普罗帕酮与洋地黄转复慢性心房颤动的比较

目的 比较普罗帕酮与洋地黄转复慢性房颤的作用。方法 房颤发作时间大于3周的患者随机分为普罗帕酮组和洋地黄组，普罗帕酮组先静脉推注普罗帕酮2mg/kg，再以5mg/kg维持24小时，后改口服每天450mg治疗4周。洋地黄组先静脉推注毛花甙C 0.4mg，然后每6小时静脉推注0．2mg，24小时后改口服地高辛每日0．25mg。结果 普罗帕酮组17例（48．6％）转复为窦性心律，洋地黄组仅2例转复成功。普罗帕酮组转复成功者与未转复者相比，左房内径明显较小（P＜0．001），房颤持续时间显著较短（P＜0．001）。结论 普罗帕酮可有效地用于慢性房颤的转复，洋地黄转复慢性房颤疗效不佳；左房内径、房颤持续时间是影响转复成功的重要因素。

A comparison between propafenone and digitalis in the therapeutic result of patients with chronic atrial fibrillation

Objective To compare the result between propafenone and digitalis for conversion of chronic atrial fibrillation. Methods Patients with an atrial fibrillation,Who continued more than 3 weeks,were randomly divided into propafenone group and digitalis group.In propafenone group the patients were given propafenone 2mg/kg intravenously first, at beginning,and 5mg/kg continued 24 hours,then 450mg/day,oral administration,for 4 weeks.Patients in digitalis group began with lanatoside C 0.4mg intravenously,followed every 6 hours and were given 0.2mg until 24 hours,then digoxin 0.25mg every day,for 4 weeks. Results Seventeen of 35(48.6%) patients with chronic atrial fibrillation converted to sinus rhythm in propafenone group,only two of 36(5.6%) patients converted to sinus rhythm in digitalis group.Patients who converted to sinus rhythm after treatment with propafenone,all had a shorter duration of atrial fibrillation and the atrial diameter was smaller too(P<0 001). Conclusion Propafenone can be used effectively for conversion of chronic atrial fibrillation to sinus rhythm,but then the left atrial diameter and duration of atrial fibrillation also obviously affect the success of conversion.