顿服心律平转复心房颤动的临床观察

Clinical observation of oral loading dose propafenone for conversion of recent-onset atrial fibrillation

目的 探讨和验证顿服 6 0 0mg心律平转复近期心房颤动的有效性及安全性。方法 2 7例阵发性房颤患者一次口服心律平 6 0 0mg后 ,记录即刻 ,1小时 ,3小时 ,8小时心电图观察房颤是否转复 ,同时监测血压变化及心电图QRS波时限及PR间期变化。结果 2 7例服药后 8小时成功 ,总有效率 74.1% ,1小时转复者 2例 (7.4% ) ,3小时转复者 14例 (5 1.9% )。与文献静注心律平转复房颤相比 ,注射组转复成功率分别为 2 8% (1小时 ) ,41% (3小时 )及 6 6 % (8小时 )。 3小时后顿服心律平转复成功率高于静脉给药组。无一例发生明显副作用。结论 顿服 6 0 0mg心律平转复房颤的方法简单 ,疗效肯定 。

Objective To evaluate the efficacy and safety of oral loading dose (600mg) propafenone for conversion of recent-onset atrial fibrillation.Methods Twenty-seven patients with atrial fibrillation of recent onset were given a single oral loading dose of propafenone (600mg). Electrocardiograms were recorded before the administration and 1,3,8h after the administration so as to confirm whether the sinus rhythm was restored. The blood pressure, QRS duration and PR intervals were evaluated simultaneously.Results Conversion to sinus rhythm was obtained within 8 h in 74.1% (20 cases) of all the 27 patients. There were 7.4% (2 cases) and 51.9% (14 cases) restored to sinus rhythm at 1 h and 3 h respectively. After 3 h, the efficacy of oral loading dose propafenone was statistically superior to intravenous propafenone (reported successful rate of 28%, 41% and 66% at 1, 3, 8 h respectively). No major side effects were observerd.Conclusion Propafenone as an oral loading dose is efficacious and fast simple way of treating atrial fibrillation of recent onset.