伊伐布雷定在心力衰竭合并非阵发性心房颤动患者中的应用研究进展  

Application of Ivabradine in Patients with Heart Failure Complicated with Non-Paroxysmal Atrial Fibrillation

作　　者：高洁[1] 董蔚[2] GAO Jie;DONG Wei(Department of Cardiology,Hebei General Hospital,Shijiazhuang 050051,Hebei,China;Department of Cardiology,The Sixth Medical Center of PLA General Hospital,Beijing Key Laboratory of Chronic Heart Failure Precision Medicine,Beijing 100853,China)

机构地区：[1]河北省人民医院心血管内科,河北石家庄050051 [2]解放军总医院第六医学中心心血管病医学部慢性心衰精准医学北京市重点实验室,北京100853

出　　处：《心血管病学进展》2022年第9期778-782,共5页Advances in Cardiovascular Diseases

基　　金：国家重点研发计划(2018YFC0910703)。

摘　　要：心力衰竭(心衰)伴非阵发性心房颤动(房颤)时,心率控制是必要且基本的治疗目标之一。目前常用于心衰合并房颤的心室率控制的药物在多种情况下使用受到限制。起搏电流(I电流)抑制剂伊伐布雷定目前被批准用于窦性心律、应用β受体阻滞剂后心室率控制未达标或不能耐受β受体阻滞剂的慢性射血分数降低性心衰或心绞痛患者。既往认为在心衰合并非阵发性房颤患者中使用伊伐布雷定是无效的,但近期研究表明I电流在左心房、房室结和肺静脉中均有分布,且在房颤的发生及维持中发挥作用。现对伊伐布雷定在心衰合并非阵发性房颤患者心室率控制方面的研究进展进行综述。Heart rate control is one of the essential therapeutic goals in patients with heart failure(HF) who had atrial fibrillation(AF).Currently, the drugs commonly used for ventricular rate control of HF with AF are limited in many cases.Ivabradine, an Icurrent inhibitor, has been approved for patients with chronic HF with reduced ejection fraction or angina with sinus rhythm who have failed to achieve target heart rate following β-blockers, or who cannot tolerate β-blockers.In the past, it was thought that ivabradine was ineffective in HF patients complicated with non-paroxysmal AF.Recent studies have shown that Iion channel is distributed in left atrium, atrioventricular node and pulmonary vein, and plays a role in the occurrence and maintenance of AF.This paper reviews the research progress of ivabradine in the control of ventricular rate in HF patients complicated with non-paroxysmal AF.

关 键 词：心力衰竭 非阵发性心房颤动 伊伐布雷定 If电流 

分 类 号：R541.75[医药卫生—心血管疾病] R541.6[医药卫生—内科学]