Talajic Mario, Roy Denis
Montreal Heart Institute, Montreal, Quebec.
Can J Cardiol. 2005 Sep;21 Suppl B:19B-25B.
Antiarrhythmic drug therapy to maintain sinus rhythm has not been demonstrated in randomized clinical trials to improve prognosis or prevent thromboembolic complications in patients with atrial fibrillation (AF). Therefore, drug therapy to restore and maintain sinus rhythm should be limited to those patients who have a greater symptomatic burden of AF. Patients with AF may be completely unaware of their arrhythmia or may present with palpitations, poor exercise tolerance or symptoms of congestive heart failure. In general, younger patients with paroxysmal arrhythmia and patients with decreased left ventricular compliance tend to be more symptomatic. The present article outlines the mechanisms of action of antiarrhythmic drugs in AF. Drugs that are recommended and frequently used to convert AF and maintain sinus rhythm are reviewed, and the toxicity of antiarrhythmic drug toxicity is discussed.
在随机临床试验中，尚未证实抗心律失常药物疗法可维持窦性心律能改善心房颤动（AF）患者的预后或预防血栓栓塞并发症。因此，恢复并维持窦性心律的药物疗法应仅限于那些房颤症状负担较重的患者。房颤患者可能完全未意识到自己的心律失常，或者可能表现为心悸、运动耐量差或充血性心力衰竭症状。一般来说，阵发性心律失常的年轻患者以及左心室顺应性降低的患者往往症状更明显。本文概述了抗心律失常药物在房颤中的作用机制。对推荐并常用于转复房颤及维持窦性心律的药物进行了综述，并讨论了抗心律失常药物的毒性。
