右美托咪定与咪达唑仑对心房颤动射频消融术后复发率的影响

目的 探讨右美托咪定与咪达唑仑对心房颤动(房颤)射频消融术后复发率的影响.方法 将73例拟行房颤射频消融的患者按照术中镇痛和镇静方案分为对照组(n=36)和试验组(n=37),对照组术中采用咪达唑仑联合芬太尼,试验组术中采用右美托咪定联合芬太尼,均为先予负荷量、继予维持量静脉泵入.消融方法2组相同,均为在双侧肺静脉隔离...

Effects of dexmedetomidine versus midazolam on recurrence rate of atrial fibrillation after radiofrequency ablation

AIM To investigate the effects of dexmedetomidine versus midazolam on the recurrence rate of atrial fibrillation(AF)after radiofrequency ablation(RF).METHODS Seventy-three patients who underwent RF of AF were divided into control group(n=36)and trial group(n=37)according to intraoperative analgesia and sedation.The patients in the control group were treated with midazolam and fentanyl,while the patients in the trial group were treated with dexmedetomidine and fentanyl.Both groups were given loading dose followed by maintenance dose via intravenous pump.The same ablation strategy(bilateral pulmonary vein isolation plus additional necessary intervention besides pulmonary vein)was carried out in all patients.Data were collected including operation time,ablation parameters,dosage of fentanyl,and so on.Occurrence of adverse events was also recorded.Patients were visited before discharge,1 month,3 months,6 months and 1 year after operation,and each recurrence rate of atrial fibrillation was counted.RESULTS There were no significant differences in the type and course of AF,occurrence of complications,left ventricular ejection fraction,dosage of fentanyl,operation time and ablation parameters between the two groups(P>0.05).No severe adverse events were documented during operation.Recurrence rate of AF within three months after operation in the trial group was 3%(1/37),which seemed lower compared with the control group(17%,6/36),while the difference was not significant(P=0.056).There were no differences in the recurrence number of AF within 6 months(4 in both groups)and 1 year(5 in the trial group vs.7 in the control group)between the two groups(P>0.05).CONCLUSION Compared with midazolam combined with fentanyl,dexmedetomidine combined with fentanyl has a tendency to reduce early postoperative recurrence of AF,but has no effect on late postoperative recurrence in RF patients.