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目的 观察和比较伊布利特和普洛帕酮终止心房扑动的疗效及其副作用。方法 于 2 0 0 1～ 2 0 0 4年对北京大学人民医院心内科 4 0例发作持续时间 <90d的心房扑动患者 ,按入院先后分 2组 ,分别静脉应用 (1～ 2次 ,每次 10min推注 )伊布利特 (1 0mg和 1 0mg)和普洛帕酮 (70 0mg和 70 0mg)。 结果 伊布利特和普洛帕酮转复心房扑动成功率分别为 90 %和 30 %。平均转复时间分别为 (2 1± 19)min和 (35± 8)min。房扑持续时间可作为房扑终止的预测因子。扑动波周长延长是伊布利特终止房扑的主要特征。心动过缓 (6 /2 0 ,30 % )和低血压 (4/2 0 ,2 0 % )是普洛帕酮的常见副作用。接受伊布利特治疗的 2 0例房扑患者有 8例出现单形性室早或短阵房扑伴差异性传导 ,未经特殊处理 ,均于用药后 1h内自行消失。结论 伊布利特作为一种Ⅲ类的抗心律失常药 ,在监测的条件下 ,能迅速、安全、有效地终止心房扑动。
Objective To observe and compare the efficacy and side effects of ibutilide and propafenone in terminating atrial flutter. Methods From 2001 to 2004, 40 patients with atrial flutter whose duration of attack was less than 90 days in Department of Cardiology, Peking University People ’s Hospital were divided into two groups according to their hospitalization: 1 ~ 2 times a day 10 min min bolus) ibutilide (10 mg and 10 mg) and pamidronate (70 0 mg and 70 mg). Results The success rates of ibutilide and ploprone in treating atrial flutter were 90% and 30% respectively. The average recovery time was (21 ± 19) min and (35 ± 8) min, respectively. The duration of atrial flutter can be used as a predictor of termination of flutter. Flutter wave perimeter extension is the main feature of Ibutilide termination of atrial flutter. Bradycardia (6/20, 30%) and hypotension (4/2 0, 20%) are common side effects of pachycipropanin. Twenty patients with atrial flutter treated with ibutilide had 8 cases of monomorphic early or short atrial flutter with differential conduction without treatment and all disappeared within 1 hour after treatment. Conclusion Ibutilide, as a class III antiarrhythmic drug, can terminate atrial flutter quickly, safely and effectively under the condition of monitoring.