无器质性心脏病老年人术后快速心房颤动的转复

Conversion of recent-onset atrial fibrillation in the elderly without heart diseases after non-cardiac surgery

目的 观察静脉推注胺碘酮转复无器质性心脏病的老年人外科手术后快速性心房颤动 (简称房颤 )的有效性和安全性。方法 16例术后 3d内发生快速房颤的无器质性心脏病的老年患者 ,年龄 5 9～ 83岁 ,平均6 7.1岁 ,发作时心室率 12 0～ 173次 /m in,平均 15 2 .3次 /min,观察 1h后 ,静推胺碘酮 15 0～ 30 0 mg,继以 6 0 0μg/m in静脉滴注维持 2 4 h。结果 16例患者 ,13例在静推胺碘酮过程中及静推后 2 0 min内转复为窦性心律 ,3例在静推后 4 0 min内转复 ,并维持到观察结束 ,无 1例出现低血压和心律失常等严重副作用。

Objective To determine the efficacy and safety of amiodarone for the rapid conversion of atrial fibrillation in the elderly without heart diseases after noncardiac surgery.Methods Sixteen patients with atrial fibrillation occurring within 3 days after surgery and lasting 1 hour were received intravenous infusions of amiodarone 150~300 mg followed by 600 μg/min for 24 hours.Patients included in the study were 59 years old or older,without heart diseases and with fast ventricular rates.Treatment was considered to be successful if sinus rhythm was restored during the infusions as well as for the period of time within 20 minutes after the infusions.Results Treatment resulted in sinus rhythm restoration in all of the patients, and efficacy was dose related.No serious adverse effect occurred.Conclusions This study indicates that amiodarone is a useful and safe and rapid treatment alternative for the atrial fibrillation with fast ventricular rates that occurred to the elderly without heart diseases after surgery.