伊布利特静脉注射转复心房扑动、心房颤动116例分析

Analysis of ibutilide for converting atrial fibrillation and atrial flutter

目的:分析Ⅲ类抗心律失常药物富马酸伊布利特(伊布利特)转复心房扑动(房扑)、心房颤动(房颤)的安全性及有效性。方法:顺序入选符合条件的116例房扑、房颤患者,使用伊布利特药物转复,先予1 mg(体质量≥60 kg)或0.01 mg/kg(体质量<60 kg)稀释后静注,观察10 min,如无效则给予相同剂量重复应用。用药后心电监护4 h,观察复律效果及安全性。结果:21例房扑患者中11例首剂转复窦性心律(窦律),6例重复剂量转复窦性,有效率80.9%;95例房颤患者中首剂转复窦律37例,重复剂量转复窦律22例,有效率62.1%。房扑组不良反应发生率9.5%;房颤组不良反应发生率10.5%。结论:伊布利特是转复房扑、房颤快速有效的药物,尤其对房扑疗效显著,充分准备及心电监护下用药具有较高的安全性。

Objective： To analyze the efficacy and safety of new Class 91 antiarrhythmic drug ibutilide for cardioversion of atrial fibrillation（AF） and atrial flutter（AFL） to sinus rhythm. Methods： 116 patients with AF/AFL were consecutively recruited in accordance with the inclusion criteria. All patients were treated with ibutilide to covert rhythm. The dose of intravenous ibutilide used for the first time was 1 mg（weight~〉60 kg） or 0.01 mg/kg（weight〈60 kg） and then observed for ten minutes. If AF/ AFL didn＇t terminate, the same dose was given for the second time. ECG was monitored for 4 hour to observe the efficacy and safety. Results： Among 21 patients with AFL, 11 patients converted to sinus rhythm（SR） after the 1st injection, and 6 pa- tients converted to SR after repeated dose. The efficiency was 80.9%. Among 95 patients with AF, 37 patients converted to SR after the 1st injection, and 22 patients converted to SR after the 2nd injection. The efficiency was 62.1% the rate of side- effects in AFL group was 9.5%, and the rate of side-effects rate in AF group was 10.5%. Conclusion： Ibutilide is a rapid and effective new anti-arrhythmic drug with high rate of conversion for AF and AFL, especially for the latter. It＇s highly safety with careful preparation and electrocardiographic monitoring.