即刻药物复律与延迟复律对老年急性阵发性房颤病人预后的影响  

Effects of immediate drug cardioversion and delayed cardioversion on prognosis in elderly patients with acute paroxysmal atrial fibrillation

作　　者：李玉巧 陈敏[1] 王蕾蕾 周卫华[1] LI Yuqiao;CHEN Min;WANG Leilei;ZHOU Weihua(Emergency Department,Jiangsu Province Official Hospital,Nanjing 210024,China)

机构地区：[1]江苏省省级机关医院急诊科,江苏省南京市210024

出　　处：《实用老年医学》2024年第12期1266-1269,共4页Practical Geriatrics

摘　　要：目的探讨即刻药物复律和延迟自主复律对急诊就诊的阵发性房颤病人4周内预后的影响。方法回顾性分析2020年1月至2022年10月期间于江苏省省级机关医院急诊科就诊的阵发性房颤病人,按病人就诊后接受的治疗方案分为即刻药物复律组和延迟自主复律组,比较2组病人房颤的持续时间、4周内房颤的复发率、转复相关不良事件发生率。结果即刻药物复律组和延迟自主复律组病人房颤的持续时间差异无统计学意义(P>0.05)。2组病人4周内房颤复发率差异无统计学意义(P>0.05)。即刻药物复律组转复相关不良事件发生率较延迟自主复律组高(29.17%比4.17%),差异有统计学意义(P<0.05)。结论即刻药物复律并非所有阵发性房颤的最优治疗方案,延迟自主复律为部分病人提供了自行转复的机会,且可以最大程度地降低抗心律失常药物导致心律失常不良反应的发生率。Objective To analyze the effects of immediate drug conversion and delayed spontaneous conversion on the short-term prognosis in the elderly patients with paroxysmal atrial fibrillation(AF)admitted to the emergency department.Methods A retrospective analysis was conducted on the clinical data of 48 patients with paroxysmal AF admitted to Emergency Department of Jiangsu Province Official Hospital from January 2020 to October 2022.The patients were divided into the immediate drug conversion group and the delayed spontaneous conversion group according to the treatment method.The duration of AF,recurrence rate of AF within 4 weeks and the incidence rate of adverse events related to conversion were compared between the two groups.Results There were no significant statistical differences in the duration of AF and recurrence rate of AF within 4 weeks between the immediate drug conversion group and the delayed spontaneous conversion group(P>0.05).However,more patients in the immediate drug conversion group experienced chronic arrhythmia(29.17%vs 4.17%).Conclusions Immediate drug conversion may not be optimal for all paroxysmal AF;Instead,delayed spontaneous cardioversion can provide opportunities for spontaneous recovery while minimizing proarrhythmic effects associated with antiarrhythmic drugs.

关 键 词：阵发性心房颤动 药物即刻复律 延迟自主复律 短期预后 

分 类 号：R541.75[医药卫生—心血管疾病]