导管消融术后早期使用决奈达隆对房颤及房扑复发的预防效果

Preventive effect of early dronedarone application on recurrence of atrial fibrillation and atrial flutter after catheter ablation

目的:研究导管消融术后早期使用决奈达隆对房颤及房扑复发的预防效果。方法:于我院行导管消融术进行肺静脉隔离术的256例阵发性房颤/房扑患者被随机均分为胺碘酮组(在常规治疗基础上加用胺碘酮口服200mg,1次/d)与决奈达隆组(在常规治疗基础上加用决奈达隆口服400mg,2次/d),两组出院后均治疗3个月,停药后再随访9个月。观察比较两组一般资料、窦性心律维持率及平均窦性心律维持时间。结果:随访期间,两组一般资料无显著差异(P均>0.05)。Kaplan-Meier曲线显示,胺碘酮组、决奈达隆组窦性心律维持率分别为73.4%、84.4%;决奈达隆组平均窦性心律维持时间为11.343月(95%CI:11.249~11.437),显著长于胺碘酮组的10.677月(95%CI:10.536~10.818),P=0.001。结论:导管消融术后早期使用决奈达隆,可显著提高房颤及房扑患者窦性心律维持率,延长平均窦性心律维持时间。

Objective:To study preventive effect of early dronedarone application on recurrence of atrial fibrillation and atrial flutter after catheter ablation.Methods:A total of 256 patients with paroxysmal atrial fibrillation or atrial flutter undergoing catheter ablation for pulmonary vein isolation in our hospital were randomly and equally divided into amiodarone group(received amiodarone 200 mg,once/d based on routine treatment)and dronedarone group(received dronedarone 400 mg,twice/d based on routine treatment),both groups were treated for three months after discharge,then followed up for nine months after withdrawal.General data,maintenance rate of sinus rhythm and mean sinus rhythm maintenance time were observed and compared between two groups.Results:During follow-up,there were no significant difference in general data between two groups(P>0.05 all).Kaplan-Meier curve indicated that maintenance rate of sinus rhythm of amiodarone group and dronedarone group were 73.4%and 84.4%respectively;and mean sinus rhythm maintenance time of dronedarone group was 11.343 months(95%CI:11.249~11.437),significantly longer than that of amiodarone group(10.677 months,95%CI:10.536~10.818),P=0.001.Conclusion:Early dronedarone application after catheter ablation can significantly improve maintenance rate of sinus rhythm in patients with atrial fibrillation and atrial flutter,and prolong mean sinus rhythm maintenance time.