缬沙坦联合胺碘酮对持续性心房颤动复律及复律后窦性心律维持率的影响

The effect of Valsartan combined with Amiodarone on cardioversion of atrial fibrillation and maintenance of sinus rhythm in patients with permanent atrial fibrillation

目的观察缬沙坦联合胺碘酮对持续性心房颤动复律及复律后窦性心律维持率的影响。方法选择持续性心房颤动患者96例,随机分为两组,治疗组49例,给予缬沙坦及胺碘酮治疗,对照组47例给予安慰剂及胺碘酮治疗,随访1年,观察两组心房颤动转复率和转复后3、12个月时心房颤动复发率,以及转复时及转复后12个月左心房内径(LAD)、左心室射血分数(LVEF)变化。结果心房颤动转复率治疗组(87.8%)与对照组(85.1%)差异无统计学意义(P>0.05),心房颤动复发率转复后3个月及12个月治疗组(14.0%、23.2%)均小于对照组(32.5%、54.5%)(P<0.05或0 01),转律后12个月LAD治疗组[(44.3±0.65)mm)]较对照组[(46,9±0.54)mm]变小(P<0.05),LVEF治疗组[(56.8±8.64)%]较对照组[(52.3±9.08)%]升高(P<0.05)。结论缬沙坦联合胺碘酮治疗持续性心房颤动在减少心房颤动的复发率以及改善心功能方面优于单独使用胺碘酮。

Objective To investigate the effect of Valsartan combined with Amiodarone on cardioversion of persistant atrial fibrillation （AF） and maintenance of sinus rhythm after cardioversion. Methods 96 patients with permanent AF were randomly divided into control group（n=47） and Valsartan group （n=49）. The conversion rate of AF at one year and reoccur- rence of AF at 3 and 12 months after cardioversion were investigated. Left atrial dimension and left ventricular ejection frac- tion （LVEF） were measured at the moment of cardioversion and 12 months after cardioversion. Results The rate of AF cardioversion was not significant difference between two groups （87.8% vs 85.1%, P 〉0.05）. The recurrence rate was sig- nificantly lower in Valsartan group than control group at 3 months （14.0% vs 32.5%, P〈0.05） and 12 months （23.2% vs 54.5%, P〈0.01 ）. Left atrium significantly decreased （44.3 ± 0.65 mm vs 46.9 ± 0.54 mm, P〈0.05） and LVEF increased （56.8 ± 8.64% vs 52.3 ± 9.08%, P〈0.05） in Valsartan group at 12 months. Conclusion Valsartan with Amiodarone is su- perior to Amiodarone alone in maintaining sinus rhythm and improving heart function in the patients with permanent AF.