Hjelms E
Department of Cardiothoracic Surgery, Rigshospitalet, Copenhagen, Denmark.
Scand J Thorac Cardiovasc Surg. 1992;26(3):193-6. doi: 10.3109/14017439209099077.
In 30 patients who developed atrial fibrillation after open-heart surgery the efficacy of intravenous procainamide was evaluated and compared with standard acute digoxin digitalisation. The patients were randomized to two groups of 15. One group received procainamide intravenously at a rate of 25 mg/min and with maximum dose 15 mg/kg. In the other group digoxin 0.75-1.0 mg was given intravenously according to renal function and body weight. Conversion to sinus rhythm occurred during or immediately after the infusion in 87% of the procainamide group, but only in 60% of the digoxin group (p < 0.05). The mean time from start of treatment to conversion was 40 min in the procainamide vs. 540 min in the digoxin group (p < 0.002). There were no serious complications of the procainamide treatment. Intravenous procainamide conversion of postoperative atrial fibrillation is concluded to be effective and safe and can be recommended as the treatment of first choice in awake and nonintubated postoperative cardiac patients.
在30例心脏直视手术后发生心房颤动的患者中，评估了静脉注射普鲁卡因胺的疗效，并与标准的急性地高辛洋地黄化进行比较。患者被随机分为两组，每组15例。一组以25mg/min的速率静脉注射普鲁卡因胺，最大剂量为15mg/kg。另一组根据肾功能和体重静脉注射0.75 - 1.0mg地高辛。在普鲁卡因胺组中，87%的患者在输注期间或输注后立即转为窦性心律，而地高辛组仅为60%（p<0.05）。从开始治疗到转为窦性心律的平均时间，普鲁卡因胺组为40分钟，地高辛组为540分钟（p<0.002）。普鲁卡因胺治疗无严重并发症。结论是静脉注射普鲁卡因胺转复术后心房颤动有效且安全，可推荐作为清醒且未插管的术后心脏患者的首选治疗方法。
