Holter analysis of ventricular arrhythmias and its treatment with propafenone

We studied 20 patients with ventricular premature beats. All of them underwent 16-24 hs Holter monitoring before and during propafenone treatment at an average dosage of 600 mgs P.O. We observed 86% decrease in the ectopic beats. In two cases there was a complete abolition of the ventricular beats. The Lown's type 3 ventricular beats had a 50% reduction. The were not significant modifications of the heart rate of blood pressure. There were not significant side effects. We consider propafenone as a potent agent for the treatment of ventricular ectopic beats.     

胺碘酮与普罗帕酮治疗老年阵发性心房颤动疗效与安全性研究

目的 探讨胺碘酮与普罗帕酮治疗老年阵发性心房颤动的疗效与安全性.方法 106例阵发性房颤患者随机分成胺碘酮治疗组和普罗帕酮治疗组,分别为54例和52例,随访1年,观察两组治疗前后房颤复发情况及左房内径的变化.结果 胺碘酮治疗组预防老年阵发性房颤复发3m的总有效率为88.9％,6m的总有效率为77.8％,9m的总有效率为74.1％,12 m的总有效率为70.4％;普罗帕酮治疗组3m的总有效率为73.1％,6m的总有效率为63.5％,9m的总有效率为57.7％,12m的总有效率为53.8％;胺碘酮治疗组左房内径在治疗前后发生了变化（P＜0.05）;两组药物长期应用不良反应均较为少见.结论 胺碘酮在老年阵发性房颤的治疗比普罗帕酮相对有效,两组药物合理使用不良反应均较低.     

Electrophysiologic effects and clinical efficacy of propafenone in pediatric patients with paroxysmal supraventricular reentrant tachycardia

Twenty patients (pts) with recurrent paroxysmal supraventricular tachycardia (PSVT), 12 female and 8 male, aged 9.8 +/- 4.7 years, underwent an electrophysiologic study (EPS) in order to assess the effects of propafenone (Pf) administered intravenously (1.5 mg/Kg in 3'). Thirteen pts (Group I) had an accessory pathway (AP) which was concealed in 5 and overt in 8 and in 12 of them an orthodromic atrioventricular reentrant tachycardia (ORT) was induced. In 5 of 7 pts (Group II) without AP an idio-nodal reentrant tachycardia (AVNRT) was induced. After Pf the sinus cycle length decreased significantly from 668 +/- 165 to 612 +/- 109 msec and PA, AH, HV intervals and QRS duration increased significantly from 35 +/- 11, 71 +/- 18, 34 +/- 6 and 73 +/- 12 to 43 +/- 11, 87 +/- 15, 39 +/- 9 and 85 +/- 10 msec respectively. The atrial and ventricular effective refractory period (ERP) increased from 216 +/- 18 and 211 +/- 19 to 227 +/- 21 and 217 +/- 21 msec respectively. The anterograde and retrograde nodal ERP and anterograde and retrograde Wenckebach point increased from 240 +/- 48, 227 +/- 28, 278 +/- 37 and 287 +/- 38 to 270 +/- 58, 330 +/- 32, 340 +/- 59 and 408 +/- 37 msec respectively. Pf terminated the tachycardia (T) in all 12 pts of Group I after prolongation of the cycle length which increased from 299 +/- 46 to 383 +/- 69 msec.(ABSTRACT TRUNCATED AT 250 WORDS)     

Predictors of atrial rhythm after atrioventricular node ablation for the treatment of paroxysmal atrial arrhythmias

OBJECTIVE: To assess the natural history of the atrial rhythm of patients with paroxysmal atrial arrhythmias undergoing atrioventricular node ablation and permanent pacemaker implantation. DESIGN AND SETTING: A retrospective cohort study of consecutive patients identified from the pacemaker database and electrophysiology records of a tertiary referral hospital. PATIENTS: 62 consecutive patients with paroxysmal atrial arrhythmias undergoing atrioventricular node ablation and permanent pacemaker implantation between 1988 and July 1996. MAIN OUTCOME MEASURES: (1) Atrial rhythm on final follow up ECG, classified as either ordered (sinus rhythm or atrial pacing) or disordered (atrial fibrillation, atrial flutter or atrial tachycardia). (2) Chronic atrial fibrillation, defined as a disordered rhythm on two consecutive ECGs (or throughout a 24 hour Holter recording) with no ordered rhythm subsequently documented. RESULTS: Survival analysis showed that 75% of patients progressed to chronic atrial fibrillation by 2584 days (86 months). On multiple logistic regression analysis a history of electrical cardioversion, increasing patient age, and VVI pacing were associated with the development of chronic atrial fibrillation. A history of electrical cardioversion and increasing patient age were associated with a disordered atrial rhythm on the final follow up ECG. CONCLUSIONS: Patients with paroxysmal atrial arrhythmias are at high risk of developing chronic atrial fibrillation. A history of direct current cardioversion.     

