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心脏手术后预防心房颤动的临床分析:兰地洛尔还是胺碘酮?

[Clinical analysis of precaution against atrial fibrillation following cardiac surgery: landiolol or amiodarone?].

作者信息

Uehara Kyokun, Ueyama Koji, Ito Hidehiro, Fukuda Terunobu, Sasaki Kenichi, Abe Tomomi, Nakane Eisaku, Miyamoto Shoichi, Haruna Tetsuya, Inoko Moriaki, Nohara Ryuji

机构信息

Department of Surgery, Cardiovascular Center, Kitano Hospital, Osaka, Japan.

出版信息

Kyobu Geka. 2010 Mar;63(3):188-91.

Abstract

Atrial fibrillation following cardiac surgery remains as a most common complication. Tachycardia with atrial fibrillation just after the operation could lead to cardiac deterioration. Although we have to control tachycardia, we often have great difficulties in managing these arrhythmias. Many reports have showed landiolol, ultra short-acting beta1 blocker, and amiodarone were effective against postoperative atrial fibrillation. However there has been no report on comparison between these 2 drugs. As excessively sympathetic activity might cause atrial fibrillation, landiolol was introduced into our therapy concomitant with the sedative. Our investigation confirmed that both landiolol and amiodarone were effective in preventing atrial fibrillation, and that the timing of transition from intravenous administration to oral intake was acceptable. When landiolol was administered, enough attention should be paid to the patients whose left ventricular function was low. The patients in whom atrial fibrillation occurred under landiolol therapy showed tendency of lower heart rate in comparison with the patients under amiodarone therapy.

摘要

心脏手术后房颤仍然是最常见的并发症。术后即刻出现的房颤伴心动过速可导致心脏功能恶化。尽管我们必须控制心动过速,但在处理这些心律失常时我们常常面临很大困难。许多报告显示,超短效β1受体阻滞剂兰地洛尔和胺碘酮对术后房颤有效。然而,尚无关于这两种药物比较的报告。由于过度的交感神经活动可能导致房颤,兰地洛尔与镇静剂同时被引入我们的治疗中。我们的研究证实,兰地洛尔和胺碘酮在预防房颤方面均有效,且从静脉给药过渡到口服给药的时机是可以接受的。使用兰地洛尔时,应特别关注左心室功能低下的患者。与接受胺碘酮治疗的患者相比,在兰地洛尔治疗期间发生房颤的患者心率有降低的趋势。

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