伊布利特治疗胺碘酮转复失败的心房颤动和心房扑动的疗效观察

The Effect of Ibutilide on Atrial Fibrillation and Atrial Flutter Unsuccessfully Treated with Amiodarone

目的探讨伊布利特对胺碘酮转复失败的心房颤动和心房扑动患者的疗效和安全性。方法心房颤动和心房扑动患者共63例,52例(A组)先行胺碘酮转复,失败后行伊布利特转复,11例(B组)只接受伊布利特转复。结果A组45例(86.5%)患者转复成窦性心律;其中25例经胺碘酮转复,20例加用伊布利特后转复。B组7例(63.6%)转复成窦性心律。转复成功率A组和B组差异有显著统计学意义(P<0.01)。心房颤动转复成功率B组为57.1%,显著低于A组胺碘酮和伊布利特合用的84.8%,差异有显著统计学意义(P<0.01),高于胺碘酮单药48.1%,差异有统计学意义(P<0.05)。A组1例患者伊布利特转复过程中出现7.4s窦性停搏。结论伊布利特能提高胺碘酮对心房颤动和心房扑动转复的成功率,两者合用时需注意窦房结功能。

Objective To evaluate the efficacy and safety of ibutilide in cardioversion of atrial fibrillation （Af） and artial flutter （AF） after amiodarone cardioversion failed. Methods 63 patients with Af or AF were included in the study. 52 pa- tients were first treated with amiodarone and then ibutilide was administered to those unsuccessfully treated with amio- darone （group A）. 11 patients were only treated with ibutilide（group B）. Results 45 cases （86.5%） were converted to si- nus rhythm in group A. Of them, 25 cases were treated with amiodarone and 20 cases with amiodarone plus ibutilide. Car- dioversion was successful in 7 cases （63.6%） in group B. The success rate was significant difference between group A and B （P〈0.01）. 57.1% Af was converted to sinus rhythm in group B, which was significantly lower than that treated with amiodarone plus ibutilide（84.8%, P〈0.01）, but higher than that treated with amiodarone（48.1%, P〈0.05）. One patient had a sinus arrest of 7.4s during ibutilide therapy in group A. Conclusion Ibutilide may improve efficacy of amiodarone in cardioversion of Af and AF. It is necessary to pay attention to sinus node function in patients treated with both amiodarone and ibutilide.