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目的 探讨心房扑动 (AF)临床处理经验。方法 89例AF患者 ,行电生理检查和 或射频消融术 2 2例 ,10例安置埋藏式起搏器 ,2例先心病行外科纠治术 ,9例行电击复律术 ,能量为 5 0～ 15 0J ,11例以可达龙口服 ,9例以心律平口服 ,2例静脉推注 ,3例以奎尼丁口服 ,4例以西地兰静注或地戈辛口服 ,10例以地戈辛 +倍他乐克口服 ,异搏定及施太可口服各 3例 ,1例口服倍他乐克 ,1例以地戈辛 +可达龙口服。 18例口服抗凝剂。随访时间为 3月～ 2年。结果 射频消融的总成功率为 84.2 1% ,复发率 2 1.0 5 %。 9例电击复律术总成功率为 10 0 %。 2例先心纠治后无AF发生。可达龙口服者 5例转复 ,5例控制复发 ,1例控制心率 ,总有效率 10 0 % ;心律平口服者 1例转复 ,6例控制复发 ,1例无效 ,静脉给药者 1例转复 ,1例控制心率 ,总有效率 81.8% ,奎尼丁口服者 2例转复 ,1例控制复发 ;洋地黄或地戈辛 +倍他乐克口服者心率控制有效 ;异搏定口服 2例有效 ,1例无效 ;施太可口服均转复 ,倍他乐克或地戈辛 +可达龙口服均有效控制心率。 89例中 1例发生可疑栓塞 ,口服抗凝剂者无血栓发生。结论 Ⅰ类和Ⅲ类药物常用于终止AF或预防其复发 ,Ⅱ类、Ⅳ类和洋地黄及洋地黄 +Ⅱ类可用于控制AF时的心室率。电复律术转复AF疗效肯定。导管射
Objective To investigate the clinical experience of atrial flutter (AF). Methods A total of 89 patients with AF underwent electrophysiological examination and radiofrequency ablation (2 cases), 10 implanted pacemakers (2), 2 patients with congenital heart disease undergoing surgical repair, and 9 patients undergoing electrical shock resuscitation with an energy of 50 ~ 15 0J, 11 cases of oral up to Long, 9 cases of oral oral rhythm, 2 cases of intravenous injection, 3 cases of oral quinidine, 4 cases of cedilanid or digoxin oral administration, 10 cases of land Gosin + Betaloc orally, verapamil and Shi Tai can orally each 3 cases, 1 case of oral Betaloc, 1 case of geoxin + up to Long oral. 18 cases of oral anticoagulants. Follow-up time was 3 months to 2 years. Results The total success rate of radiofrequency ablation was 84.2% and the recurrence rate was 2 1.05%. 9 cases of electric shock surgery assembly rate was 100%. 2 cases of heart disease without AF after correction. Up to 5 oral reopening Long oral control, 5 cases of relapse control, 1 case of control heart rate, the total efficiency of 10 0%; rhythm oral oral 1 case of reversion, 6 cases of relapse control, 1 case of ineffective intravenous administration 1 1 case of control heart rate, the total effective rate was 81.8%, 2 cases of quinidine oral reversion, 1 case of control recurrence; digitalis or geoxin + times Betaloc Oral heart rate control is effective; verapamil Oral 2 cases were effective, 1 case is invalid; Shi Tai can be orally transferred, Betaloc or Digoxin + up to Long oral effective control of heart rate. One of the 89 patients had a suspicious embolization, and no oral anticoagulants were thrombotic. Conclusions Class I and III drugs are commonly used to terminate AF or prevent its recurrence. The ventricular rate of class II and IV and digitalis and digitalis can be used to control AF. Cardioversion rehabilitation AF positive effect. Catheter injection