Reversible protective effect of propafenone or flecainide during atrial fibrillation in patients with an accessory atrioventricular connection.

In 34 patients with a symptomatic accessory atrioventricular connection the reversible protective effect of orally administered flecainide (300 mg/day) and of propafenone (900 mg/day) in control of ventricular response during atrial fibrillation by exercise was assessed. The study consisted of three sections of 1 week each: an initial treatment phase during which propafenone or flecainide was administered, a drug-free phase, and a period of crossover to treatment with the other drug. At the end of each phase, transesophageal stimulation was performed during physical exercise to induce atrial fibrillation episodes: the goal was to control the persistence of drug effectiveness. At rest, the mean and shortest R-R interval during the period of induced atrial fibrillation in patients who were treated with flecainide or propafenone increased significantly as compared with the drug-free period. On the other hand, at maximum exercise levels no difference in both shortest and mean R-R intervals during atrial fibrillation was observed between patients who were treated with flecainide and those who were treated with propafenone, as well as between flecainide treatment and the drug-free period, whereas a slightly significant difference persisted with propafenone treatment (p less than 0.05). In addition, at maximum exercise levels no significant difference in the number of preexcited QRS complexes among the three treatments was noted. The data from this study suggests that a reversible protective effect against rapid ventricular rate as the result of an episode of atrial fibrillation exists during exercise in patients with a symptomatic accessory atrioventricular connection who are treated with flecainide or propafenone.     

艾司洛尔和普罗帕酮治疗阵发性室上性心动过速的临床疗效

目的观察艾司洛尔和普罗帕酮治疗阵发室上性心动过速（PSVT）的临床疗效,分析比较两种药物的差异。方法纳入PSVT患者120例,随机分为艾司洛尔组（n=60）和普罗帕酮（n=60）。两组在积极治疗原发病及纠正电解质紊乱、低氧血症,调整盐酸平衡的基础上,艾司洛尔组通过输液泵注射艾司洛尔,初始按负荷量0.5mg/kg,每次增加0.05mg/kg,直至显效,最大剂量≤0.25mg/kg。普罗帕酮组采用注射用水20mL＋普罗帕酮70mg缓慢注射（10min～15min）。结果两组治疗有效率无统计学差异（85.0%vs.83.3%,P〉0.05）,且减慢心率和降低血压的疗效接近（P〉0.05）。结论艾司洛尔注射液治疗PSVT与普罗帕酮同等有效。     

Efficacy of amiodarone during long-term treatment of potentially dangerous ventricular arrhythmias in patients with chronic stable ischemic heart disease

Amiodarone was administered orally to 30 patients with chronic stable coronary artery disease and severe ventricular arrhythmias. Control studies revealed frequent (more than 30/hr) ventricular premature beats (VPBs) (27 patients), bigeminy (21 patients), couplets (29 patients), R-on-T phenomenon (14 patients), ventricular tachycardia (16 patients), and ventricular fibrillation (1 patient). Two 24-hour Holter recordings and stress tests were performed before treatment, and an average of 3.6 per patient were done during treatment. Amiodarone caused suppression of all ventricular arrhythmias in 13 (43%) of the 30 patients and suppression of all complex forms and greater than 90% reduction of VPB number in 14 patients (47%) during a follow-up of 12.4 months. The mean dose was 590 mg/day in the 27 responders and 300 mg/day in the three nonresponders. A similar antiarrhythmic response was observed during stress testing. One of the 30 patients died due to massive pulmonary embolism and no arrhythmias were detected. In addition, amiodarone suppressed the occurrence of anginal pain and effort-induced ST changes in 9 of 10 patients and in 11 of 13 patients, respectively. The rate—pressure product and peak heart rate were significantly reduced in all patients. Our results suggest that amiodarone may be ideally suited for treatment of ventricular arrhythmias and for possible prevention of sudden death in patients with ischemic heart disease.     

