Komatsu T, Nakamura S, Kimura M, Owada S, Saito E, Kobayashi T, Okumura K
Division of Cardiology, Department of Internal Medicine, Iwate Prefectural Iwai Hospital, Iwate.
J Cardiol. 2001 Feb;37(2):75-82.
The efficacy of cibenzoline was assessed in the termination and long-term prevention of paroxysmal atrial fibrillation in relation to the time of onset in a series of patients with paroxysmal atrial fibrillation.
Study of the termination included 92 patients (63 males, 29 females, mean age 64 +/- 12 years) and study of long-term prevention included 106 patients (77 males, 29 females, mean age 64 +/- 11 years; mean follow-up 32.7 +/- 18.8 months). Paroxysmal atrial fibrillation was classified into 3 types based on the time of onset: day type (AM 7:00-PM 5:00), night type (PM 5:00-AM 7:00) and mixed type (anytime). Successful termination was defined as pharmacological cardioversion within 30 min of the intravenous administration of 70 mg cibenzoline and efficacy of long-term prevention was presented as the event-free ratio of patients after oral administration of 300 mg/day cibenzoline.
Successful pharmacological termination was achieved in 66.7% of the day type (n = 24), 70.0% of the night type (n = 48), and 41.6% of the mixed type (n = 20). There was a significantly higher success in the day type (p < 0.05), and tendency to success in the night type (p = 0.079) compared to the mixed type. The event-free ratios at 1, 3, 6, 12, 24 months after oral administration were 84.6%, 76.9%, 73.1%, 65.4%, 61.5% in the day type (n = 26), 92.0%, 80.0%, 80.0%, 72.0%, 60.0% in the night type (n = 25), and 81.8%, 61.8%, 47.3%, 30.9%, 23.6% in the mixed type (n = 55), respectively. Significantly higher success was achieved at 24 months in the day type and the night type compared to the mixed type (p < 0.05).
Termination and long-term prevention of paroxysmal atrial fibrillation by cibenzoline has a high degree of efficacy in patients with both day and night onset of paroxysmal atrial fibrillation.
在一系列阵发性房颤患者中，评估昔苯唑啉在终止阵发性房颤发作及长期预防方面的疗效，并探讨其与发作时间的关系。
终止发作的研究纳入了92例患者（男性63例，女性29例，平均年龄64±12岁），长期预防的研究纳入了106例患者（男性77例，女性29例，平均年龄64±11岁；平均随访32.7±18.8个月）。阵发性房颤根据发作时间分为3种类型：日间型（上午7:00至下午5:00）、夜间型（下午5:00至上午7:00）和混合型（任何时间）。成功终止发作定义为静脉注射70mg昔苯唑啉后30分钟内实现药物复律，长期预防的疗效以每日口服300mg昔苯唑啉后患者的无事件发生率表示。
日间型患者（n = 24）中66.7%成功实现药物终止发作，夜间型患者（n = 48）中70.0%成功，混合型患者（n = 20）中41.6%成功。与混合型相比，日间型的成功率显著更高（p < 0.05），夜间型有成功的趋势（p = 0.079）。口服后1、3、6、12、24个月的无事件发生率，日间型（n = 26）分别为84.6%、76.9%、73.1%、65.4%、61.5%，夜间型（n = 25）分别为92.0%、80.0%、80.0%、72.0%、60.0%，混合型（n = 55）分别为81.8%、61.8%、47.3%、30.9%、23.6%。与混合型相比，日间型和夜间型在24个月时的成功率显著更高（p < 0.05）。
昔苯唑啉对发作时间为日间和夜间的阵发性房颤患者在终止发作及长期预防方面均有高度疗效。
