静脉及口服胺碘酮重叠应用治疗器质性心脏病心房颤动伴快速心室率的临床疗效

观察重叠应用静脉及口服胺碘酮治疗器质性心脏病阵发心房颤动 (简称房颤 )伴快速心室率的临床疗效及安全性。 36例器质性心脏病合并房颤的患者 ,男 2 2例、女 14例 ,年龄 6 5 .3± 11.5 (49～ 80 )岁。房颤发作时心室率142 .5± 2 5 .2 (12 0～ 176 )次 /分 ,先给予静脉负荷量胺碘酮 (15 0～ 30 0mg)后 ,继之以 6 0 0 μg/min静脉点滴维持 48h ,同时口服胺碘酮 6 0 0mg/d治疗。结果 :36例患者用药后 30min、1,2 ,2 4,48h心室率分别为 12 4.1± 11.5 ,113.3±8.6 ,10 5 .1± 8.2 ,92 .7± 8.5 ,88.6± 9.4次 /分 ,较用药前明显下降 (P <0 .0 1)。 30例 (83 .3% )患者转复为窦性心律 ,于 2h ,2～ 2 4h ,2 4～ 48h ,2～ 7d转复率分别为 11.1%、2 7.8%、2 2 .2 %和 2 2 .2 %。未转复组患者左房径大于转复组(P <0 .0 5 ) ,而射血分数明显低于转复组 (P <0 .0 5 ) ,这可能是 6例患者未转复的原因。 2例患者用药后出现长RR间期 ,1例出现窦性心动过缓 ,1例出现双手震颤 ,经减药或停药后恢复。结论 :静脉及口服胺碘酮重叠应用治疗器质性心脏病房颤是有效和安全的。

Efficacy United With Intravenous and Oral Amiodarone in Treatment of Atrial Fibrillation With Organic Heart Disease.

To observe the efficacy and security united with intravenous and oral amiodarone for atrial fibrillation(AF) with organic heart disease,thirty six patients of AF with organic heart disease was treated with loaded intravenous amiodarone (150～300 mg),and then dripped one 600 μg/min for 48 hours,united with oral amiodarone observed the efficacy of reduced ventricular rate,reversion,and side effects.Results:The ventricular rate was 124.1±11.5,113.3±8.6, 105.1 ±8.2,92.7±8.5 and 88.6±9.4 bpm at 30 min?1,2,24,48 h respectively,ventricular rate was reduced significantly than pre treated(142.5±25.2 bpm, P <0.01).30/36 patients reversed to sinus rhythm.Long RR intermittent was observed in 2 patients,sinus bradycardia in 1 patient,hands tremor in 1 patient,which disappeared after withdraw or reduce.Conclusion:The results showed it was effective and safe united with intravenous amiodarone and oral amiodarone in treatment of AF atrial fibrillation with organic heart disease.