心房颤动电复律与胺碘酮节律控制的效果——附53例临床观察

目的：观察电复律＋胺碘酮维持治疗对持续性心房颤动（房颤）节律控制的效果及安全性。方法：回顾分析2007年8月至2010年12月在我院行心脏电复律＋胺碘酮维持治疗的53例持续性房颤患者的资料,对复律≥2年的24例患者进行随访,其中维持窦性心律1.5年者16例（复律组）,房颤复发者8例（复发组）。结果：53例有50例达到复律早期成功,早期成功率为94.3%,与电复律前比较,电复律后患者的总心室率（109777±6757）次/min比（81083±5036）次/min]、平均心率（81±8）次/min比（62±6）次/min]、最快心室率（145±13）次/min比（123±11）次/min]、最慢心室率（67±7）次/min比（45±6）次/min]明显减低（P〈0.05）;与复律组比较,复发组的房颤持续时间（4.36±1.47）月比（8.7±2.15）月]、左房内径（35.85±2.07）mm比（43.15±1.95）mm]、年龄（54.3±11.7）岁比（72.1±8.3）岁]均明显增大（P〈0.01～〈0.001）。所有病人无明显副作用。结论：电复律联合小剂量胺碘酮维持治疗对大部分持续性房颤患者有效、安全、简便,应该推广。

Effect of electrical cardioversion combined amiodarone rhythm control in 53 cases with atrial fibrillation

Objective:To observe effect and safety of electrical cardioversion combined amiodarone rhythm control on patients with persistent atrial fibrillation(AF).Methods: Data of 53 patients with persistent AF by electrical cardioversion and amiodarone maintenance therapy in our hospital from Aug 2007 to Dec 2010 were retrospectively analyzed.A total of 24 patients undergoing cardioversion for over two years were followed up,in which 16 patients maintained sinus rhythm for 1.5 years were regard as conversion group and eight cases recurred AF were enrolled as recurrence group.Results:A total of 50 patients(94.3%) achieved early success among 53 cases.Compared with before electrical cardioversion,there were significant decrease in total ventricular rate (109777±6757) timesmin vs.(81083±5036) timesmin],mean heart rate (81±8) timesmin vs.(62±6) timesmin],maximum ventricular rate (145±13) timesmin vs.(123±11) timesmin]and minimum ventricular rate (67±7) timesmin vs.(45±6) timesmin]after electrical cardioversion(P<0.05 all).Compared with conversion group,there were significant increase in AF duration (4.36±1.47) months vs.(8.7±2.15) months],left atrial diameter (35.85±2.07) mm vs.(43.15±1.95) mm]and age (54.3±11.7) years vs.(72.1±8.3) years]in recurrence group(P<0.01～<0.001).No obvious side effects occurred in all patients.Conclusion:It is effective,safe and feasible to eliminate persistent atrial fibrillation for most patients by electrical cardioversion combined with low dose amiodarone,must be spread.