受试者为66±12(38～79)岁的16(男11、女5)例慢性(心)房颤(动)患者,亚极量(活动平板)运动(试验)末(3分钟、3英里/小时、坡度0°)心室率均>100bpm。其中单纯性房颤6例,余为冠心病、二尖瓣狭窄、二尖瓣置换术后、特发性心肌病、高血压(已控制)及糖尿病。除3例外,13例长期服用地高辛的患者将剂量调整至血清浓度在治疗范围10.5～2.0ng/ml)以内,并在试验期间仍服该剂量。试验前停用其它抗心律失常药物至少5个半衰期。第一阶段7天内测定静卧心率,作亚极量运动试验并记录24小时动态心电图(Holter)作为基础测值。第二阶段,口服地尔硫革(60mg,qid)7天,末次服药后2～5小时复查。若运动最高心率仍>135bpm,再服最大剂量(90mg,qid)7天,仍在末次服药后2～5小时复查,包括症状限制性极量运动试验。第三阶段停服地尔硫(艹卓)7天,再次复查。地尔硫(艹卓)最大剂量如下:1例30mg,qid(因较大剂量有副作用);11例60mg,qid;4例90mg,qid。最大剂量下,血清地尔硫革浓度为234±187ng/ml。地尔硫(艹卓)治疗期间静卧位、亚极量和极量运动末心 Participants were 16 (11 men and 5 women) chronic (atrial fibrillation) patients with 66 ± 12 (38-79) years of age who were at the end of sub-maximal exercise (exercise) at the end of the trial (3 minutes, 3 mph, slope 0 °) ventricular rate> 100bpm. One of 6 cases of simple atrial fibrillation, more than coronary heart disease, mitral stenosis, mitral valve replacement, idiopathic cardiomyopathy, hypertension (controlled) and diabetes. Thirteen patients who took digoxin for a long time adjusted the dose to a serum concentration within the therapeutic range of 10.5-2.0 ng / ml, with the exception of three and remained on the dose during the trial. At least 5 half-lives of other anti-arrhythmic agents should be discontinued before testing. During the first phase, the heart rate of the sleeping in the abdomen was measured within 7 days. The submaximal exercise test was performed and a 24-hour Holter was taken as the basic measurement. The second phase, oral diltiazem (60mg, qid) for 7 days, the last medication 2 to 5 hours after the review. If the maximum exercise heart rate is still> 135bpm, and then the maximum dose (90mg, qid) for 7 days, still 2 to 5 hours after the last dose of the review, including the Symptom Limited maximal exercise test. The third phase stopped diltiazem (艹 Zhuo) 7 days, once again reviewed. The maximum dose of diltiazem is as follows: 1 case of 30mg, qid (side effects due to larger doses); 11 cases of 60mg, qid; 4 cases of 90mg, qid. At the highest dose, the serum diltiazem concentration was 234 ± 187 ng / ml. Diltiazem (艹 Zhuo) during treatment of supine, sub-maximal amount of extreme movement and heart