伊伐布雷定在心力衰竭合并非阵发性心房颤动患者中的应用研究进展

Application of Ivabradine in Patients with Heart Failure Complicated with Non-Paroxysmal Atrial Fibrillation

心力衰竭(心衰)伴非阵发性心房颤动(房颤)时,心率控制是必要且基本的治疗目标之一。目前常用于心衰合并房颤的心室率控制的药物在多种情况下使用受到限制。起搏电流(I电流)抑制剂伊伐布雷定目前被批准用于窦性心律、应用β受体阻滞剂后心室率控制未达标或不能耐受β受体阻滞剂的慢性射血分数降低性心衰或心绞痛患者。既往认为在心衰合并非阵发性房颤患者中使用伊伐布雷定是无效的,但近期研究表明I电流在左心房、房室结和肺静脉中均有分布,且在房颤的发生及维持中发挥作用。现对伊伐布雷定在心衰合并非阵发性房颤患者心室率控制方面的研究进展进行综述。

Heart rate control is one of the essential therapeutic goals in patients with heart failure(HF) who had atrial fibrillation(AF).Currently, the drugs commonly used for ventricular rate control of HF with AF are limited in many cases.Ivabradine, an Icurrent inhibitor, has been approved for patients with chronic HF with reduced ejection fraction or angina with sinus rhythm who have failed to achieve target heart rate following β-blockers, or who cannot tolerate β-blockers.In the past, it was thought that ivabradine was ineffective in HF patients complicated with non-paroxysmal AF.Recent studies have shown that Iion channel is distributed in left atrium, atrioventricular node and pulmonary vein, and plays a role in the occurrence and maintenance of AF.This paper reviews the research progress of ivabradine in the control of ventricular rate in HF patients complicated with non-paroxysmal AF.