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维拉帕米对阵发性房颤患者心房颤动负荷的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第4期
页码:
321-223,325
栏目:
临床研究
出版日期:
2003-07-01

文章信息/Info

Title:
Effect of Verapamil on burden of atrial fibrillation in patients implanted with an implantable atrial defibrillator
作者:
王琼1; 任卫华2; 贾国良1; 谢鸿发3; 刘柱柏3
1.第四军医大学西京医院心脏内科,陕西 西安 710032;2.广州边防武警指挥学校卫生处;3.香港大学医学院玛丽医院心脏内科
Author(s):
WANG Qiong1;  REN Wei-hua2;  JIA Guo-liang1;  TSE Hung-fat3;  LAU Chu-pak3
1.Department of Cardiology, Xijing Hospital, Xi'an, Shaanxi, 710032, China;2. Departmentof Health, Command School of Frontier Armed Police, Guangzhou;3.Division of Cardiology, Queen Mary Hospital, University of HongKong, HongKong
关键词:
心房颤动; 植入型心房除颤器; 钙通道阻滞剂; 维拉帕米
Keywords:
atrial fibrillation;  implantable atrial defibrillator;  calcium channel blocker;  Verapami
分类号:
R543.2
DOI:
-
文献标识码:
A
摘要:
目的:评估预防性地应用维拉帕米(Verapamil)对安装植入型心房除颤器(IAD)的慢性阵发性房颤患者心房颤动负荷的影响。方法:因反复发作有症状的房颤而安装植入型体内心房除颤器(IAD)患者10例,随机交叉地进入维拉帕米(240mg/d)组或安慰剂组并持续3个月。由IAD储存并记录房颤发作的起始时间和每次发作的持续时间,必要时发放R波同步电流进行体内除颤。结果:93%的的症状性自发房颤片段由IAD成功地转复。维拉帕米组体内除颤的成功率与安慰剂组比较无显著差异(100% vs88%,P=0.8),且每次成功复律所发放的电击次数亦无显著差异(1.7±2.4vs1.8±2.1,P=0.6)。房颤发作的平均次数(8.0±8.0vs9.1±10.8,P=0.83),每次房颤发作的持续时间(44±84hvs45±87h,P=0.93)及总的房颤持续时间(418±511hvs586±409h,P=0.51),在安慰剂组和维拉帕米组之间无显著差异。结论:慢性房颤患者中预防性地使用维拉帕米并不能有效地影响心房颤动的负荷。
Abstract:
AIM: To prospectively evaluate the effect of verapamilon AF burden in patients implanted with animplantable atrial defibrillator (IAD) for recurrent AF. METHODS: 10 patients (7M/3F,60± 6 years old) were implanted withan IAD when each patient had recurrences of AF despite treatment with a class III antiarrhythmic drug. Patients were randomized to receive verapamil 240mg/day or placebo in across over fashion for 12 weeks, without changing their antiarrhythmic agents. Patients were followed up for eache pisode of symptomatic AF and internal atrial defibrillation with low energy shocks (<6J) were delivered by IAD. IAD were programmed to "monitor mode" throughout the study for AF detection and record the episode data continuously from the episode log. RESULTS: 93% (13/14) spontaneous AF episodes were successfully converted by IAD with 1.7±2.1 shock per episode.There was no significant change with the efficiency of cardioversion between groups with or without Verapamil (successful cardioversion rate: 100% vs 88%, P=0.8, number of cardioversion:1.7±2.4 vs 1.8±2.1,P=0.6).AF burden was not significantly different between groups with or without Verapamil (total AF duration:418±511vs586±409,P=0.51;number of AF episode:8.0±8.0 vs 9.1±10.8,P=0.3). CONCLUSION: This is the first prospective study to evaluate the effect of Verapamil on the AF recurrence in patients implanted with an IAD. Prophylactic treatment with Verapamil does not significantly affect the AF burden nor the efficacy of IAD cardioversion in patients with recurrent AF.

参考文献/References

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备注/Memo

备注/Memo:
收稿日期：2002-03-19.
更新日期/Last Update: 2003-07-01