伊布利特转复房颤110例的疗效分析

Observation on effectiveness and safety of ibutilide in pharmacological cardioversion of atrial fibrillation or atrial flutter to normal sinus rhythm

目的探讨伊布利特药物复律心房颤动的疗效和安全性,并分析影响转复成功率的因素。方法回顾性分析2009年1月至2011年6月期间110例使用伊布利特行药物复律的心房颤动患者的临床资料。结果 65例患者转复为窦性心律,成功率59.1%;转复组在年龄、合并器质性心脏病的比率、心房颤动发作持续时间及左房内径等方面均小于未转复组,差异有统计学意义(P均<0.05);4例在用药过程中发生频发室性早搏;2例发生非持续性尖端扭转性室速(TdP);所有患者均未出现血流动力学不稳定及其他严重不良反应。结论伊布利特转复心房颤动疗效肯定,转复成功率与年龄、合并器质性心脏病、心房颤动发作持续时间和左房内径等因素有关。用药期间有发生TdP的可能,做好用药期间的监护可以显著减少这一不良反应的发生。

Objective To explore the effectiveness and safety of ibutilide in pharmarcological cardioversion of atrial fibrillation or atrial flutter to normal sinus rhythm.Methods The clinical data of 110 cases treated by pharmacological cardioversion of atrial fibrillation with intravenous infusion of ibutilide were retrospectively reviewed and analyzed.Results Arrhythmia in 65（59.1%） of 110 cases had been converted to normal sinus rhythm and patients in this group were in older age range,with higher rate of complications of heart disease,a longer lasting time of episode,and a larger left atrial diameter than patients without conversion to normal sinus rhythm.Frequent premature ventricular contractions（in 4 of 110） and torsade de pointes（TdP）（in 2 of 110） had been occurred during the first hour of treatment with ibutilide.Conclusion The efficacy of ibutilide for conversion of atrial fibrillation or atrial flutter to sinus rhythm is affirmative.Age,complicated with organic heart disease,lasting time of episode,and large left atrial diameter are associated with its effectiveness.However,it also increase the risk of occurrence of fatal arrhythmia and TdP.Therefore,adequate intensive care can dramatically reduce the occurrence of these risks.