Stípal R, Minarík T, Martínek A
Interní klinika ILF FNsP Ostrava.
Vnitr Lek. 1992 Nov;38(11):1045-9.
The authors investigated the long-term therapeutic effect in 33 patients after a medicamentous reversal of recent atrial fibrillation and 18 patients after reversal of an attack of supraventricular tachycardia (SVT). None of the patients had signs of cardiac failure. A change to sinus rhythm was achieved in the group with atrial fibrillation by digoxin with verapamil, in the group with SVT by verapamil. Treatment was then adjusted, based on testing by means of diagnostic oesophageal pacing. The basic drug for long-term use in atrial fibrillation was digoxin either as monotherapy or in combination; the majority of patients with SVT had verapamil treatment. At the end of the period 24.5 +/- 8.4 (12-36) months after the reversal in the group with atrial fibrillation 8 (25.8%) had permanent atrial fibrillation or different therapy on account of atrial fibrillation; short-term attacks of palpitation were recorded during the investigation period in 16 (51.6%), and the remaining 7 patients (22.6%) had no complaints. In the group with SVT none of the patients was hospitalized on account of persisting dysrhythmia and it was not necessary to alter treatment. Testing treatment of supraventricular dysrhythmias by means of diagnostic oesophageal pacing is of prognostic importance and the authors consider it the method of choice.
作者对33例近期房颤药物复律后的患者和18例室上性心动过速(SVT)发作复律后的患者进行了长期治疗效果的研究。所有患者均无心力衰竭迹象。房颤组通过地高辛联合维拉帕米实现了窦性心律的转变,SVT组通过维拉帕米实现了转变。然后根据诊断性食管起搏测试调整治疗方案。房颤长期治疗的基本药物是地高辛,可单药治疗或联合用药;大多数SVT患者接受维拉帕米治疗。在房颤组复律后24.5±8.4(12 - 36)个月时,8例(25.8%)出现永久性房颤或因房颤接受不同治疗;在研究期间,16例(51.6%)记录到短期心悸发作,其余7例患者(22.6%)无不适主诉。SVT组中没有患者因持续性心律失常住院,也无需改变治疗方案。通过诊断性食管起搏测试治疗室上性心律失常具有预后意义,作者认为这是首选方法。