伊布利特转复房颤的效果及不良反应分析  

Analysis on the effect and adverse reactions of ibutilide in the conversion of atrial fibrillation

作　　者：王贵方 樊梅 叶佳辉 WANG Guifang;FANG Mei;YE Jiahui(Department of Cardiovascular Medicine,Southern Central Hospital of Yunnan Province/First People's Hospital of Honghe Prefecture,Honghe Yunnan 661100,China)

机构地区：[1]云南省滇南中心医院/红河州第一人民医院心血管内科,云南蒙自661100

出　　处：《云南医药》2023年第6期65-67,共3页Medicine and Pharmacy of Yunnan

摘　　要：目的 观察新一代Ⅲ类抗心律失常药伊布利特转复阵发性房颤的效果、不良反应。方法 选择2019年1月-2023年3月本科室治疗的68例阵发性房颤患者,10min一次性静脉注射伊布利特1mg,观察转复率、转复时间、严重不良反应。结果 伊布利特对阵发性房颤转复成功55例,成功率80.8%,平均转复时间26.7min,最快转律时间为3min,最长转律时间138min。无器质性心脏病患者,发生1例非持续性单型性室速,4h内自行消失。合并冠心病、慢性心力衰竭患者,发生持续性单型性室速、阿斯综合征1例,电复律终止;发生非持续性单型性室速1例,4h内自行终止。未发生尖端扭转性室速,未发生严重心动过缓、加重、低血压,无死亡病例。结论 无器质性心脏病的阵发性房颤患者,使用伊布利特转律快速、有效、安全;合并冠心病、慢性心力衰竭、急性心肌梗死的患者,在急救完备的情况下,可谨慎使用。Objective To observe the efficacy and adverse reactions of ibutilide,a new generation of class III antiarrhythmic drug,in the treatment of paroxysmal and persistent atrial fibrillation(AF).Methods 68 patients with paroxysmal atrial fibrillation treated in our department from January 2019 to March 2023 were selected.Ibutilide 1mg was injected intravenously for 10 minutes at a time.The conversion rate,conversion time and severe adverse reactions were observed.Results Ibutilide successfully converted 55 patients with paroxysmal atrial fibrillation,with a success rate of 80.8%.The average conversion time was 26.7 minutes,the fastest conversion time was 3 minutes,and the longest conversion time was 138 minutes.There was no organic heart disease,1 case of unsustained monotypic ventricular tachycardia,which spontaneously disappeared within 4 hours.One patient complicated with coronary heart disease and chronic heart failure,developed persistent monotypic ventricular tachycardia and Adams-Stokes syndrome,and electrical cardioversion was terminated;One case of non persistent monotypic ventricular tachycardia occurred and spontaneously terminated within 4 hours.No occurrence of tip torsional ventricular tachycardia,severe bradycardia,heart failure/aggravated heart failure,hypotension and death.Conclusions In patients with paroxysmal atrial fibrillation withour organic heart disease,the use of ibutilide is fast,effective and safe,who combined with coronary heart disease,chronic heart failure,and acute myocardial infarction,in the case of complete emergency,can be used with caution.

关 键 词：伊布利特 阵发性房颤 单型性室速 尖端扭转性室速 

分 类 号：R541.7[医药卫生—心血管疾病]