European experience with the antiarrhythmic efficacy of propafenone for supraventricular and ventricular arrhythmias

Seventy-one patients (mean age 53 years) were treated with oral propafenone, 900 mg/day, for a mean of 6.6 months. A large spectrum of arrhythmias was encountered, and particular attention was paid to their relation with the autonomic nervous system. Drug efficacy was graded from 1 (no effect) to 5 (complete control) according to the clinical result and Holter recording. This method permitted comparisons to be made between propafenone and 3 other antiarrhythmic agents: quinidine, beta-blockers and amiodarone. Among the 32 patients with supraventricular arrhythmias, 9 cases of vagally dependent atrial flutter and fibrillation were less sensitive to propafenone (mean effect 1.4) than to quinidine (mean effect 2.0) or amiodarone (mean effect 2.3). However, 8 cases of adrenergically dependent atrial tachycardia and fibrillation were more sensitive to propafenone (mean effect 4.1) than to beta blockers (3.0) or amiodarone (mean effect 3.5). In 12 cases of miscellaneous atrial arrhythmias the response to propafenone was intermediate. However, 3 patients with resistant junctional tachycardia were improved with propafenone. Among 42 ventricular arrhythmias, 5 patients with extrasystole who were responsive to quinidine (mean effect 3.8) were also improved with propafenone (mean effect 4.6). Propafenone (mean effect 4.1) was much more effective than quinidine (mean effect 2.4) in treating 8 cases of idiopathic benign ventricular tachycardia and even more successful in treating 13 cases of more severe arrhythmias in diseased hearts (propafenone's mean effect 4.1, quinidine's mean effect 1.9 and amiodarone's mean effect 1.9). Propafenone was less effective (mean effect 3.3) than amiodarone (mean effect 4.0) in 4 cases of severe, adrenergically dependent idiopathic ventricular tachycardia (VT).(ABSTRACT TRUNCATED AT 250 WORDS)     

胺碘酮和心律平治疗心力衰竭并室性心律失常的对比观察

目的 分析对比观察胺碘酮、心律平治疗充血性心力衰竭合并室性心律失常的临床疗效与安全性.方法 80例充血性心力衰竭合并室性心律失常的患者分成两组,每组各40例.两组患者抗心力衰竭治疗相同,观察组应用胺碘酮抗心律失常,对照组应用心律平抗心律失常,疗程4周,观察临床疗效、室性心律失常及左心室射血分数（LVEF）的变化,并对结果进行回顾性分析.结果 治疗后观察组临床疗效高于对照组（P＜0.01）,室性心律失常减少高于对照组（P＜0.05）,LVEF值增加优于对照组（P＜0.05）.对照组有6例出现新的心律失常,停用心律平后恢复.结论 充血性心力衰竭合并室性心律失常必须长期使用抗心律失常药物时,应首选胺碘酮治疗而不宜使用心律平.     

Reproducible efficacy of loading oral propafenone in restoring sinus rhythm in patients with paroxysmal atrial fibrillation

This is the first study to demonstrate the reproducibility of an oral propafenone loading dose in converting paroxysmal atrial fibrillation in patients without significant cardiac disease or hypertension. This finding may support the development of the "pill-in-the-pocket" treatment strategy in this group of patients.     

Washout of long-term treatment with flecainide and propafenone in patients with complex ventricular arrhythmias and cardiac disease. Antiarrhythmic Drug Evaluation Group.

To assess the spontaneous variability of ventricular arrhythmias after withdrawal of apparently successful antiarrhythmic therapy, we enrolled in a washout protocol 40 patients who had completed a randomized controlled 2-year study of antiarrhythmic drugs (the Antiarrhythmic Drug Evaluation Group [ADEG] study). All of them had heart disease and were first seen with high-grade ventricular arrhythmias (Lown class 4a and 4b) at enrollment. After 2 years all of them had responded to propafenone or flecainide; patients who completed the study on a regimen of amiodarone were not considered for the washout study. A total of 27 patients discontinued flecainide and 13 propafenone. Seven days after withdrawal they underwent 24- or 48-hour ECG testing and were classified as true responders (TR) if the arrhythmias were present at the same level as 2 years previously and false responders (FR) if they were below the ADEG responsiveness level. TR patients had a third 24-hour ECG 7 days later, after rechallenge with the same treatment, and FR patients had a third ECG without drugs. Adherence to the protocol was ascertained by measuring drug plasma concentrations at every 24-hour ECG recording. No differences were found in distribution of heart disease and grade of ventricular arrhythmias between patients in the washout study and the remaining group of the ADEG trial. Twenty-four of 40 patients (60%) were true responders. In 4 of the 17 patients who had a third 24 hour ECG, the responsiveness to the same drug was not confirmed.(ABSTRACT TRUNCATED AT 250 WORDS)     

Short-term and long-term treatment with propafenone: determinants of arrhythmia suppression, persistence of efficacy, arrhythmogenesis, and side effects in patients with symptoms.

