抗心律失常药及心律失常持续时间对心房扑动、心房颤动转复效果的影响

目的 探讨抗心律失常药及持续时间对心房颤动、心房扑动转复效果的影响.方法 回顾分析180例房扑及180例房颤患者的临床资料,并按选择的药物伊布利特、普罗帕酮及胺碘酮治疗各分为三组,每组患者再分为持续时间≤3 d和＞3d,每组各30例,比较各组患者治疗1.5h后的转复率,采用SPSS 16.0进行统计分析.结果伊布利特组≤3 d和＞3d的房扑的转复率为90.00％和83.33％,普罗帕酮的≤3 d和＞3d的房扑的转复率为76.67％和36.67％,胺碘酮的房扑的转复率为73.33％和33.33％,对于房扑持续时间≤3 d,伊布利特、普罗帕酮、胺碘酮的房扑的转复率差异没有统计学意义(P＞0.05)；对于房扑持续时间＞3d,伊布利特的转复率明显高于普罗帕酮、胺碘酮的(P＜0.05)；三种药物房颤的转复效果比较:伊布利特的≤3 d和＞3d的房颤的转复率为80％和73.33％,普罗帕酮的≤3 d和＞3d的房颤的转复率为43.33％和26.67％,胺碘酮的房颤的转复率为50％和36.67％,对于房颤持续时间＜3d,伊布利特的转复率明显高于普罗帕酮、胺碘酮(P＜0.05)；对于房颤持续时间＞3d,伊布利特的转复率明显高于普罗帕酮、胺碘酮的(P＜0.05)；三组药物房扑、房颤总转复率分别为81.67％、45.83％、48.33％,伊布利特明显高于普罗帕酮、胺碘酮(P＜0.05)；伊布利特对房扑的转复率明显高于房颤的转复率(P＜0.05).结论 对于持续时间≤3 d的患者,伊布利特、普罗帕酮及胺碘酮房扑转复成功率没有明显差异,但伊布利特房颤转复率明显增高；对于持续时间＞3d的患者,伊布利特房扑、房颤转复的成功率均高于普罗帕酮及胺碘酮,应根据心律失常具体情况灵活选用伊布利特、普罗帕酮及胺碘酮进行治疗.

The study on the impact of arrhythmic drugs and arrhythmia duration in cardioversion effect on atrial flutter and atrial fibrillation

Objective To optimize antiarrhythmic drugs in the treatment of atrial fibrillation and atrial flutter patient different duration,improve the success rate and safety of cardioversion.Methods Make a retrospective analysis of 180 atrial flutter and 180 atrial fibrillation patients data,which were divided into group ibutilide,propafenone group and amiodarone group,Each group were further divided into duration≤3d〉3d,n=30,cardioversion rate was compared after 1.5h,and aralyzed by SPSS16.0.Results Atrial flutter cardioversion rate of ibutilide group≤3d and 3d was 90% and 83.33%;propafenone≤3d and 3d were 76.67% and 36.67%,amineamiodarone were 73.33% and 33.33%,cardioversion rate of three groups had no significant difference when atrial flutter duration≤3d,P＞0.05;Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration 〉3d,P＜0.05;atrial fibrillation cardioversion rate of ibutilide group≤3d and 3d was 80% and 73.33%;propafenone≤3d and 3d were 43.33% and 26.67%,amineamiodarone were 50% and 36.67%,Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration≤3d,P＜0.05;Ibutilide cardioversion was significantly higher than propafenone,amiodarone when atrial flutter duration 〉3d,P＜0.05;the atrial flutter,atrial fibrillation total cardioversion rate of three groups were 81.67%,45.83%,48.33%,ibutilide was significantly higher than propafenone,amiodarone（P＜0.05）;the atrial fluttercardioversion of ibutilide was significantly higher than the atrial fibrillation rate（P＜0.05）.Conclusion For the duration of ≤3d patients,atrial flutter cardioversion rate of ibutilide,propafenone,and amiodarone did not differ significantly,but the atrial fibrillation cardioversion rate of ibutilide was significantly higher;For the duration of〉 3d patients,the atrial flutter and atrial fibrillation cardioversion rate of Ibutilide were higher than propafenone and amiodarone,when choose ibutilide,propafenone,or amiodarone for treating atrial flutter and atrial fibrillation according to individual arrhythmia.