老年人阵发性房颤急诊复律的临床比较

目的 比较不同种类药物的转复率、心室率控制情况及药物应用的安全性与有效性,并对直流电转复治疗的选择进行探讨。方法 总结57例老年人阵发性房颤的临床复律治疗资料,分别给予毛花苷丙(西地兰)及不影响不应期的钠通道阻滞剂类药物普罗帕酮,观察转复及心率控制情况,对合并严重并发症、药物控制无效的患者,给予同步直流电复律。结果 毛花苷丙24 h内急诊转复率28.1％,安静状态下心室率控制满意;普罗帕酮24 h内急诊转复率62.2％,心室率控制满意,两者疗效比较差异有显著性(P<0.01);直流电复率组即刻转复率为73.3％,心室率控制不满意。结论普罗帕酮较毛花苷丙的急诊转复率明显提高,对危急患者同步直流电转复为有效的治疗方法,但需谨慎应用。

Comparison of varied treatment for emergency cardioversion of paroxysmal atrial fibrillation in the aged patients

Objective To compare the safety and efficacy of varied treatments for cardioversion of paroxysmal atria] fibrillation (AF) in the aged patients and to explore choice of electrical cardioversion with direct current. Methods Clinical data of cardioversion with lanatoside (cedilandid) or propafenone, a sodium channel blocker prolongs refractoriness, for 57 aged patients with paroxysmal AF were summarized to observe their cardioversion and control of heart rate. And, synchronous electrical cardioversion will be offered to those with severe complications and ineffective with drug treatment within 24 h after the onset of AF. Results An emergency cardioversion ratio was 28.1 % with lanatoside within 24 h with a satisfactory control of ventricular rate, as compared with that of 62.2% with propafenone (P < 0.01) with unsatisfactory control of ventricular rate. Immediate cardioversion ratio was 73.3% with direct current, with unsatisfactory control of ventricular rate. Conclusions Propafenone had a significantly higher cardioversion ratio than lanatoside did, and synchronous electrical cardioversion was also an effective method for severe patients with AF, but should be used with caution.