静脉注射胺碘酮对阵发性房颤复律的疗效

Efficacy of intravenous amiodarone in cardioversion of paroxysmal atrial fibrillation

目的 :观察静注胺碘酮对阵发性房颤 (AF)复律的临床疗效。方法 :将 5 1例阵发性AF患者分为胺碘酮组 (n =2 6 )和普罗帕酮组 (n =2 5 )。胺碘酮组先给予胺碘酮 15 0mg ,iv ,0 5h后再给予胺碘酮 15 0mg ,iv ,继之以 1mg·min-1,ivgtt,6h ,随后以 0 5mg·min-1,ivgtt,2 4h。普罗帕酮组给予普罗帕酮 70mg ,iv ,继之以 0 5mg·min-1,ivgtt,总量至 2 80mg。结果 :胺碘酮组4h内转复 8例 (30 8% ) ,4～ 8h内转复 8例 (30 8% ) ,8～ 12h内转复 2例 (7 7% ) ,12～ 2 4h内转复 2例 (7 7% ) ,未转复 6例 ,总显效率为 76 9%。普罗帕酮组 4h内转复 7例 (2 8% ) ,4～ 8h内转复 6例 (2 4 % ) ,8～ 12h内转复 3例 (12 % ) ,12～ 2 4h内转复1例 (4% ) ,未转复 8例 ,总显效率为 6 8%。结论

AIM: To study the clinical efficacy of intravenous amiodarone for cardioversion of paroxysmal atrial fibrillation. METHODS: Fifty one patients entered the study. They all suffered from paroxysmal atrial fibriallation. They were divided into 2 groups. Twenty six patients were treated with amiodarone. Twenty five patients were treated with propafenone. Amiodarone 150 mg iv at first, followed by another 150 mg iv after 0 5 h later. Then amiodarone 1 mg·min -1 , iv gtt, for 6 h, then 0 5 mg·min -1 until 24 h. Propafenone 70 mg iv at first, then 0 5 mg·min -1 until 280 mg. RESULTS: Eight patients in amiodarone group recovered in 4 h (30 8%), 8 in 4-8 h (30 8%), 2 in 8-12 h (7 7%), 2 in 12-24 h (7 7%), 6 patients had no response to the therapy. Total efficiency rate was 76 9%. Seven patients in propafenone group recovered in 4 h (28%), 6 in 4-8 h (24%), 3 in 8-12 h (12%), 1 in 12-24 h (4%). Eight patients had no response to the therapy. Total efficiency rate was 68%. CONCLUSION: The efficacy of intravenous amiodarone and propafenone is comparable. And intravenous amiodarone is safer and more effective.