Maintenance of sinus rhythm after atrial defibrillation.
Maintenance of sinus rhythm after atrial defibrillation.
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心房除颤后窦性心律的维持。
DOI：
10.1136/hrt.32.6.741
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发表时间：
1970
影响因子：
--
通讯作者：
G. A. Batson
中科院分区：
文献类型：
--
作者：
P. Szekely;D. Sideris;G. A. Batson
本文回顾了250例患者356次直流电心房除颤的长期结果。在78%的病例中，尽管使用奎尼丁或普鲁卡因胺或普萘洛尔（单独或联合使用），但12个月后房颤复发。然而，当不使用抗心律失常药物时，在所有观察期内复发率较高，12个月结束时复发率为100%。除普萘洛尔组外，未给药组和给药组之间的总体结果差异显著（p <0.05）。此外，普萘洛尔组在1个月时的复发率明显降低，但随后的结果趋于接近未治疗组。接受瓣膜手术的患者维持窦性心律的时间与未接受心脏手术的患者基本相同。然而，在少数患者中，二尖瓣置换术后窦性心律维持的时间比置换术前更长，房颤持续时间小于1年的患者窦性心律维持的时间明显长于房颤持续时间大于1年的患者（p <0.001）。结论：心房除颤后，有理由进行明智的抗心律失常预防。
The long-term results of 356 episodes of atrial defibrillation by DC shock carried out in 250 patients are reviewed. In 78 per cent of the cases, atrial fibrillation recurred by the end of 12 months in spite of the administration of quinidine or procainamide or propranolol, singly or combined. However, when no antidysrhythmic drugs were used the recurrence rate was higher at all periods of observation and 100 per cent at the end of 12 months. The difference in the overall results between the untreated group and the treated groups with the exception of the propranolol group is significant (p less than 0.05). In addition, the propranolol group showed an obviously reduced recurrence rate at 1 month, but afterwards the results tended to approximate those in the untreated group. The period during which sinus rhythm could be maintained in patients who underwent valve operations was on the whole the same as in patients who did not have heart surgery. However, in a small number of patients sinus rhythm was maintained for longer periods after mitral valve replacement than before it. Sinus rhythm was maintained for significantly longer periods when atrial fibrillation lasted less than 1 year than when it had been present for more than 1 year (p less than 0.001). It is concluded that there is justification for a judicious antidysrhythmic prophylaxis after atrial defibrillation.