口服单剂普罗帕酮转复阵发性心房颤动的疗效观察

观察口服单剂负荷量Ⅰc类抗心律失常药物普罗帕酮 (悦复隆 )转复阵发性心房颤动 (PAF)的疗效 ,以期减少患者反复住院治疗的次数。32例门诊及住院患者经心电图证实均为PAF ,持续时间 >2h ,剔除心功能Ⅱ级 (NYHA分级 )以上、病窦综合征、房室阻滞和束支阻滞。随机将患者分为两组 :治疗组 18例 ,口服悦复隆 4 5 0mg ;对照组 14例 ,口服安慰剂。以Holter或心电监护记录观察给药后 2 ,4 ,12h内心律。转复窦性心律后记录 12导联心电图。结果 :两组性别、年龄、病因、PAF病程、左房内径均无差别 (P >0 .0 5 )。治疗组转复率 2h内为 11.1% (2 / 18)、4h内为4 4 .4 % (8/ 18例 )、12h内为 6 1.1% (11/ 18例 ) ;对照组转复率则分别为 0、7.1% (1/ 14例 )、2 1.4 % (3/ 14例 )。两组比较 ,在 4和 12h内的转复率有显著性差异 (P <0 .0 5 )。治疗中两例患者转复窦律后PR间期 0 .2 2s ,2～ 2 4h后恢复至 0 .2 0s。结论 :对不伴严重心功能不全及缓慢性心律失常的PAF患者 ,口服单剂负荷量普罗帕酮能有效和迅速地使PAF转复 ,缩短PAF持续时间

The Effect of Single Oral Propafenone in Converting Paroxysmal Atrial Fibrillation

Department of Cardiology,Tianjin Medical University Hospital,Tianjin 300052,ChinaTo investigate the effect of single oral loading propafenone(450 mg) in convertion of paroxysmal atria fibrillation (PAF),thirty two patients suffering from PAF for over 2 hours each time and without heart failure above NYHA class II,sick sinus sydrome,atrioventricular or blanch block were divided into two groups.Group A (propafenone group):Eighteen patients took propafenone 450mg.Group B (control group) 14 patients took placebo.Then the heart rate/rhythm was observed using Holter or cardiogram monitor within 2,4 and 12 hours,and record ECG after sinus rhthym.Result:There was no marked difference between the two groups in age,gender,etiology,course of disease,diameter of left atrium ( P >0.05).Percentage on convertion of PAF in group A was 11% (2/18) within 2 hours,44.4% (8/18) within 4 hours and 61.1% (11/18) within 12 hours.That in group B was separately 0 (0/14), 7.1% (1/14) and 21.4% (3/14).There were significantly difference within 4 and 12 hours between the two groups ( P <0.05) and without severe side effect.Conclusion :The results indicate that single oral propafenone is effective to convertion of PAF rapidly in the patients without severe heart failure and bradyarrhythmia.