Viktorsdottir O, Henriksdottir A, Arnar D O
Department of Emergency Medicine, Landspitali University Hospital, Reykjavik, Iceland.
Emerg Med J. 2006 Feb;23(2):133-4. doi: 10.1136/emj.2004.021394.
The purpose of this study was to assess the efficacy and safety of ibutilide, a class III antiarrhythmic drug, for acute treatment of atrial fibrillation (AF) in the emergency department (ED) setting. A retrospective analysis was done reviewing all patients with AF who received ibutilide in the ED in a university hospital setting. A total of 22 patients received ibutilide. Another 24 patients who received rate control drugs only served as a control group. Of the 22 patients who received ibutilide, 14 (64%) converted to sinus rhythm. The mean (SD) rate of AF was 137 (24) bpm and the mean QTc interval immediately after conversion to sinus rhythm was 420 (28) ms. There were no complications. In the rate control group 7 patients (29%) converted to sinus rhythm (p<0.05, compared with ibutilide). The mean rate of AF was 126 (26) bpm (p = ns, compared with ibutilide) and the mean QTc interval in those who converted was 377 (28) ms (p<0.05, compared with ibutilide). One patient developed severe bradycardia. Ibutilide is effective for conversion of recent onset AF in patients presenting to the ED and there is a low rate of complications from ibutilide in this setting.
本研究的目的是评估Ⅲ类抗心律失常药物伊布利特在急诊科环境中急性治疗心房颤动（AF）的疗效和安全性。我们进行了一项回顾性分析，纳入了在大学医院急诊科接受伊布利特治疗的所有房颤患者。共有22例患者接受了伊布利特治疗。另外24例仅接受心率控制药物治疗的患者作为对照组。在接受伊布利特治疗的22例患者中，14例（64%）转为窦性心律。房颤的平均（标准差）心率为137（24）次/分，转为窦性心律后即刻的平均QTc间期为420（28）毫秒。未出现并发症。在心率控制组中，7例患者（29%）转为窦性心律（与伊布利特组相比，p<0.05）。房颤的平均心率为126（26）次/分（与伊布利特组相比，p=无显著性差异），转为窦性心律患者的平均QTc间期为377（28）毫秒（与伊布利特组相比，p<0.05）。1例患者出现严重心动过缓。伊布利特对急诊科就诊的近期发作房颤患者转复有效，且在此情况下伊布利特引起并发症的发生率较低。
