胺碘酮在心房颤动复律和预防复发中的作用

The Eficacy of Amiodarone for the Cardioversion and the Maintenance of Normal Sinus Rhythm in Patients With Chronic Atrial Fibrillation.

探讨胺碘酮在心房颤动 (简称房颤 )复律和预防复发中的作用。 10年间共 10 8例房颤患者给予胺碘酮负荷剂量治疗共 10天进行房颤复律 ,9例房颤 (8.3% )持续 2周以内的患者自动复律 ,99例房颤再进行改良的胸背前后位贴片法电复律 ,94例 (94.9% )复律成功 ,复律成功能量为 78.1± 40 .6J。复律成功的 10 3例给予胺碘酮 0 .2 ,每日一次 ,预防复发 ,其后 1个月 ,0 .5年 ,1年 ,2年 ,维持窦律者分别为 98.1% ,88.3% ,71.8% ,5 6 .3% ;而早期用奎尼丁标准法复律共 36例 ,2 0例 (5 5 .6 % )自动复律 ;另 16例再行电复律 ,12例 (75 .0 % )复律成功 ,复律后在相应随访时间维持窦律者分别为 6 5 .0 % ,2 0 .0 % ,0 % ,0 %。结论 :胺碘酮药物复律房颤成功率低于奎尼丁 ,而预防复发却远优于奎尼丁 ;低能电复律法辅助胺碘酮复律是房颤复律的良好选择。慢性房颤心功能良好可用胺碘酮复律并预防复发。

The aim is to evaluat the efficacy of Amiodarone for the Cardioversion and the maintenance of nornal sinus rhytm in patients with chronic atrial fibrillation(AF).108 patients with AF underwent the standard loading amiodarone administration(0.2 tid×10 days),9 patients(8.3%)restored to normal sinus rhythm during loading administration,the remainer received a low energy electric cardioversion(78.1±40.6 J),94(94.9%)restored to sinus rhythm successfully,thereafter,the patients received amiodarone maintenance therapy(0.2 qd),the maintenance rate of sinus rhythm was 98.1%,88.3%,71.8%,and 56.3% at 1 month,0.5,1 and 2 years,respectively.Before 1991,36 patients underwent standard loading administration of quinidine,20 patients(55.6%)restored to normal sinus rhythm,the remainder received electrical cardioversion,12(75.0%)restored to sinus rhythm,and all the restored patients received quinidine maintenance therapy(0.2 tid),the maintenance rate of sinus rhythm was 65%,20%,0%,0% at the same duration.Conclusion:the chemical cardioversion rate of amiodarone is lower;however the maintenance rate of sinus rhythm is much better than quinidine.The low energy electrical cardioversion is useful means to restore to sinus rhythm for the chronic AF.It is suggested that AF with better cardiac function can be cardioverted and maintained in sinus rhythm.