• 哈爾濱醫(yī)科大學(xué)附屬第一醫(yī)院心內(nèi)三科 （哈爾濱150001）;

目的 　比較普羅帕酮與胺碘酮聯(lián)合電復(fù)律轉(zhuǎn)復(fù)持續(xù)性心房顫動(dòng)及維持竇性心律的療效與安全性。
方法 　將60例基礎(chǔ)疾病治療良好的持續(xù)性房顫患者隨機(jī)分為兩組，每組各30例。普羅帕酮組：普羅帕酮600 mg頓服后觀察6 h，未轉(zhuǎn)復(fù)者予電復(fù)律，并以最低有效量口服維持竇律；胺碘酮組：胺碘酮600 mg分3次口服，連服7天，未轉(zhuǎn)復(fù)者電復(fù)律，以最低有效量維持竇律。
結(jié)果 　單純藥物復(fù)律，普羅帕酮組4例，胺電酮組3例，聯(lián)合電復(fù)律兩組分別轉(zhuǎn)復(fù)25例和22例，兩組早期有效率分別為90.0%和80.0%，晚期有效率分別為73.3%和70.0%，兩組比較差異無(wú)統(tǒng)計(jì)學(xué)意義。住院時(shí)間普羅帕酮組短于胺碘酮組（P lt;0.001）。普羅帕酮組1例服藥后出現(xiàn)一過(guò)性低血壓，放棄復(fù)律，經(jīng)對(duì)癥治療后好轉(zhuǎn)；胺碘酮組4例服藥后惡心、嘔吐，未能堅(jiān)持負(fù)荷量連服7天；但兩組副反應(yīng)發(fā)生率差異無(wú)統(tǒng)計(jì)學(xué)意義。
結(jié)論 　普羅帕酮與胺碘酮聯(lián)合電復(fù)律治療持續(xù)心房顫動(dòng)安全而有效，但普羅帕酮起效快，可相對(duì)減少患者的住院時(shí)間。

引用本文： 馬丹,劉鳳岐,富路,李元十,高倩平,吳炳祥. 口服普羅帕酮與胺碘酮聯(lián)合電復(fù)律轉(zhuǎn)復(fù)持續(xù)性房顫的隨機(jī)對(duì)照試驗(yàn). 中國(guó)循證醫(yī)學(xué)雜志, 2007, 07(3): 165-168. doi: 復(fù)制

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, 楊新春, 劉彤. 心房顫動(dòng)的復(fù)律. 中華心律失常學(xué)雜志, 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.
  1. 1. Hu DY, Yang XC, Liu T. The conversion of atrial fibrillation. Chin J Cardiac Arrhyth, 2000, 4(1): 43–45.
  2. 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. 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. 4. 胡大一, 楊新春, 劉彤. 心房顫動(dòng)的復(fù)律. 中華心律失常學(xué)雜志, 2000, 4(1): 43~45.
  5. 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. 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. 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. 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. 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. 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. 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.