普罗帕酮口服与静脉应用胺碘酮转复48h内新发心房颤动的对比研究

目的本随机对照研究观察普罗帕酮口服与静脉应用胺碘酮对于转复新近发生心房颤动的安全性及效果。方法选择新近发生心房颤动在48h内之患者87例,随机分为普罗帕酮组与胺碘酮组进行药物复律。普罗帕酮组43例;起始口服普罗帕酮450～600mg,12h后未转复窦性心率追加300mg。胺碘酮组44例,起始300mg胺碘酮静脉给药1h,后按20mg/kg持续24h。以24h后恢复窦性心率为治疗有效。结果普罗帕酮组有效率83.7%,胺碘酮组84.1%,两组无统计学差异;平均起效时间普罗帕酮组2.7h,胺碘酮组7.8h,两组有明显统计学差异。结论口服普罗帕酮与静脉应用胺碘酮均可安全有效转复48h内新近发生心房颤动,口服普罗帕酮起效时间更短。

A Comparative Study of Oral Propafenone Versus Intravenous Amiodarone for the Conversion of Recent Onset Atrial Fibrillation within 48 Hours

Objective A prospective, randomized study was conducted to evaluate the efficacy and safety of oral propafenone and intravenous amiodarone for the conversion of new onset atrial fibrillation（AF）. Methods Eighty seven consecutive patients admitted to hospital with AF lasting no longer than 48 hours, were randomized in terms of their pharmacological therapy. 43 patients were assigned to receive propafenone 600mg orally as the initial therapy, with an additional dose of 300mg after 12 hours if the sinus rhythm had not been restored by then. 44 patients received amiodarone 300mg intravenously over 1 hour, followed by 20mg/kg in the next 24 hours. Treatment was considered successful if conversion to sinus rhythm was achieved within the 24-hour study period. Results The conversion rate assessed 24 hours was the same in both groups（propafenone 86.0%;amiodrone 81.8%）. The average time required to successful conversion for propafenone group is 2.7 hours, for amiodarone group is 7.8hours. Conclusion both methods are effective in the restoration of sinus rhythm in recent onset AF. While oral propafenone are faster.