口服普罗帕酮与胺碘酮联合电复律转复持续性房颤的随机对照试验_Chinese Journal of Evidence-Based Medicine

Authors：

 马丹 , 刘凤岐 , 富路 , 李元十 , 高倩平 , 吴炳祥

Corresponding author：

马丹, Email: madan@medmail.com.cn

Keywords：

心房颤动; 心脏复律-直流电; 普罗帕酮; 胺碘酮; 随机对照试验

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目的　比较普罗帕酮与胺碘酮联合电复律转复持续性心房颤动及维持窦性心律的疗效与安全性。
方法　将60例基础疾病治疗良好的持续性房颤患者随机分为两组，每组各30例。普罗帕酮组：普罗帕酮600 mg顿服后观察6 h，未转复者予电复律，并以最低有效量口服维持窦律；胺碘酮组：胺碘酮600 mg分3次口服，连服7天，未转复者电复律，以最低有效量维持窦律。
结果　单纯药物复律，普罗帕酮组4例，胺电酮组3例，联合电复律两组分别转复25例和22例，两组早期有效率分别为90.0%和80.0%，晚期有效率分别为73.3%和70.0%，两组比较差异无统计学意义。住院时间普罗帕酮组短于胺碘酮组（P lt;0.001）。普罗帕酮组1例服药后出现一过性低血压，放弃复律，经对症治疗后好转；胺碘酮组4例服药后恶心、呕吐，未能坚持负荷量连服7天；但两组副反应发生率差异无统计学意义。
结论　普罗帕酮与胺碘酮联合电复律治疗持续心房颤动安全而有效，但普罗帕酮起效快，可相对减少患者的住院时间。

Citation： 马丹,刘凤岐,富路,李元十,高倩平,吴炳祥. 口服普罗帕酮与胺碘酮联合电复律转复持续性房颤的随机对照试验. Chinese Journal of Evidence-Based Medicine, 2007, 07(3): 165-168. doi: Copy

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5.	Kochiadakis GE, Igoumenidis NE, Parthenakis FI, et al. Amiodarone versus propafenone for conversion of chronic atrial fibrillation: results of a randomized, controlled study. J Am Coll Cardiol, 1999, 33(4): 966–971.
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7.	Kosior DA, Opolski G, Wozakowska-Kaplon B, et al. Serial antiarrhythmic therapy: role of amiodarone in prevention of atrial fibrillation recurrence--a lesson from the HOT CAFE Polish Study. Cardiology, 2005, 104(1): 35–44.
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9.	Bellandi F, Simonetti I, Leoncini M, et al. Long-term efficacy and safety of propafenone and sotalol for the maintenance of sinus rhythm after conversion of recurrent symptomatic atrial fibrillation. Am J Cardiol, 2001, 88(6): 640–645.
10.	Kochiadakis GE, Marketou ME, Igoumenidis NE, et al. Amiodarone, sotalol, or propafenone in atrial fibrillation: which is preferred to maintain normal sinus rhythm? Pacing Clin Electrophysiol, 2000, 23(11 Pt 2): 1883–1887.
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1. Hu DY, Yang XC, Liu T. The conversion of atrial fibrillation. Chin J Cardiac Arrhyth, 2000, 4(1): 43–45.
2. Steinberg JS, Sadaniantz A, Kron J, et al. Analysis of cause-specific mortality in the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study. Circulation, 2004, 109(16): 1973–1980.
3. Curtis AB, Gersh BJ, Corley SD, et al. Clinical factors that influence response to treatment strategies in atrial fibrillation: the Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study. Am Heart J, 2005, 149(4): 645–649.
4. 胡大一, 杨新春, 刘彤. 心房颤动的复律. 中华心律失常学杂志, 2000, 4(1): 43~45.
5. Kochiadakis GE, Igoumenidis NE, Parthenakis FI, et al. Amiodarone versus propafenone for conversion of chronic atrial fibrillation: results of a randomized, controlled study. J Am Coll Cardiol, 1999, 33(4): 966–971.
6. Singh BN, Singh SN, Reda DJ, et al. Amiodarone versus sotalol for atrial fibrillation. N Engl J Med, 2005, 352(18): 1861–1872.
7. Kosior DA, Opolski G, Wozakowska-Kaplon B, et al. Serial antiarrhythmic therapy: role of amiodarone in prevention of atrial fibrillation recurrence--a lesson from the HOT CAFE Polish Study. Cardiology, 2005, 104(1): 35–44.
8. Korantzopoulos P, Kolettis TM, Papathanasiou A, et al. Propafenone added to ibutilide increases conversion rates of persistent atrial fibrillation. Heart, 2006, 92(5): 631–634.
9. Bellandi F, Simonetti I, Leoncini M, et al. Long-term efficacy and safety of propafenone and sotalol for the maintenance of sinus rhythm after conversion of recurrent symptomatic atrial fibrillation. Am J Cardiol, 2001, 88(6): 640–645.
10. Kochiadakis GE, Marketou ME, Igoumenidis NE, et al. Amiodarone, sotalol, or propafenone in atrial fibrillation: which is preferred to maintain normal sinus rhythm? Pacing Clin Electrophysiol, 2000, 23(11 Pt 2): 1883–1887.
11. Goette A, Staack T, Rochen C, et al. Increased expression of extracellular signal regulation kinase and angiotensin converting enzyme in human atria during atrial fibrillation. J Am Coll Cardiol, 2000, 35(6): 1669–16771.

Chinese Journal of Evidence-Based Medicine

口服普罗帕酮与胺碘酮联合电复律转复持续性房颤的随机对照试验

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