伊布利特转复房颤对跨壁复极异质性及室性心律失常的影响分析

Analysis of influence by ibutilide for atrial fibrillation cardioversion on transmural repolarization heterogeneity and ventricular arrhythmias

目的分析伊布利特转复心房颤动(房颤)对跨壁复极异质性及室性心律失常的影响。方法 68例房颤患者依据治疗方法不同分为胺碘酮组与伊布利特组,每组34例。胺碘酮组患者实施胺碘酮治疗,伊布利特组患者实施伊布利特治疗。对比分析两组患者的房颤转复成功率,并统计分析两组患者用药之前、用药后4 h内的QT间期和Tpeak-end/QT间期比值变化。结果 34例伊布利特组患者中有21例患者转复成功,成功率为61.8%,34例胺碘酮组患者中有12例患者转复成功,成功率为35.3%,两组成功率比较,差异具有统计学意义(P<0.05)。伊布利特组患者用药后2 h内QT间期与用药前比较显著延长,差异具有统计学意义(P<0.05),伊布利特组患者用药后30 min内Tpeak-end/QT间期比值与用药前比较明显升高,差异具有统计学意义(P<0.05);胺碘酮组患者用药后的QT间期与用药前比较显著延长,差异具有统计学意义(P<0.05),胺碘酮组患者用药后的Tpeak-end/QT间期比值与用药前比较差异无统计学意义(P>0.05)。结论在房颤患者临床治疗中,伊布利特治疗转复成功率显著高于胺碘酮,并能够对患者QT间期、Tpeak-end/QT间期比值显著改善,值得推广。

Objective To analyze influence by ibutilide for atrial fibrillation cardioversion on transmural repolarization heterogeneity and ventricular arrhythmias. Methods A total of 68 patients with atrial fibrillation were divided by different treatment measures into amiodarone group and ibutilide group, with 34 cases in each group. The amiodarone group received amiodarone for treatment, and the ibutilide group received ibutilide for treatment. Comparative analysis was made on successful cardioversion rate between the two groups, along with statistical analysis of changes in QT interval and Tpeak-end/QT interval ratio before and in 4 h after medicine administration. Results Among 34 patients in the ibutilide group, there were 21 cases with successful cardioversion, and their success rate was 61.8%. Among 34 patients in the amiodarone group, there were 12 cases with successful cardioversion, and their success rate was 35.3%. The difference of success rate had statisticalsignificance between the two groups（P〈0.05）. The ibutilide group had obviously longer QT interval in 2 h after medicine administration than that before medicine administration, and the difference had statistical significance（P〈0.05）. The ibutilide group had obviously higher Tpeak-end/QT interval ratio in 30 min after medicine administration than that before medicine administration, and the difference had statistical significance（P〈0.05）. The amiodarone group had much longer QT interval after medicine administration than that before medicine administration, and the difference had statistical significance（P〈0.05）. There was no statistically significant difference of Tpeak-end/QT interval ratio before and after medicine administration in the amiodarone group（P〉0.05）. Conclusion In clinical treatment of atrial fibrillation patients, ibutilide shows remarkably higher success rate in cardioversion than amiodarone. Ibutilide can also excellently improve QT interval and Tpeak-end/QT interval ratio during treatment, and it is worth promoting.