OBJECTIVE--To assess the clinical criteria predicting the short and long-term efficacy of propafenone, an agent with class IC antiarrhythmic activity and a broad pharmacological profile. DESIGNS--Prospective study of propafenone at doses of 450 to 900 mg/day during a six week dose titration period (including a placebo phase with two separate 24 Holter recordings). Responders to treatment were followed for one year. PATIENTS--One hundred patients with frequent ventricular arrhythmias (greater than 30 extrasystoles/h) of Lown class III and IVA/B and without evidence of myocardial infarction within the past six months. ANALYSIS--Multivariate regression analysis of spontaneous arrhythmia variability and of different clinical variables to determine the short and long-term efficacy and safety of propafenone. MEASUREMENTS AND MAIN RESULTS--Propafenone 450 mg/day was effective in 30/100 patients (30%), and at 600 mg/day another 14 responded. The efficacy of propafenone correlated with a low spontaneous arrhythmia variability and, as shown by multivariate analysis, with a lower patient age (p less than 0.05). When the dose was increased to 900 mg/day a further six (12%) patients responded. However, with increasing doses of propafenone, the one year probability of effective treatment decreased from 86% (450 mg/day) to 67% (600 mg/day) and to 44% (900 mg/day). After restudying the patients at three, six, and 12 months and after dose adjustment in 11/44 patients (25%), 31 patients (70%) remained responders. Loss of permanent antiarrhythmic efficacy was best predicted by the initial dose that achieved a response. No patient died suddenly or had arrhythmogenic effects during Holter monitoring. Side effects occurred in 36% of patients but these rarely limited long-term treatment. CONCLUSIONS--A younger age, low spontaneous arrhythmia variability, and particularly a low titration dose were the best predictors of the short and long term efficacy of propafenone. All other responders should have repeated Holter recordings during the first year of treatment.     

Short-term and long-term treatment with propafenone: determinants of arrhythmia suppression, persistence of efficacy, arrhythmogenesis, and side effects in patients with symptoms.

OBJECTIVE--To assess the clinical criteria predicting the short and long-term efficacy of propafenone, an agent with class IC antiarrhythmic activity and a broad pharmacological profile. DESIGNS--Prospective study of propafenone at doses of 450 to 900 mg/day during a six week dose titration period (including a placebo phase with two separate 24 Holter recordings). Responders to treatment were followed for one year. PATIENTS--One hundred patients with frequent ventricular arrhythmias (greater than 30 extrasystoles/h) of Lown class III and IVA/B and without evidence of myocardial infarction within the past six months. ANALYSIS--Multivariate regression analysis of spontaneous arrhythmia variability and of different clinical variables to determine the short and long-term efficacy and safety of propafenone. MEASUREMENTS AND MAIN RESULTS--Propafenone 450 mg/day was effective in 30/100 patients (30%), and at 600 mg/day another 14 responded. The efficacy of propafenone correlated with a low spontaneous arrhythmia variability and, as shown by multivariate analysis, with a lower patient age (p less than 0.05). When the dose was increased to 900 mg/day a further six (12%) patients responded. However, with increasing doses of propafenone, the one year probability of effective treatment decreased from 86% (450 mg/day) to 67% (600 mg/day) and to 44% (900 mg/day). After restudying the patients at three, six, and 12 months and after dose adjustment in 11/44 patients (25%), 31 patients (70%) remained responders. Loss of permanent antiarrhythmic efficacy was best predicted by the initial dose that achieved a response. No patient died suddenly or had arrhythmogenic effects during Holter monitoring. Side effects occurred in 36% of patients but these rarely limited long-term treatment. CONCLUSIONS--A younger age, low spontaneous arrhythmia variability, and particularly a low titration dose were the best predictors of the short and long term efficacy of propafenone. All other responders should have repeated Holter recordings during the first year of treatment.     

