胺碘酮联合电复律治疗心脏外科术后房颤疗效分析

Curative effect of amiodarone combined with electrical cardioversion in treatment of atrial fibrillation after cardiac surgery

目的:探讨胺碘酮联合电复律治疗心脏外科术后房颤的疗效和安全性。方法:选取2016年1月至2018年9月心脏外科术后出现房颤给予负荷剂量胺碘酮应用无效的患者74例,按出现房颤先后顺序分为对照组和观察组,各37例。对照组继续胺碘酮治疗,观察组采用胺碘酮联合同步直流电复律治疗。比较两组患者的疗效、并发症情况,监测观察组复律前及复律后24 h、48 h、72 h和1周心肌损伤标志物水平。结果:观察组有效率显著高于对照组(72.97%vs48.65%,P<0.05);而并发症发生率两组差异无统计学意义(P>0.05)。电复律后心肌损伤标志物在不同时段出现上升,并随时间发展逐渐恢复至复律前水平。结论:同步治疗电复律可明显提高胺碘酮在治疗心脏外科术后房颤的疗效,虽然可造成心肌一过性损伤,但并不增加并发症发生率,是一种安全有效的治疗手段。

Objective: To investigate the efficacy and safety of amiodarone combined with electrical cardioversion in the treatment of atrial fibrillation after cardiac surgery.Methods: From Jan.2016 to Sep.2018,74 patients who suffered from atrial fibrillation after cardiac surgery were divided into control group and treatment group according to the sequence of occurrence of atrial fibrillation,37 cases in each group.The control group was treated with amiodarone,while the treatment group was treated with amiodarone plus synchronous DC cardioversion.The curative effect and complications of the two groups were compared,and the levels of myocardial injury markers before cardioversion and 24 h,48 h,72 h,1 week after cardioversion in the treatment group were monitored.Results: The effective rate of the treatment group was significantly higher than that of the control group(72.97%vs 48.65%,P<0.05),but there was no significant difference in the incidence of complications between the two groups(P >0.05).After cardioversion,the markers of myocardial injury increased at different time points,and gradually recovered to the precardioversion level with the development of time.Conclusion: Simultaneous electrical cardioversion can significantly improve the efficacy of amiodarone in the treatment of atrial fibrillation after cardiac surgery.Although amiodarone can cause transient myocardial injury,it does not increase the incidence of complications.It is a safe and effective treatment method.