophysiologic exami-nation, seventy patients were divided into two groups according to the result if the functional impairment of atrionector and/or atrioventricular node happened. Then we in- vestigated these patients＂ symptom related to bradycardia and performed statistical analy- sis. Meanwhile, these patients were followed up to know the prognosis. Results： Transesophageal electmphysiological exami- nation was positive in 27 （38.6%） and neg- ative in 43 （61. 4% ） among seventy pa- tients. Bradycardia occur in the positive group while 4 in the negative group. The sta- tistical difference was significant and a high- ly positive relation was found by spearman correlation analysis between between them. The following up showed that after six months withdrawal 16 patients （ 59. 3% ） converted to negative in the positive group. None of them had symptoms of bradycardia. The other 11 cases（40.7% ）were still posi- tive and four patients of them still had symp- toms of bradycardia. The patients in negative group continued treatment with original doses of amiodarone. No new patients with bradycardia related symptoms appeared. A- mong the original four patients who had been suffered from bradycardia, two cases had a symptomatic remission while the other two had persistent symptoms. Conclusion： Transesophageal cardiac electrophysiological examination could be applied to predict if the patients with sinus bradycardia due to amiodarone have latent risk and could be applied to patients＂ follow - up. This method has a high safety and successful inspection rate.