Intravenous nitroglycerin suppresses exercise-induced arrhythmias in patients with ischaemic heart disease: implications for long-term treatment

We studied 20 patients with ischaemic heart disease, who consistentlydeveloped complex ventricular arrhythmias during exercise testing.Treadmill exercise was performed twice, both during the placeboinfusion and then during intravenous administration of nitroglycerin,titrated to reduce systolic blood pressure by 10 mmHg. Exerciseduration in those administered placebo was 7·8 ±1·7 and 7·9 ± 1·5 min, respectively(ns): angina developed in five patients and ischaemic ST changesin 10. In those administered nitroglycerin, exercise durationincreased to 8·4 ± 2 mm (P<0·05). DiagnosticST segment depression was observed in only two patients andonly one had angina. Ventricular arrhythmias, consistently presentduring both tests on those administered placebo, were dramaticallyreduced by nitroglycerin in all 20 patients. There were 455(mean 35·8± 16·8) and 4l8 (mean 34·4±11·1)ventricular ectopic beats in the two exercise tests on thoseadministered placebo and 11 in those receiving the nitroglycerininfusion (mean 0·6 ± 0·1 (P<0·001).There were 28 and 29 couplets in those receiving placebo (ns)and none in those receiving nitroglycerin (P<0·001).Ventricular tachycardia was present in six and eight patientswho received placebo but in none in those administered nitroglycerin(P<0·001). Abolition of exercise-induced arrhythmiaswas maintained during chronic treatment with oral coronary vasodilators.Prevention of exercise-related arrhythmias by nitroglycerinappears a good indicator of their ischaemic origin and may providevaluable information for long-term prophylaxis with oral vasodilators,thus avoiding antiarrhythmic agents with their potential sideeffects.     

Intravenous nitroglycerin suppresses exercise-induced arrhythmias in patients with ischaemic heart disease: implications for long-term treatment

We studied 20 patients with ischaemic heart disease, who consistentlydeveloped complex ventricular arrhythmias during exercise testing.Treadmill exercise was performed twice, both during the placeboinfusion and then during intravenous administration of nitroglycerin,titrated to reduce systolic blood pressure by 10 mmHg. Exerciseduration in those administered placebo was 7·8 ±1·7 and 7·9 ± 1·5 min, respectively(ns): angina developed in five patients and ischaemic ST changesin 10. In those administered nitroglycerin, exercise durationincreased to 8·4 ± 2 mm (P<0·05). DiagnosticST segment depression was observed in only two patients andonly one had angina. Ventricular arrhythmias, consistently presentduring both tests on those administered placebo, were dramaticallyreduced by nitroglycerin in all 20 patients. There were 455(mean 35·8± 16·8) and 4l8 (mean 34·4±11·1)ventricular ectopic beats in the two exercise tests on thoseadministered placebo and 11 in those receiving the nitroglycerininfusion (mean 0·6 ± 0·1 (P<0·001).There were 28 and 29 couplets in those receiving placebo (ns)and none in those receiving nitroglycerin (P<0·001).Ventricular tachycardia was present in six and eight patientswho received placebo but in none in those administered nitroglycerin(P<0·001). Abolition of exercise-induced arrhythmiaswas maintained during chronic treatment with oral coronary vasodilators.Prevention of exercise-related arrhythmias by nitroglycerinappears a good indicator of their ischaemic origin and may providevaluable information for long-term prophylaxis with oral vasodilators,thus avoiding antiarrhythmic agents with their potential sideeffects.     

Effects of propafenone on arrhythmias induced by exertion in patients with ischemic cardiopathy

The efficacy of Propafenone to prevent exercise-induced ventricular arrhythmias (EIVA) has been studied in eleven patients affected by ischemic heart disease. None of the patients manifested any arrhythmia at rest, but ventricular arrhythmias occurred in every case during a treadmill test. EIVA disappeared after Propafenone in nine patients, while a reduction by 90% was achieved in the remaining two patients. A further treadmill test carried out five days after withdrawal of the drug induced again the same ventricular arrhythmias in all the patients. Thus, Propafenone appears effective to prevent EIVA in patients with ischemic heart disease.     

