胺碘酮与普罗帕酮静脉给药转复新近发生心房颤动的比较

目的 比较胺碘酮与普罗帕酮静脉给药转复新近发生心房颤动的有效性和安全性。方法 95例被随机分成两组：48例接受胺碘酮治疗，即10分钟内缓慢静脉推注150mg，1mg／min维持静脉滴注6小时，0．5mg／min维持静脉滴注18小时；47例接受普罗帕酮治疗，即10分钟内缓慢静咏推注70mg，未转为窦性心律者，30—60舒钟后再静脉追加70mg，口服普罗帕酮450mg／d维持。主要观察终点是24小时复律成功率，次要观察终点是8小时复律成功率。同时观察两组死亡率和不良反应。结果 24小时复律成功率两组无差别，但8小时复律成功率，普罗帕酮高于胺碘酮。两组不良反应轻微，无死亡病例。结论 和普罗帕酮相比，胺碘酮静脉给药在24小时内转复新近发生的心房颤动同样安全、有效。

The comparison of intravenous amiodarone versus propafenone for immediate cardioversion of recent-onset atrial fibrillation

ObjectiveTo compare the efficacy and safet y of intravenous amiodarone versus propafenone for immediate cardioversion of re cent-onset atrial fibrillation.Methods95 consecutive pat ients with atrial fibrillation (onset within 48 h) were randomly assigned to two groups: 48 patients in amiodarone group and 47 patients in propafenone group as control. Patients randomized to amiodarone received 150 mg IV over 10 minutes, followed by infusion at 1mg/minute for 6 hours, then 0.5mg/minute for 18 hours. Patients randomized to propafenone received 70mg IV over 10 minutes, if atrial f ibrillation persists, repeat 70 mg boluses was given 30-60 min after the first l oading,daily maintenance dose of 450mg orally. The primary end point was rate o f cardioversion within 24 hours, the secondary end point was rate of cardioversi on at 8 hours. Mortality and adverse events also were analyzed.Result sPropafenone had a significantly better rate of cardioversion than amiodarone for up to eight hours, but there was no difference between the two gr oups at 24 hours. The adverse events were minimal in both groups, with no deaths reported in both groups.Conclusion Intravenous amiodaro ne is as safe and effective as propafenone at 24 hours in cardioversion of recen t-onset atrial fibrillation.