目的验证三种常用药物转复老年急性房颤成为窦律的疗效。方法选择60岁以上急性房颤者91例(起病<72h、HR>90次/min),随机分为普罗帕酮组(A组)、西地兰组(B组)、异搏定组(C组)。最初15min内,A组静注罗帕酮70g,B组静注西地兰0.4mg,C组静注异搏定5mg。观察30min,若仍未转律且心室率>100次/min,由A组加用普罗帕酮5mg,B组加用西地兰0.2mg,C组加用异搏定5mg静脉滴注,对三组进行血压及心电图监测。结果A组转复率为63.3%,平均转复时间为48.2±9.7min;B组转复率为26.7%,平均转复时间为120.7±34min;C组转复率为86.7%,平均转复时间为21.7±11.8min。A组窦缓2例(1￣5min内恢复),窦性静止2例(2.7s和3.3s),一过性低血压2例;B组窦缓2例,窦性静止2例(3.1s和3.7s)。C组窦缓4例,窦性静止4例(3.1s、3.7s、3.0s和3.5s)。三组患者均无宽QRS心动过速。结论三组病人在血压及心电图变化方面差异均无统计学意义,在转复率和平均复律时间方面存在显著性差异,C组优于A组,A组优于B组。 Objective To verify the efficacy of three commonly used drugs in the treatment of sinus rhythm in elderly patients with acute atrial fibrillation. Methods A total of 91 acute atrial fibrillation patients over 60 years old (onset <72h, HR> 90 beats / min) were randomly divided into propafenone group (group A), cedilanid (group B) (C group). Within the first 15 min, group A received intravenous injection of 70g of pirbalone, group C received cedilanid 0.4mg, and group C received intravenous verapamil 5mg. Observed 30min, if still untransformed and ventricular rate> 100 beats / min, propafenone group A plus 5mg, B plus cedilanid 0.2mg, C plus verapamil 5mg intravenous infusion of Three groups were monitored for blood pressure and ECG. Results The average recovery time was 63.3% in group A and 48.2 ± 9.7 minutes in group A, the recovery rate in group B was 26.7% and the average recovery time was 120.7 ± 34 minutes. The recovery rate in group C was 86.7% The time was 21.7 ± 11.8 min. A group of sinus slow in 2 cases (1 ~ 5min recovery), sinus static in 2 cases (2.7s and 3.3s), transient hypotension in 2 cases; B group sinus slow in 2 cases, sinus static in 2 cases (3.1s And 3.7s). C group sinus slow in 4 cases, sinus rest in 4 cases (3.1s, 3.7s, 3.0s and 3.5s). Three groups of patients had no wide QRS tachycardia. Conclusion There was no significant difference in blood pressure and electrocardiogram between the three groups of patients, there was significant difference in the recovery rate and mean duration of cardioversion. C group was better than A group and A group was better than B group.