重症患者阵发心房颤动伴快速心室率的治疗方法研究

目的:观察病因治疗能否使重症监护病房中阵发心房颤动(简称房颤)患者转复窦律;比较静脉注射毛花苷丙-胺碘酮序贯治疗与单独注射胺碘酮转复无心脏病基础的房颤效果。方法:42例发作阵发性房颤伴快速心室率的危重症患者进行病因治疗,对未纠律者随机分配至毛花苷丙-胺碘酮序贯治疗与单独胺碘酮治疗组。结果:病因治疗后23例患者转复窦律。余19例患者进行随机分组,2组胺碘酮用量差异无统计学意义(P=0.386),心率变化差异无统计学意义(P=0.974),复发率差异无统计学意义(P=0.85)。结论:病因治疗可转复危重症患者房颤心律。对病因治疗不能纠律者,直接静脉注射胺碘酮效果与毛花苷丙-胺碘酮序贯治疗相同。

Treatment of Paroxysmal Atrial Fibrillation with Rapid Ventricular Rhythm in Critically Ill Patients

OBJECTIVE：To observe effect of etiological treatments on revival of sinus rate in patients with paroxysmal atrial fibrillation and to compare the effect of cedilanid-amiodarone with amiodarone alone with intravenous administration on atrial fibrillation without heart disease history.METHODS：42 critically ill patients with paroxysmal atrial fibrillation were treated with etiological therapy.Patients without revival of sinus rhythm were randomly assigned to be treated with cedilanid-amiodarone or amiodarone alone.RESULTS：After etiological therapy,sinus rhythm of 23 patients was revived and other 19 patients were randomly grouped.No statistically significance was noted in difference of amiodarone dosages（P=0.386）,change of heart rate（P=0.974） and recurrence rate（P=0.85） between two groups.CONCLUSION：Etiological therapy could restore sinus rhythm in patients with paroxysmal atrial fibrillation.The effecicacy of venous injection of amiodarone in patients without revival of sinus rhythm is similar to cedilanid-amiodarone sequence therapy.