Shubik Iu V, Medvedev M M, Kriatova T V
St-Petersburg, Russia.
Kardiologiia. 2003;43(9):52-5.
To find out whether selective beta-adrenoblocker nebivolol can be used for heart rate (HR) control in patients with chronic tachysystolic atrial fibrillation.
Patients (n=20, 7 men, 13 women, age 47-79 years) with ischemic heart disease and permanent atrial fibrillation (duration 2.5 months - 11 years) admitted to a specialized clinic for diagnosis and treatment of cardiac arrhythmias. All patients had tachycardia throughout 24 hours despite therapy.
Dosing of nebivolol: week 1 - 2.5 mg/day, week 2 7 5 mg/day. If after 2 weeks HR was considered inadequate the dose was increased up to 7.5 mg/day. Holter ECG was registered at baseline and in the end of weeks 1 and 2 of treatment.
After 1 week of nebivolol (2.5 mg/day) HR decreased: day-time average - from 116.3+/-13.4 to 97.2+/-14.5, day-time minimal - from 78.1+/-13,5 to 71.4+/-8.2, day-time maximal - from 154.4+/-18.1 to 142.1+/-15.5; night-time average - from 83.6+/-7.1 to 76.3+/-7.14, night-time minimal - from 61.2+/-6.7 to 56.6+/-5.1, night-time maximal - from 93.5+/-10.5 to 88.2+/-10.8 bpm. After week 2 when patients received 5 mg/day of nebivolol their HR was: day-time average - 79.6+/-9,8, day-time minimal -65.2+/-7.7, day-time maximal - 128.7+/-12,2, night-time average - 69.9+/-7.6, night-time minimal - 53.1+/-4,7, night-time maximal - 80.8+/-10.1 bpm. In 2 patients (10%), interruption of nebivolol was required because of atrioventricular block in evening and nocturnal periods.
Nebivolol effectively controlled HR in hospitalized patients with chronic atrial fibrillation due to ischemic heart disease. In most patients 5 mg /day was sufficient for attainment of acceptable HR.
探究选择性β-肾上腺素能阻滞剂奈必洛尔是否可用于慢性快速性收缩型心房颤动患者的心率控制。
因缺血性心脏病和永久性心房颤动（病程2.5个月至11年）入住心律失常专科诊所进行诊断和治疗的患者（n = 20，男性7例，女性13例，年龄47 - 79岁）。尽管接受了治疗，但所有患者24小时内均存在心动过速。
奈必洛尔给药方案：第1周 - 2.5毫克/天，第2周 - 5毫克/天。如果2周后心率仍被认为控制不佳，则剂量增加至7.5毫克/天。在基线以及治疗第1周和第2周结束时记录动态心电图。
服用奈必洛尔1周（2.5毫克/天）后心率下降：日间平均心率 - 从116.3±13.4降至97.2±14.5，日间最低心率 - 从78.1±13.5降至71.4±8.2，日间最高心率 - 从154.4±18.1降至142.1±15.5；夜间平均心率 - 从83.6±7.1降至76.3±7.14，夜间最低心率 - 从61.2±6.7降至56.6±5.1，夜间最高心率 - 从93.5±10.5降至88.2±10.8次/分钟。第2周患者服用5毫克/天奈必洛尔后，其心率为：日间平均心率 - 79.6±9.8，日间最低心率 - 65.2±7.7，日间最高心率 - 128.7±12.2，夜间平均心率 - 69.9±7.6，夜间最低心率 - 53.1±4.7，夜间最高心率 - 80.8±10.1次/分钟。2例患者（10%）因夜间和傍晚出现房室传导阻滞而需要中断服用奈必洛尔。
奈必洛尔可有效控制因缺血性心脏病导致的慢性心房颤动住院患者的心率。在大多数患者中，5毫克/天的剂量足以使心率达到可接受水平。