Efficacy of amiodarone during long-term treatment of malignant ventricular arrhythmias in patients with chronic chagasic myocarditis

Oral amiodarone was administered to 24 patients with chronic chagasic myocarditis (CCM) and malignant ventricular arrhythmias. Control 24-hour Holter recordings revealed frequent ventricular premature beats (VPBs) (157 to 2572/hr; mean 714 ± 125), multiform VPBs, and countless numbers of ventricular couplets in all patients, R-on-T phenomenon in 17 patients, and ventricular tachycardia in 21 patients. Amiodarone caused total and persistent suppression of ventricular couplets and tachycardia and greater than 93% reduction of VPB number in 22 patients, during a follow-up of 26.6 months (range 2 to 55 months). In 1 patient, ventricular couplets and tachycardia persisted despite the fact that a 98.2% reduction of VPB number was achieved. This latter patient was the only one in the whole group who experienced sudden death. The maximal antiarrhythmic effect was attained gradually after 3 to 26 weeks (mean 7.4). In four patients in whom treatment was discontinued after 3 to 12 months, the antiarrhythmic protection lasted 4 to 9 weeks. In nine patients the dose of amiodarone was 600 to 800 mg/day. In 15 patients the dose had to be increased to 800 to 1000 mg/day. Despite the presence of congestive heart failure in seven patients and intraventricular block in 17 patients, no limiting side effects were observed. Amiodarone proved to be extremely effective and safe against the most malignant ventricular arrhythmias of CCM.     

Intravenous nitroglycerin suppresses exercise-induced arrhythmias in patients with ischaemic heart disease: implications for long-term treatment.

We studied 20 patients with ischaemic heart disease, who consistently developed complex ventricular arrhythmias during exercise testing. Treadmill exercise was performed twice, both during the placebo infusion and then during intravenous administration of nitroglycerin, titrated to reduce systolic blood pressure by 10 mmHg. Exercise duration in those administered placebo was 7.8 +/- 1.7 and 7.9 +/- 1.5 min, respectively (ns); angina developed in five patients and ischaemic ST changes in 10. In those administered nitroglycerin, exercise duration increased to 8.4 +/- 2 min (P less than 0.05). Diagnostic ST segment depression was observed in only two patients and only one had angina. Ventricular arrhythmias, consistently present during both tests on those administered placebo, were dramatically reduced by nitroglycerin in all 20 patients. There were 455 (mean 35.8 +/- 16.8) and 418 (mean 34.4 +/- 11.1) ventricular ectopic beats in the two exercise tests on those administered placebo and 11 in those receiving the nitroglycerin infusion (mean 0.6 +/- 0.1) (P less than 0.001). There were 28 and 29 couplets in those receiving placebo (ns) and none in those receiving nitroglycerin (P less than 0.001). Ventricular tachycardia was present in six and eight patients who received placebo but in none in those administered nitroglycerin (P less than 0.001). Abolition of exercise-induced arrhythmias was maintained during chronic treatment with oral coronary vasodilators. Prevention of exercise-related arrhythmias by nitroglycerin appears a good indicator of their ischaemic origin and may provide valuable information for long-term prophylaxis with oral vasodilators, thus avoiding antiarrhythmic agents with their potential side effects.     

血糖浓度对普罗帕酮转复阵发性心房颤动患者疗效的影响简

目的 探讨血糖浓度对普罗帕酮转复阵发性心房颤动（房颤）患者疗效的影响.方法 回顾性分析2010年1月至2012年12月在复旦大学附属中山医院青浦分院住院患者中的阵发性房颤（房颤持续时间＜24 h）108例的临床资料.依据患者就诊时的血糖浓度分为3组：Ⅰ组（血糖浓度＜7.0 mmol/L）52例;Ⅱ组（血糖浓度7.0～11.0 mmol/L） 33例;Ⅲ组（血糖浓度≥11.1 mmol/L）23例.所有患者转复前完成糖化血红蛋白检测、超声心动图检查,采用盐酸普罗帕酮药物转复.结果 Ⅰ、Ⅱ两组转复率分别为94.2％（49/52）、84.8％（28/33）,与Ⅲ组69.6％（16/23）比较,差异有统计学意义（P＜0.05）.Ⅰ、Ⅱ两组糖化血红蛋白水平明显低于Ⅲ组,差异有统计学意义（P＜0.05）.各组左心房内径比较,差异无统计学意义（P＞0.05）.结论 血糖浓度≥11.1 mmol/L的阵发性房颤患者使用普罗帕酮的转复率低.