静脉滴注胺碘酮治疗急性心肌梗死伴快速房颤的临床疗效及安全性

目的观察静脉滴注胺碘酮治疗急性心肌梗死(AMI)伴快速房颤患者的临床疗效及安全性。方法19例AMI患者伴新近发生的快速房颤,静脉应用胺碘酮负荷量后,继以静脉滴注维持,观察房颤转复、心室率控制、血压变化情况及副作用。结果19例患者中14例(73.7%)在24h内转为窦性心律,用药后15min、1h、2h、24h心室率分别为(132.1±17.4)次/min、(118.5±15.0)次/min、(108.2±18.6)次/min和(89.6±23.7)次/min,较用药前(149.7±19.7)次/min明显下降(P<0.01);5例患者心律未转复,用药后15min、1h、2h和24h心室率分别为(137.6±11.9)次/min、(131.8±15.8)次/min、(120.6±12.6)次/min和(101.4±14.1)次/min,较用药前(159.6±18.0)次/min亦有明显下降(P<0.01)。19例患者(包括转复与未转复者)用药前后血压无明显变化(P>0.05)。3例患者用药后出现长间歇,1例出现窦性心动过缓,经临时停药或减量后恢复,无其他副反应发生。结论静脉应用胺碘酮治疗AMI并发快速房颤是有效及安全的。

Clinical efficacy and safety of intravenous amiodarone in the treatment of fast atrial fibrillation in patients with acute myocardial infarction

Objective To observe the clinical efficacy and safety of intravenous amiodarone in the treatment of fast atrial fibrillation in patients with acute myocardial infarction(AMI).Methods 19 AMI patients with newly onset of fast atrial fibrillation were observed.After an intravenous load, amiodarone was intravenously injected continuously.Efficacy of amiodarone in the reversion of atrial fibrillation,the control of ventricular rate and changes of blood pressure as well as the side effects were observed.Results The ventricular rate 15 min,1h, 2h,24h after the administration of amiodarone in the 19 patients was (132.1±17.4)beats/min,(118.5±15.0)beats/min,(108.2±18.6)beats/min,(89.6±23.7)beats/min respectively, which were significantly lowered than (149.7±19.7)beats/min before administration of the drug (P<0.01).The atrial fibrillation was reverted to sinus rhythm within 24h in 14 of 19 cases (73.7%),5 patients failed to revert,but the ventricular rate 15 min,1 h,2 h,24 h after administration was (137.6±11.9)betas/min,(131.8±15.8)beats/min,(120.6±12.6)beats/min and (101.4±14.1)beats/min respectively,which was obviously lowered than that of before treatment (159.6±18.0)beats/min(P<0.01).Long intermission was observed in 3 patients,and sinus bradycardia occurred in 1 patient. Patients' cardiac rhythm return to normal state after reducing the dose or stopping administration of the drug.Conclusion Intravenous amiodarone is effective and safe in the treatment of fast atrial fibrillation in patients with AMI.