盐酸尼非卡兰在瓣膜置换术同期行心房颤动射频消融术后窦性心律的维持作用  

Effects of nifekalant on prevention of arrhymia after valve replacement concomitant with radiofrequency ablation of atrial fibrillation

作　　者：黄园琴[1] 秦长喻 李颖[1] 刘彬[1] HUANG Yuan qin;QIN Chang-yu;LI Yin;LIU Bin(Wuhan Asia Heart Hospital ICU, Wuhan 430022,Chin)

机构地区：[1]武汉亚洲心脏病医院ICU,湖北武汉430022

出　　处：《中国心脏起搏与心电生理杂志》2018年第1期38-40,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的总结瓣膜置换同期行心房颤动(简称房颤)射频术后心律失常的防治。方法 2015年1月至2016年3月本院共实施39例瓣膜置换同期房颤射频消融患者,观察不同剂量尼非卡兰对房颤射频消融术后窦性心律的维持作用。将患者随机分为A组(尼非卡兰0.1mg/kg)和B组(尼非卡兰0.2mg/kg),两组患者转入ICU后皆完善床旁12导联即刻心电图、用药后1h,停药后即刻心电图。结果两组患者QT间期明显延长,A组用药后1h及停药后即刻心电图QT间期较用药前延长(P<0.05);B组用药后1h心电图QT间期较用药前延长(P<0.05),停药后即刻QT间期延长明显高于用药前(P<0.01),所有患者术后随访3~6个月,A组术后1、3、6个月房颤的复发率分别为22.2%、27.8%、33.3%,B组术后1、3、6个月房颤的复发率则为19.0%、23.8%、23.8%。结论尼非卡兰对瓣膜置换同期射频消融术后窦性心律的维持有良好的剂量相关性,但需严密监控。Objective To summarize the prevention of arrhymia after valve replacement concomitant with radiofrequeney ablation of atrial fibrillation（AF）. Methods From January 2015 to March 2016,39 cases in our hospital were performed heart valve replacement and radiofrequency ablation for AF, the effects of different doses of nifek alant, to maintain sinus rhythm after radiofrequency ablation of AF were observed. A total of 39 patients, were ran domly divided into group A（0.1 mg/kg）and group B（0.2 mg/kg）.Two groups of patients were performed 12 lead beside ECG after transferred to the ICU,one hours after medication and immediately after withdrawal Nifekalant. Results QT interval of both group was significantly prolonged.In group A,the QT interval of ECG at one hours after medication and immediately after the withdrawal was longer than that before the medication（P〈0.05） ; In group B, the QT interval of ECG at one hours after medication was longer than that before the medication（P〈0.05）,The prolongation of QT interval immediately after drug withdrawal was higher than that before medication（ P〈0.01 ）. All patients were followed up after 3 to 6 months after operation. In group A, AF recurrence rate at 1,3 and 6 months was 22.2%,27.8%,33.3% and in group 13 that wasrepectively 19.0%,23.8%,23.8%. Conclusions A good corre lation between dosage and effects about Nifekalant to maintain the sinus rhythm after valve replacement concomitant with radiofrequency ablation of AF has been observed,but it needs to be closely monitored.

关 键 词：心血管病学 盐酸尼非卡兰 瓣膜置换 射频消融术 心房颤动 

分 类 号：R541.75[医药卫生—心血管疾病] R454.1[医药卫生—内科学]